Which statement describes the second 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. Rotate the upper hand to massage the uterus.
• D. Use slight downward pressure to compress the fundus.

Answer: (B)

Fundal massage uses a two-hand technique to promote a firm uterus and prevent hemorrhage. The second step is to stabilize the uterus by placing a hand just above the pubic symphysis. This positioning provides support for the lower uterus, helping keep it in place as you perform the massage on the fundus with the other hand. Once the lower uterus is stabilized, you would use the other hand to massage the fundus in a circular motion and apply gentle downward pressure as needed to encourage contraction and expel any clots. Lying flat with knees flexed is a setup step done before massage begins, and rotating the hand or applying downward pressure are actions that occur during the massage after stabilization.