In a normal delivery, which step occurs immediately after delivering the head?

• A. Deliver upper shoulder, then lower shoulder
• B. Deliver placenta
• C. Clamp and cut the umbilical cord
• D. Suction mouth, then nose; deliver upper shoulder, then lower shoulder

Answer: (D)

Airway management is the immediate priority after the head is delivered. Suctioning the mouth first, then the nose, clears secretions from the airway and helps prevent aspiration as the rest of the baby is born. Once the airway is cleared, the shoulders are delivered—the anterior (upper) shoulder first, followed by the posterior (lower) shoulder—to facilitate the remaining body emergence. Placenta delivery and clamping of the umbilical cord occur later, after the baby is fully delivered. So the sequence of suctioning the mouth, then the nose, and then delivering the shoulders (upper first, then lower) reflects the correct order.