The perinatal nurse knows that changes in the pelvic floor musculature that normally occur in labor include which of the following? (Select all that apply.)
A.
Eversion of the anus
B.
Exposure of the internal rectal wall
C.
Pulling downward on the levator ani muscles
D.
Rectum drawn upward and backward
E.
Thinning of the perineal body
ANS: A, B, E
Uterine contractions bring about changes in the pelvic floor musculature. The forces of labor cause the levator ani muscles and fascia of the pelvic floor to draw the rectum and vagina upward and forward. During descent, the fetal head exerts increasing pressure and causes thinning of the perineal body from 5 cm to less than 1 cm in thickness. Continued pressure causes the maternal anus to evert, and the interior rectal wall is exposed as the fetal head descends forward.
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