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

• A. Lie on her back with her knees flexed.
• B. Place a hand just above the symphysis pubis.
• C. Position a hand around the top of the fundus.
• D. Rotate the upper hand to massage the uterus.

Answer: (D)

Fundal massage is done in a sequence that moves from positioning to stabilizing the uterus to applying the massage. After the patient lies supine with knees flexed, one hand is placed just above the symphysis pubis to support the uterus, and the other hand is positioned around the top of the fundus to begin the massage. The next step is to rotate the hand that’s on top to massage the uterus. This rotation allows the massage to cover the entire fundal area in a circular, rhythmic motion, promoting firm contractions and helping prevent postpartum hemorrhage.