North American Registry of Midwives (NARM) Practice Exam

The retraction of the head against the perineum during delivery is referred to as what?

1. Cephalhematoma

2. Turtle sign

3. Fetal distress indicator

4. Bradycardia indicator

The correct answer is: Turtle sign

The phenomenon where the baby's head retracts against the perineum during delivery is known as the turtle sign. This sign typically occurs after the head has emerged, and it indicates that there may be shoulder dystocia, a situation where the baby's shoulder gets stuck behind the mother's pelvic bone. The turtle sign suggests that further intervention may be necessary to assist with the delivery, as it can signal potential complications that require immediate attention from the birthing team. Understanding this sign is crucial for midwives and healthcare providers, as recognizing it can lead to timely and appropriate actions to facilitate a safer delivery for both the mother and the baby. In contrast, the other options do not relate to this specific observation during delivery. Cephalhematoma refers to bleeding between the skull and its periosteum, fetal distress indicators signify problems with the baby's well-being, and bradycardia indicators relate to a slow heart rate in the fetus. All these terms address different aspects of labor and delivery, but the turtle sign specifically highlights a mechanical issue during the birthing process.