North American Registry of Midwives (NARM) Practice Exam

Which maternal condition is related to an abnormal drop in hemoglobin during labor?

1. Extreme dehydration

2. Abnormal blood loss

3. Anemia prior to labor

4. Infection

The correct answer is: Abnormal blood loss

An abnormal drop in hemoglobin during labor is most directly related to abnormal blood loss. During labor, significant blood loss can occur due to various reasons, such as placental abruption, uterine atony, or lacerations. This blood loss can lead to a rapid decrease in hemoglobin levels, which is critical to monitor, as it can affect maternal well-being and the overall progress of labor. While conditions such as extreme dehydration, anemia prior to labor, and infections can also impact overall maternal health, they do not specifically cause an acute decrease in hemoglobin during the labor process as directly as abnormal blood loss does. For example, anemia prior to labor denotes a chronic condition, and while it may predispose a woman to lower hemoglobin levels, it does not typically cause an acute drop during labor itself. Similarly, extreme dehydration and infections can affect hemoglobin levels in different ways but are not the primary concern directly related to an acute response during labor.