During your visual inspection of a laboring patient, the baby's head crowning at the vaginal opening. What should you do?

• A. Apply gentle pressure to the head as it delivers.
• B. Grasp and pull the head to speed delivery.
• C. Immediately deliver with forceps.
• D. Stop delivery and push the head back.

Answer: (A)

When crowning, the priority is to guide the birth in a controlled, gentle way while protecting both mother and baby from injury. As the head begins to emerge, support it with your hands and apply light downward pressure to help the delivery occur smoothly and prevent a rapid, forceful expulsion that could tear the perineum or cause trauma. Pulling on the head, rushing with forceps, or trying to push the head back are risky and beyond what should be done in most EMS settings; these actions can cause injury to the baby or mother and are not appropriate without specialized training and equipment. By maintaining a steady, supportive touch and allowing the contractions to do the work, you help ensure a safer delivery, and you can focus on clearing the airway, monitoring the infant, and preparing for the next stages of birth.