North American Registry of Midwives (NARM) Practice Exam

During the normal fourth stage of labor, how often should a woman's BP, pulse, and respirations be monitored?

1. Every 5 minutes until stable

2. At least every 15 minutes until stable

3. Once an hour

4. Every 30 minutes

The correct answer is: At least every 15 minutes until stable

In the fourth stage of labor, which refers to the period immediately after delivery, careful monitoring of the mother’s vital signs is crucial due to the physiological changes and potential risks such as postpartum hemorrhage or other complications. Monitoring blood pressure, pulse, and respirations at least every 15 minutes until the mother's condition stabilizes allows for timely detection of any abnormalities. This frequency is based on the understanding that the risk of complications is highest immediately after birth as the body begins to readjust from the labor process. By assessing these vital signs regularly, healthcare providers can ensure that the mother is recovering appropriately and can promptly respond to any changes that may indicate distress or complications. Monitoring every 5 minutes may be too frequent for stable patients, leading to unnecessary interventions, while options of once an hour or every 30 minutes may not provide adequate oversight during this critical time. Thus, the recommendation to check vital signs at least every 15 minutes strikes a balance, ensuring patient safety while respecting her comfort during recovery.