A client is 6 weeks postpartum and is explaining involution. Which statement indicates understanding of the expected progress of the uterus?

• A. The fundus should not be palpable at 6 weeks postpartum
• B. The fundus should remain at the umbilicus for several weeks
• C. The fundus should descend into the pelvis by 6 weeks
• D. The fundus should rise back toward the abdomen after birth

Answer: (A)

Postpartum involution is about the uterus returning to its pre-pregnant size and position. The fundus descends about 1 cm each day after birth. By about 2 weeks postpartum, it is usually no longer palpable in the abdomen because it has moved into the pelvis, and by 6 weeks it should be back in the pelvic cavity and not felt on palpation. Therefore, saying that the fundus should not be palpable at 6 weeks postpartum reflects the expected progress of involution.

Arguments against the other ideas: the fundus does not stay at the umbilicus for weeks; it descends promptly. While it does descend into the pelvis, the important indicator at 6 weeks is that it is not palpable, not just that it has moved downward. It does not rise back toward the abdomen after birth; it continues to descend, not ascend.