Certified Midwife Exam Prep

Category - Midwifery

A client is in the second stage of labor and has been pushing for almost an hour. Which of the following interventions is the most appropriate for the client at this stage?
  1. Offer clear fluids in between contractions.
  2. Encourage ambulation.
  3. Instruct the client to push with each contraction.
  4. Encourage frequent changes in position.
Explanation
Answer: C - The most appropriate intervention during the second stage of labor is to instruct the client to push with each contraction. The midwife should also encourage the client to rest in between contractions. Pushing expends energy, and the client should be taught to conserve and regain energy every time she has the opportunity. It is not recommended to offer foods and fluids at this time; however, ice chips may be offered for hydration. Ambulation is recommended during early labor. Frequent position changes are not recommended during the second stage because the client needs to conserve her energy.
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Additional Answers

B O says:

Absolutely not. If the pushing stage is not progressing, different positions will ABSOLUTELY help. This is entirely wrong. Why would you have a birthing person stay in one position the entire time?? If there is no progress after an entire hour, obviously the position currently being tried is NOT working. Their body could also be exhausted from the outdated and debunked medical advice to keep them starved for the entire labor and birth! ‘Ice chips’ are completely insufficient. This question was ridiculous.

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