Which statement describes the final step in the fundal massage sequence?

• A. Use slight downward pressure to compress the fundus.
• B. Rotate the upper hand to massage the uterus.
• C. Place a hand just above the symphysis pubis.
• D. Lie on back with knees flexed.

Answer: (A)

Fundal massage is done to stimulate uterine contraction and prevent postpartum hemorrhage. After locating the fundus and performing the massage in a circular fashion, finishing with a gentle downward pressure helps compress the fundus toward the pelvis. This downward pressure reinforces the contraction, aiding in expelling any clots and keeping the uterus firm and midline. Other actions described—altering hand position during massage, placing a hand above the pubic symphysis, or having the patient lie flat with knees flexed—relate to setup or technique at different points, not the final step of the massage. So the final step is applying slight downward pressure to compress the fundus.