During labor, a 28-year-old female has contractions 1 minute apart and the umbilical cord protrudes from the vagina. What should you do?

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A prolapsed umbilical cord is an urgent obstetric emergency because the cord can be compressed by the presenting part, cutting off the baby’s oxygen. The priority is to relieve pressure on the cord and expedite delivery. Do not try to push the cord back into the uterus. Instead, position the mother to relieve pressure on the cord—knees to chest or Trendelenburg with the hips elevated. If possible, gently lift the presenting part off the cord with a gloved fingertip to prevent compression, but keep the cord moist with sterile saline-soaked gauze. Administer high-flow oxygen to the mother if available, and call for help so delivery can occur as soon as possible. Prepare for an imminent delivery and assist as needed, aiming to deliver promptly rather than delay for transport or other measures.