Which assessment would indicate that a woman is in true labor?

Correct option is B

Correct Answer:
✅ (b) Progressive cervical dilatation, 90% effaced
Explanation:
True labor is defined by regular, strong uterine contractions that lead to progressive cervical changes, including dilatation (opening of the cervix) and effacement (thinning of the cervix).
Signs of True Labor:
1. Progressive Cervical Changes
· Dilatation → The cervix opens from 0 cm to 10 cm.
· Effacement → The cervix thins out from 0% (thick) to 100% (fully effaced).
· Option (b) mentions "90% effaced," which is a clear indication of labor progress.
2. Regular, Strong Contractions
· True labor contractions occur at regular intervals and become more intense over time.
· They do not stop with rest or hydration (unlike false labor).
3. Descent of Baby (Fetal Engagement)
· The baby moves lower into the birth canal.
· But engagement alone (option c) is not a confirmation of true labor.
4. Bloody Show and Rupture of Membranes
· A mucus plug is discharged with some blood (called "bloody show").
· Water breaking (rupture of membranes) can happen before or during labor, but its presence alone does not confirm true labor.
Why Other Options Are Incorrect?
❌ (a) Membranes are ruptured and fluid is clear
· Rupture of membranes ("water breaking") can happen before labor starts.
· Some women may experience Premature Rupture of Membranes (PROM) without contractions, meaning labor has not yet begun.
❌ (c) Presenting part is engaged and not floating
· The baby's head engaging in the pelvis is a sign of labor readiness, but it can happen weeks before true labor in first-time mothers.
· Some babies engage late and labor may still proceed normally.
❌ (d) Contractions last 30 seconds, every 5 to 10 minutes
· True labor contractions become stronger, longer (lasting 45–60 seconds), and more frequent (every 2–5 minutes).
· 30-second contractions are too short and may indicate false labor (Braxton Hicks contractions).