On postpartum day 3, the fundus should be located relative to the umbilicus?

• A. Above the umbilicus
• B. At the umbilicus
• C. Not palpable
• D. Below the umbilicus

Answer: (D)

After delivery the uterus undergoes involution, shrinking in size and moving downward toward the pelvis. It typically descends about 1 centimeter per day. By postpartum day 3, this downward progression means the fundus is below the level of the umbilicus (often a couple of centimeters below). This position reflects normal involution and return toward the pelvis. A fundus that remains at the level of the umbilicus or higher on day 3 would suggest slower involution or bladder distention, while a boggy or soft fundus indicates potential uterine atony. Regularly assess fundal height, firmness, and midline position, and ensure the bladder is empty to support proper involution.