Five finger manual rotation from occiput posterior

(A) The operator places four fingers behind the posterior parietal bone with the palm up and the thumb over the anterior parietal bone. The right hand is used for left OP position and the left hand is used for right OP position. The head is grasped with the tips of the fingers and thumb.
(B-F) During a contraction, the patient is encouraged to push and the operator attempts to flex and rotate the fetal head to the OA postion.