Which finding is expected 1 hour after birth as the fundus is assessed postpartum?

• A. Fundus 1 cm above the umbilicus
• B. Fundus 1 cm below the umbilicus
• C. Fundus at the umbilicus
• D. Fundus 2 cm above umbilicus

Answer: (A)

Postpartum fundal assessment is about involution—the uterus shrinking and rebuilding to its nonpregnant state. In the first hour after birth, the uterus should feel firm, be midline, and be located at about the level of the umbilicus or just above it. Saying it is about 1 cm above the umbilicus fits within the expected range for this time frame, reflecting normal contraction and early involution. Remember, the fundus will descend further each day after birth, descending about 1–2 cm daily. If the fundus were significantly below the umbilicus, boggy, or displaced, that would signal a potential issue and require assessment and intervention (like ensuring the bladder is empty or performing fundal massage).