North American Registry of Midwives (NARM) Practice Exam

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What is the best method for a midwife to intermittently listen to fetal heart tones during labor?

Listen continuously throughout labor
Start listening midway through contractions
Count fetal heart tones every minute
Listen only during active labor

The correct answer is: Start listening midway through contractions

The best method for a midwife to intermittently listen to fetal heart tones during labor is to start listening midway through contractions. This approach is effective because it allows the midwife to assess the fetal heart rate during the most critical moments when the uterine pressure is highest, which can influence the fetal heart rate response. Listening midway through contractions can provide valuable insight into how the fetus is tolerating labor, especially regarding any potential stress responses. Continuous listening may not be practical or necessary in all situations and can lead to unnecessary interventions if fluctuations in heart tones are misinterpreted. Counting fetal heart tones every minute could lead to excessive focus on the rate rather than understanding the trends and patterns, which are more relevant to fetal well-being. Moreover, only listening during active labor may miss important indicators of fetal distress that can occur in the earlier stages of labor. Therefore, the chosen method emphasizes a balanced and careful approach to monitoring without overstepping into continuous listening or ignoring earlier stages of labor.