Which sequence describes how the shoulders are delivered after the head?

• A. Anterior shoulder is birthed first, then posterior
• B. Posterior shoulder first, then anterior
• C. Both shoulders delivered simultaneously
• D. Only head emerges

Answer: (A)

The sequence of delivering the shoulders after the head is typically anterior first, then posterior. After the head is born, the shoulder closest to the mother's pubic symphysis—the anterior shoulder—passes under the pubic arch first. Guiding the head and supporting the perineum helps this shoulder slip out, and once the anterior shoulder is born, the posterior shoulder follows as the torso rotates and the remaining shoulder aligns with the birth canal. This order aligns with the natural mechanics of a vertex birth, where the head and shoulders rotate to facilitate passage through the pelvis. Delivering the posterior shoulder first or attempting to deliver both simultaneously isn’t the usual pattern, and delivering only the head is incomplete birth.