If the umbilical cord protrudes during delivery, the immediate action is to:

• A. Push the cord back into the vagina.
• B. Push the infant's head away from the cord.
• C. Immediately deliver by cesarean.
• D. Remove the cord with sterile technique.

Answer: (B)

Relieve pressure on the cord immediately. When the umbilical cord prolapses, it can be squeezed between the presenting part and the vaginal wall, cutting off oxygen to the baby. The quickest, most effective action is to gently push the infant’s head away from the cord (lifting the presenting part off the cord) to relieve that compression. Keep the cord moist with sterile gauze, and if possible position the mother to reduce pressure while rapidly arranging for definitive care. Do not push the cord back inside the vagina and do not attempt to remove the cord; cesarean delivery is a consideration for definitive care, not the immediate field action.