North American Registry of Midwives (NARM) Practice Exam

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What is indicated by increased intensity in labor contractions?

Decrease in uterine tone
Progress in dilation and effacement
Stagnation in labor
Need for intervention

The correct answer is: Progress in dilation and effacement

Increased intensity in labor contractions is a strong indicator of progress in the labor process, particularly in terms of dilation and effacement of the cervix. As labor progresses, contractions generally become more intense, more frequent, and more effective at promoting changes in the cervix. This is part of the normal physiological process that leads to the eventual delivery of the baby. When contractions become more intense, they create sufficient pressure on the cervix which stimulates hormonal responses and further dilation. This change is an essential part of the labor process, allowing the baby to descend through the birth canal. Therefore, an increase in contraction intensity is typically a positive sign of labor progress as the body works towards delivery. Monitoring contraction intensity is essential to assess the overall progression of labor. If the contractions were to decrease in intensity, it could indicate a stall or stagnation in labor, whereas increased intensity correlates directly with cervical changes that are needed for birth. Thus, this understanding helps midwives in managing and supporting women through labor effectively.