Upon delivery, if the umbilical cord is not functioning effectively, what immediate action should be taken?

The immediate action to take if the umbilical cord is not functioning effectively is to check for a heartbeat. This step is crucial because it allows the responder to assess the baby's condition and understand whether the infant is receiving adequate oxygenation. If the umbilical cord isn't delivering sufficient blood flow to the baby, it can lead to a lack of oxygen, which may necessitate urgent intervention.

By assessing the heartbeat, the responder can determine if the baby is still in a viable state or if there are signs of distress, which would guide further actions. If the baby has a heartbeat, it may indicate that additional support is needed, such as stabilizing the baby or assisting with breathing. This assessment provides vital information for deciding the next steps in care.

In contrast, while other approaches may seem relevant—like massaging the baby’s back or clamping the cord—checking for a heartbeat is the most immediate and critical action to ensure the baby’s well-being and to inform subsequent medical interventions. Starting resuscitation would only be warranted if the heartbeat is absent or if the baby shows signs of significant distress.