North American Registry of Midwives (NARM) Practice Exam

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What should be done immediately after a breech delivery until the baby is born up to the umbilicus?

Pull down the cord and place a warm towel around the baby
Completely assist with delivery
Immediately clamp the umbilical cord
Monitor maternal heart rate

The correct answer is: Pull down the cord and place a warm towel around the baby

After a breech delivery until the baby is born up to the umbilicus, the appropriate action is to pull down the cord and place a warm towel around the baby. This procedure helps stabilize the newborn, as it is important to keep them warm to prevent hypothermia and to provide comfortable and secure support as the rest of the delivery is prepared. The focus during this critical time is on ensuring that the baby remains warm and that the umbilical cord is not excessively pulled or constricted, which can cause complications. By placing a warm towel around the baby, midwives can help maintain the infant's body temperature while also ensuring that the cord remains intact until the baby is fully delivered and can properly breathe on their own. In contrast, completely assisting with delivery may not prioritize the immediate care and warmth of the baby during this partial delivery stage. Clamping the umbilical cord right after the breech emerges isn't advisable until the entire delivery is complete, to allow for adequate blood transfer from the placenta to the infant. Monitoring maternal heart rate is important, but this does not address the immediate needs of the newborn during this phase of delivery.