For a routine delivery, if the placenta has delivered, what should EMS do?

• A. Wait 60 seconds after delivery, then clamp and cut cord between clamps.
• B. Document the name of the person cutting the cord.
• C. Place identification bands on mother and newborn.
• D. If placenta delivered, massage fundus. Do not wait on scene.

Answer: (D)

After the placenta has delivered in a routine birth, the priority is to keep the uterus firm to prevent heavy bleeding. You achieve this by massaging the fundus to stimulate contraction and reduce the risk of uterine atony, which is a common cause of postpartum hemorrhage. While doing this, do not delay transport—get the mother and baby to the hospital promptly and continue to monitor for ongoing bleeding and vital signs. Cord clamping and cutting timing, or documenting who cuts the cord, are secondary steps and do not address the immediate need to prevent hemorrhage or to get the patient to definitive care quickly.