If the umbilical cord protrudes during delivery, you should:

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

Answer: (C)

When the umbilical cord prolapses, the baby’s oxygen supply is at risk because the cord can be compressed by the presenting part. The priority is to relieve that pressure right away. Pushing the infant’s head away from the cord accomplishes this by lifting the presenting part off the cord, which reduces compression and helps restore blood flow to the fetus.

If possible, position the mother to further ease pressure—such as knee-chest or Trendelenburg—to keep the presenting part from compressing the cord. Keep the exposed cord moist with sterile saline gauze and avoid manipulating the cord any more than necessary. Do not push the cord back into the vagina or attempt to remove it, as those actions can worsen the situation. Call for urgent help and transport promptly, continuing to monitor both mother and baby until delivery.