What is the rationale behind performing a fundal massage after delivery?

Performing a fundal massage after delivery is primarily aimed at promoting uterine contraction and preventing postpartum hemorrhage. After childbirth, the uterus needs to contract effectively to reduce the risk of excessive bleeding due to the separation of the placenta from the uterine wall. Fundal massage stimulates the uterine muscle, encouraging it to tighten and thus minimize the potential for hemorrhage, which is a leading cause of maternal morbidity and mortality.

The action of massaging the fundus (the top part of the uterus) helps to ensure that the uterus is firm and contracted. A well-contracted uterus reduces the likelihood of atony, where the uterus fails to contract adequately, leading to excessive bleeding.

Although fundal height assessment and facilitating the expulsion of the placenta are part of post-delivery care, they are not the primary rationale for performing a fundal massage. Additionally, while comfort for the mother may be a secondary benefit, it is not the main purpose of this intervention. Thus, the correct answer focuses on the critical role that fundal massage plays in uterine contraction to prevent complications related to postpartum hemorrhage.