The nurse knows that the second stage of labor, the descent phase, has begun when:
a. The amniotic membranes rupture.
b. The cervix cannot be felt during a vaginal examination.
c. The woman experiences a strong urge to bear down.
d. The presenting part is below the ischial spines.
ANS: C
During the descent phase of the second stage of labor, the woman may experience an increase in the urge to bear down. Rupture of membranes has no significance in determining the stage of labor. The second stage of labor begins with full cervical dilation. Many women may have an urge to bear down when the presenting part is below the level of the ischial spines. This can occur during the first stage of labor, as early as 5-cm dilation.
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