North American Registry of Midwives (NARM) Practice Exam

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What time period is referred to as the fourth stage of labor?

  1. From the start of contractions to the birth of the baby

  2. The time from the birth of the placenta to one hour later

  3. The time from the onset of labor to the delivery of the placenta

  4. The period immediately following delivery

The correct answer is: The time from the birth of the placenta to one hour later

The fourth stage of labor specifically refers to the time immediately following the birth of the placenta, typically considered to be the first hour postpartum. During this stage, the focus is on maternal recovery and the initiation of bonding with the newborn. It is a crucial period where healthcare providers monitor for potential complications, such as excessive bleeding, and perform assessments to ensure that the mother is stable and comfortable. Additionally, this stage allows for the establishment of breastfeeding and skin-to-skin contact, which are beneficial for both the mother and baby. The time frame captures the immediate physiological changes that occur as the uterus contracts to minimize blood loss and begins to involute, alongside the emotional and bonding experiences for the family. The other choices describe different phases of labor, but they do not encapsulate the specific focus and timing required to define the fourth stage accurately.