Which statement describes the third 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: (C)

Fundal massage aims to prevent postpartum hemorrhage by promoting firm uterine contraction. In the massage sequence, you first establish control and support for the uterus, then grasp the fundus to begin the massage. Placing a hand around the top of the fundus is the correct third step because it provides a secure grip on the fundus so you can apply circular, kneading strokes to stimulate contraction and assess tone. After this grip is established, you would rotate the hand to continue the massage. The other actions described are preparatory positioning or subsequent steps rather than the moment you start directly massaging the fundus.