A woman who has been in labor for 6 hours is now 9 centimeters dilated and has intense contractions every 1 to 2 minutes. She is anxious and feels the need to bear down with her contractions. What is the best action for the nurse to take?


• Because the woman has not reached full cervical dilatation, which is 10 centimeters, it is best for the nurse to encourage the woman to breathe using repeated, short puffs to delay pushing while allowing her cervix time to reach full dilation.

• Allowing the woman to push without a fully dilated cervix will predispose her to bleeding and cervical lacerations.

• By this time, the woman has already reached the transition phase of the first stage of labor. The contractions have reached their peak of intensity, occurring every 1 to 2 minutes. A woman in this phase may experience intense discomfort so strong that she may also experience a feeling of loss of control, anxiety, panic, and irritability.

• Incorrect: During the first stage of labor, it is best to position the woman in the left side lying position. This position causes the heavy uterus to tip forward, away from the vena cava, allowing blood return from the lower extremities and adequate placental filling and circulation.

• Incorrect: During the transition phase, the woman often becomes irritable and restless. The patient may resist being touched and push away.

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