The maternal pelvis is a unique osteoligamentous structure that plays a fundamental role in normal vaginal
delivery. While obstetric practice primarily focuses on maternal and fetal factors influencing labor, orthopedic
understanding of pelvic anatomy, biomechanics, joint mobility, and pelvic morphology is equally important. The
bony pelvis serves as the birth canal, and its dimensions, shape, orientation, and dynamic adaptations determine
the ease with which the fetal head traverses the pelvic inlet, cavity, and outlet. Although true cephalopelvic
disproportion (CPD) is relatively uncommon, abnormalities of pelvic architecture resulting from congenital
deformities, trauma, metabolic bone disease, hip disorders, or previous pelvic fractures may significantly
influence labor outcomes.

Recent evidence suggests that routine pelvimetry alone is a poor predictor of successful vaginal delivery.
Modern obstetrics increasingly relies on dynamic assessment through clinical examination and intrapartum
ultrasound rather than static measurements. Nevertheless, orthopedic evaluation remains valuable in women
with previous pelvic injuries, skeletal dysplasia, acetabular abnormalities, or pelvic reconstructive surgery. This
review summarizes pelvic anatomy, biomechanics, orthopedic conditions affecting childbirth, methods of pelvic
assessment, and current evidence regarding delivery planning from an orthopedic perspective.