When a multigravida in active labor shows fetal heart rate decelerations that mirror contractions as she begins to push, what should the nurse do?

• A. Continue to monitor the client and fetus.
• B. Stop the labor and prepare for cesarean
• C. Administer tocolytics
• D. Reposition the patient for comfort

Answer: (A)

When fetal heart rate decelerations occur in sync with contractions as the mother begins to push, this pattern is most consistent with early decelerations caused by fetal head compression. The vagal response from the head being compressed during the second stage is normal and indicates the fetus is tolerating labor. These decelerations mirror the contractions and reach their nadir at the peak of contraction, and they typically resolve as labor progresses. Thus the best action is to continue to monitor both mother and fetus, maintaining ongoing assessment and documentation. Interventions like stopping labor with tocolytics or preparing for cesarean aren’t indicated for this benign pattern, and repositioning is more relevant to cord compression-related decelerations rather than head compression.