A 19 year old female in active labor with head retraction should prompt what action?

In the context of active labor, head retraction—commonly referred to as "turtle sign"—indicates a potential problem, such as shoulder dystocia. This occurs when the fetal head delivers, but the shoulders fail to follow due to an obstruction. The presence of head retraction signals that the baby is in distress and may require immediate intervention.

When head retraction is observed, it is essential to escalate care promptly. Contacting medical control and initiating immediate transport is critical in this situation because shoulder dystocia can lead to complications for both the mother and baby. Early intervention and advanced medical assistance may be necessary, as well as the need for expertise or equipment that may not be available in the field, warranting transport to a facility capable of managing the delivery safely.

While other actions like performing fundal massage or assisting with a vacuum delivery might be considered in different clinical scenarios, they do not address the urgent need for experienced obstetrical care when head retraction is noted. Continuing monitoring and providing reassurance might be appropriate in stable labor situations, but head retraction is a complication that requires immediate attention. Thus, the appropriate action in this scenario is contacting medical control and preparing for transportation to a medical facility.