What is the appropriate action if the uterus feels boggy after delivery?

When the uterus feels boggy after delivery, it is indicative of uterine atony, which can lead to postpartum hemorrhage. The most appropriate action in this scenario is to massage the fundus and assess for bladder distension.

Massaging the fundus can help stimulate the uterus to contract, which is crucial in preventing excessive bleeding. Additionally, during the assessment, if the bladder is found to be distended, it may be contributing to the bogginess of the uterus. An overfull bladder can push the uterus upward and make it difficult for it to contract effectively. Therefore, both actions—massaging the fundus and addressing bladder distension—are essential in managing the situation effectively and can assist in returning the uterus to a firm state.

This approach prioritizes immediate, non-invasive interventions that can help stabilize the patient before considering additional medications or surgical options.