A multigravida in active labor is 7 cm dilated. The fetal heart rate baseline is 130 bpm with moderate variability. Variable decelerations occur to 100–110 bpm. What should the nurse do next?

• A. Reposition the client and continue to evaluate the tracing
• B. Increase oxytocin rate
• C. Prepare for immediate cesarean delivery
• D. Apply internal fetal monitoring

Answer: (A)

Variable decelerations reflect cord compression. When the fetal heart rate baseline is reassuring (around 130) and variability is moderate, the priority is to relieve potential cord compression rather than escalate to more invasive or urgent steps. Changing the mother’s position—such as to a left side or other comfortable, non-supine position—can relieve external pressure on the cord and often improve the tracing. After repositioning, continue to monitor the tracing to see if the decelerations resolve.

Increasing oxytocin would likely worsen contractions and deepen cord compression. Preparing for immediate cesarean delivery is reserved for persistent nonreassuring patterns (like recurrent late decelerations or severe, unresponsive variable decelerations). Internal fetal monitoring isn’t the first step here, since the current tracing is reassuring and the initial focus is to relieve cord compression and observe.