What should a midwife monitor closely during labor to address uterine atony?

Monitoring uterine tone during labor is crucial for identifying and addressing uterine atony, a condition where the uterus fails to contract effectively after childbirth. Uterine tone is assessed to ensure adequate contractions are occurring, which are necessary to maintain proper uterine function and prevent postpartum hemorrhage.

In cases of uterine atony, the uterus becomes soft and does not contract, which can lead to excessive bleeding after delivery. By closely monitoring the uterus's tone, the midwife can quickly recognize any signs that indicate a lack of adequate contraction strength. Immediate interventions can then be initiated to stimulate uterine contractions and manage any associated risks.

Other factors, such as maternal heart rate and fetal heart rate, are also monitored during labor; however, they do not directly indicate uterine tone or the risk of uterine atony. Uterine fundal height may be helpful in some assessments but is not as relevant in monitoring uterine tone specifically. Thus, focusing on the tone of the uterus is vital for the prevention and management of uterine atony during labor.