A nurse midwife is examining a client who is a primigravida at 42 weeks of gestation and states that she believes she is in labor.
Which of the following findings confirm to the nurse that the client is in labor?.

The correct answers are choices B, E, and F.

Choice A rationale:

Nausea with vomiting during the first trimester is a common symptom of pregnancy and does not need to be reported immediately to the health care provider.

Choice B rationale:

Sudden leakage of fluid during the second trimester could indicate premature rupture of membranes, which can lead to infection and preterm labor. This should be reported immediately.

Choice C rationale:

Urinary frequency in the third trimester is a common symptom of pregnancy due to the growing uterus putting pressure on the bladder.

Choice D rationale:

Backache during the second trimester is a common symptom of pregnancy as the body adjusts to the growing uterus.

Choice E rationale:

Lower abdominal pain with shoulder pain in the first trimester could indicate an ectopic pregnancy, which is a medical emergency and should be reported immediately.

Choice F rationale:

Headache with visual changes in the third trimester could indicate preeclampsia, a serious condition that can lead to seizures, stroke, and other complications. This should be reported immediately.

The correct answer is choice D.

Choice A rationale:

While some mothers with postpartum depression may have thoughts of harming their infant, it’s not the most common manifestation.

Choice B rationale:

Postpartum depression typically begins within the first few weeks after childbirth, not necessarily within 48 hours.

Choice C rationale:

Psychotic behavior is more commonly associated with postpartum psychosis, a rare and severe form of postpartum psychiatric illness, not postpartum depression.

Choice D rationale:

Women with a history of depression are indeed more likely to experience postpartum depression. This is the correct answer.