Three finger digital rotation from occiput posterior

The tips of the index and middle fingers are placed in the anterior segment of the lambdoidal suture near the posterior fontanelle. The fingers are used to flex and slightly dislodge the vertex, rotating the fetal head to the occiput anterior position via rotation of the operator's hand and forearm. The thumb may also be used with gentle downward pressure more anteriorly on the parietal bone to aid in this rotation.