Question 1

As a doula, you are supporting a laboring mother whose contractions are 12 minutes apart, and last 30 seconds each. She is uncomfortable, but still feels she can relax in between contractions. Which of the following is NOT a suggestion you make to this mother?

Accepted Answer

A) Suggest she walk during contractions to alleviate pain. 
B) Encourage her to leave for the hospital or birthing center. 
C) Ask her if she would like massage during a contraction. 
D) Recommend a warm bath or shower.

Question 2

What is "Friedman's Curve"?

Accepted Answer

A) A way of moving the hips to aid in fetal descent 
B) The arch of the lower back caused by a shift in the mother's center of gravity 
C) A graph depicting the progress of labor by plotting centimeters dilation over time 
D) A modern measure of cervical dilation

Question 3

A doula is supporting a laboring client at 38 weeks' gestation. The most recent assessment by the healthcare provider includes full dilation and cervical effacement. The client says, "I feel this uncontrollable urge to push." The client is in which stage of labor?

Accepted Answer

A) First 
B) Second 
C) Third 
D) Fourth

Question 4

It is common for women to feel which of the following emotions after a Caesarean birth?

Accepted Answer

A) Anger and resentment 
B) Relief 
C) Guilt and disappointment 
D) All of the above

Question 5

Which of the following is NOT a benefit of forceps or vacuum assisted delivery?

Accepted Answer

A) Aids in fetal descent when the mother's efforts are insufficient 
B) Decreased incidence of episiotomy 
C) Helps the baby rotate into an anterior position 
D) Speeds delivery in cases of fetal distress

Question 6

What is the role of relaxin in pregnancy?

Accepted Answer

A) It helps the placenta produce other hormones. 
B) It causes the uterus to contract. 
C) It relaxes the ligaments. 
D) It relieves pain.

Question 7

Which of the following BEST describes how to time contractions?

Accepted Answer

A) Time from the start to finish of a single contraction. 
B) Time from the beginning of one contraction to the beginning of the next contraction. 
C) Time from when the contraction ends to when the next one begins. 
D) Time throughout labor - from the first sign of tightening to the birth of the baby.

Question 8

Which of the following is NOT a good indication for induction of labor?

Accepted Answer

A) The amniotic sac has been ruptured for more than 24 hours without the onset of contractions. 
B) The provider believes the baby is larger than average. 
C) The pregnancy has progressed beyond 42 weeks. 
D) The woman has developed a pregnancy related complication such as pregnancy induced hypertension or gestational diabetes that would make it more dangerous to remain pregnant.

Question 9

One way to change pain perception is to think of the pain of labor in a new way, sometimes called "reframing pain." Which of the following is not a description of this technique?

Accepted Answer

A) P = Purposeful 
B) A = Anticipated 
C) I = Intermittent 
D) N = Noisy

Question 10

Which of the following BEST describes what should be done if a woman's bag of waters breaks at the onset of labor?

Accepted Answer

A) She should immediately go to her birth location. 
B) She should take note of the time, amount, odor, and color of the fluid, and notify her healthcare provider. 
C) She should lie down and rest so she has energy for the rest of labor. 
D) She should not take a tub bath.

Question 11

Which of the following BEST describes the purpose of a birth plan?

Accepted Answer

A) A way for a woman to clarify and communicate her wishes for labor, birth and the early postpartum. 
B) A way to make mom feel like a failure if she does not achieve the birth she had envisioned. 
C) A binding contract between the pregnant woman and her healthcare provider. 
D) A list of demands a laboring woman presents to her support staff.

Question 12

Prolapsed cord can BEST be described as:

Accepted Answer

A) A wrapping of the umbilical cord around the baby's neck 
B) An emergency situation where the umbilical cord precedes the baby into the birth canal 
C) Allowing the umbilical cord to stop pulsing before it is clamped and cut 
D) A normal variation of labor

Question 13

Breathing techniques used during labor can do all of the following EXCEPT:

Accepted Answer

A) Improve oxygenation of the fetus keeping the fetal heart rate more stable 
B) Make a mom lightheaded 
C) Increase oxygen to the uterus, which decreases pain and makes contractions more effective 
D) Reduce the risk of Caesarean birth when exhale pushing is used as opposed to directed pushing

Question 14

Midwife and author Ina May Gaskin has coined the term "Sphincter Law" in relation to how the cervix works in labor. Which of the following is NOT part of her theory?

Accepted Answer

A) Sphincters hold bodily openings closed and, when relaxed, expel something, then close again. 
B) The cervix can be opened with relaxation. 
C) Keeping the jaw tight can help the cervix to open. 
D) Fear can contribute to cervical closing.

Question 15

A doula is supporting a client who is in early labor. Which of the following guidelines is least important?

Accepted Answer

A) Be certain that the outcomes are realistic 
B) Incorporate both the client and her support person. 
C) Project a definite time limit for labor to be completed. 
D) Address the discomforts of labor.

Question 16

The role of catecholamines in labor can BEST be described as:

Accepted Answer

A) Can slow labor if released because of fear 
B) Help the mother feel more relaxed 
C) Create feelings of euphoria at the time of birth 
D) Help to start milk production

Question 17

All of the following non-pharmacological techniques might be used for labor induction or augmentation EXCEPT:

Accepted Answer

A) Accupressure 
B) Nipple stimulation 
C) Herbal remedies 
D) Episiotomy

Question 18

Comfort measures for labor include all of the following EXCEPT:

Accepted Answer

A) Aromatherapy 
B) Warm water 
C) Walking 
D) Remaining in bed

Question 19

All of the following make "back labor" take longer EXCEPT:

Accepted Answer

A) A baby needs additional time to rotate into an occiput anterior position. 
B) Contractions are not as effective if the baby is malpositioned. 
C) Pushing takes longer if the baby is still malpositioned at the beginning of second stage. 
D) A baby cannot be born in an occiput posterior position.

Question 20

If a mother does not have the urge to push once she is fully dilated, which of the following is the BEST position for her to adopt?

Accepted Answer

A) Squatting 
B) Lithotomy 
C) Side-lying 
D) Semi-recumbent

Exam 3: Labor Birth