During active labor, a nurse observes V-shaped decelerations in the fetal heart rate that align with the peak of contractions. What action should be taken?

• A. Notify the healthcare provider of fetal status.
• B. Give oxygen at 10 L per nasal cannula.
• C. Place the client in a side-lying position.
• D. Increase the flow rate of intravenous fluids.

Answer: (C)

This pattern reflects fetal head compression during active labor. When the head is being baby’s descent and the contractions tighten, the vagal response briefly slows the heart rate in step with the contraction, producing early decelerations that mirror the contraction curve. This is a reassuring, typically benign finding and usually indicates normal labor progress rather than distress. The appropriate step is to continue routine fetal monitoring and document the pattern, without intervening actions like repositioning, giving oxygen, or increasing IV fluids. Those interventions are more appropriate for patterns suggesting fetal compromise, such as late decelerations from placental insufficiency or variable decelerations due to cord compression, where the tracing does not simply mirror the contractions. If the tracing later shows nonreassuring patterns, then targeted interventions would be considered.