A nurse is reinforcing teaching about the process of involution with a client who is postpartum. Which of the following pieces of information should the nurse provide?

• A. The fundus is not palpable abdominally at 2 weeks postpartum
• B. The fundus remains palpable at the umbilicus for several weeks
• C. The uterus enlarges after birth before returning to normal
• D. The uterus should descend to the pelvis within 2 weeks

Answer: (A)

Involution means the uterus is shrinking and moving from the abdomen back into the pelvis after birth. The fundus starts at the level of the umbilicus at birth and descends about 1 cm per day. By about two weeks postpartum, the uterus has descended into the pelvis and is no longer palpable in the abdomen. This is the expected sign that involution is progressing normally. If the fundus remains at the level of the umbilicus or higher, that can indicate delayed involution. The uterus does not enlarge after birth; it shrinks, and the important point to teach is that by two weeks you should not be able to feel the fundus in the abdomen.