Maternity Nursing Q 79
At what stage of labor is the mother advised to bear down?
A. When the mother feels the pressure at the rectal area.
B. During a uterine contraction.
C. In between uterine contraction to prevent uterine rupture.
D. Anytime the mother feels like bearing down.
Correct Answer: B. During a uterine contraction
The primary power of labor and delivery is the uterine contraction. This should be augmented by the mother’s bearing down during a contraction.
Option A: During the second stage of labor, the fetal presentation comes down and compression occurs in both the bladder and rectum, generating a reflex that causes a strong urge to bear down, or ‘push’. Therefore, the combination of involuntary intrauterine contractions and voluntary expulsive effort, through the abdominal and respiratory muscles, will help fetus delivery.
Option C: Maternal pushing during the second stage of labor is an important and indispensable contributor to the involuntary expulsive force developed by uterine contraction.
Option D: Waiting for the urge to push with an epidural does shorten the duration of pushing and increases spontaneous vaginal delivery, but lengthens the second stage and doubles the risk of low umbilical cord pH (based on data from one study).