Practice Quiz

CPM Certified Professional Midwife

Category - Labor, Birth, and Immediate Postpartum

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A midwife assesses a client in labor. Combined abdominal inspection and palpation and sonography indicate that the occiput of the fetus is the presenting part. The midwife also finds out that there is a disproportion between the fetus and the client’s pelvis. The history of the client’s pregnancy is not remarkable. Routine screening tests suggested good fetal well - being. Which of the following statements made by the midwife is the most appropriate when informing the client about the findings?
  1. “Your pelvis is too small for the baby’s head. Your baby cannot be born vaginally.”
  2. “Your baby’s head is too large for your pelvis. You should consider a cesarean birth.”
  3. “We’re considering a cesarean birth. Tell me how you feel about that.”
  4. “Your baby cannot be born vaginally. Do not worry much about it. We’ll do everything to keep you and your baby safe.”
Explanation
Answer: A - The midwife should inform the client that her pelvis is too small for the baby’s head and that the baby cannot be born vaginally. Learning about the disproportion can be distressing for the client, but it is important to emphasize to the client that the pelvis structure is most likely at fault and not the baby. Informing the client that the baby’s head is too large may imply that something is seriously wrong with the baby, which increases the client’s anxiety level. In most cases of CPD, especially in cases where fetal well - being is suggested throughout the pregnancy, it is usually the client’s pelvis that has problems. Option C does not inform the client why a cesarean birth is necessary and it may further increase the client’s anxiety levels. Option D offers false reassurance and does not indicate why the baby cannot be born vaginally.
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