North American Registry of Midwives (NARM) Practice Exam

What should be your first action when membranes rupture?

1. Call the physician

2. Check the fetal heart rate

3. Assess maternal vitals

4. Administer fluids

The correct answer is: Check the fetal heart rate

When membranes rupture, the primary concern is ensuring the well-being of the fetus, and checking the fetal heart rate is a crucial first step in this process. It allows the midwife to assess the fetal response to the change in environment and to detect any signs of distress that may occur as a result of the rupture. The fetal heart rate can provide important information about the baby's condition—if it is within an expected range, it suggests that the fetus is tolerating the rupture well. If there are any abnormalities or indications of distress, timely interventions can be initiated. While assessing maternal vitals, notifying the physician, or administering fluids are all important aspects of care that may need to follow, the immediate priority after the membranes rupture centers around the fetal heart rate to ensure the safety and health of the fetus in this critical moment.