During a routine delivery, if the placenta has delivered, what is the initial step you should take?

During a routine delivery, if the placenta has delivered, what is the initial step you should take?

• A. Massage fundus
• B. Clamp and cut cord between clamps
• C. Document name of person cutting cord, time cut, and delivery location
• D. Place identification bands on mother and newborn

Answer: (A)

When the placenta has delivered, the first priority is preventing heavy bleeding by promoting uterine contraction. This is done with fundal massage—the clinician gently presses and circles the fundus (top of the uterus) to stimulate the myometrium to contract and to compress blood vessels. If the uterus feels soft or “boggy,” massage until it firms and remains midline. This step directly addresses uterine atony, the most common cause of postpartum hemorrhage, and helps stabilize the mother before proceeding with other routine post-delivery tasks. After achieving a firm uterus, you can continue with the remaining care, such as verifying the placenta delivered intact and completing documentation, but the initial move is to massage the fundus to restore tone.

When the placenta has delivered, the first priority is preventing heavy bleeding by promoting uterine contraction. This is done with fundal massage—the clinician gently presses and circles the fundus (top of the uterus) to stimulate the myometrium to contract and to compress blood vessels. If the uterus feels soft or “boggy,” massage until it firms and remains midline. This step directly addresses uterine atony, the most common cause of postpartum hemorrhage, and helps stabilize the mother before proceeding with other routine post-delivery tasks. After achieving a firm uterus, you can continue with the remaining care, such as verifying the placenta delivered intact and completing documentation, but the initial move is to massage the fundus to restore tone.