Which action is most effective in promoting uterine contraction by addressing bladder distension in the immediate postpartum period?

• A. Massaging the uterus
• B. Assist to void
• C. Check for distended bladder
• D. Rechecking the uterus in 1 hour

Answer: (B)

A full bladder after delivery pushes the uterus upward and away from its midline, hindering its ability to contract effectively. Assisting the mother to void directly addresses this distension, allowing the uterus to assume a midline position and contract firmly. When the bladder empties, the fundus typically becomes firm and well-contracted, which helps prevent postpartum hemorrhage from uterine atony. After voiding, reassess the fundus and continue to monitor; if the uterus remains boggy, fundal massage can be used, but that step should follow the relief of bladder distension.