North American Registry of Midwives (NARM) Practice Exam

When is a vaginal exam indicated?

1. Only when the mother requests one

2. To establish a baseline upon admission

3. When the mother is fully dilated

4. After the baby is born

The correct answer is: To establish a baseline upon admission

A vaginal exam is an important tool used during the intrapartum period to gauge the progress of labor and ensure the safety and well-being of both the mother and the baby. Establishing a baseline upon admission is a key reason for performing a vaginal examination. This examination helps in assessing cervical dilation, effacement, and the station of the presenting part, providing crucial information to guide further management of labor. By conducting a vaginal exam at admission, the healthcare provider can create a clear picture of where the mother is at in her labor process. This initial assessment can inform decisions about whether to admit the mother to the hospital, continue monitoring, or take other necessary actions based on her progress. Performing a vaginal exam only upon request can lead to delays in care and potentially impact the outcomes of the labor process. Likewise, examining when the mother is fully dilated doesn't contribute to the ongoing labor assessment but merely confirms the end stage of labor. Performing a vaginal exam after the baby is born would typically not have the same clinical relevance as pre-delivery assessments.