In face presentation, the fetal neck is in extreme extension, causing the face to lead. During labor, the mechanism begins with extension as the presenting part negotiates the pelvis. This is followed by internal rotation to align the face with the maternal pelvis for optimal passage. Finally, flexion occurs after the chin passes under the pubic symphysis, allowing the head to deliver. Understanding this sequence is critical for managing labor and delivery in face presentations, which often require careful monitoring and may necessitate operative intervention if progression is compromised.

Reference: Cunningham, Williams Obstetrics, 25th Edition.