Expulsion

Almost immediately after external rotation, the anterior (foremost) shoulder moves out from under the pubic bone (Figure 1.3, diagram 7). The mother's perineum becomes distended by the posterior (second) shoulder, which is then also born (Figure 1.3, diagram 8). The rest of the baby's body is then born (expulsion), with an upward motion of the baby's body assisted by the care provider.