Postpartum assessment should recognize that a full bladder most directly contributes to which uterine finding?

• A. Boggy uterus
• B. Firm uterus
• C. No change in uterus
• D. Excess lochia

Answer: (A)

A full bladder can push the uterus out of its midline and hinder its ability to contract after delivery. When the uterus can’t contract effectively, it loses its firmness and becomes soft or “boggy.” This setting increases the risk of postpartum hemorrhage because a well-contracted uterus compresses blood vessels to stop bleeding, whereas a boggy uterus does not. So, the most direct postpartum finding associated with a full bladder is a boggy uterus. Address it by having the patient empty the bladder, then perform fundal massage as needed and reassess the uterus for firmness. A firm uterus would be the expected, healthy finding, no change in uterus would imply normal tone, and while heavy lochia can indicate bleeding, it isn’t the direct result of bladder distension.