You have a pregnant woman in active labor with the baby presenting with an arm sticking out. Which position is best for transport?

The best position for the transport of a pregnant woman in active labor, especially with a presentation of an arm sticking out, is the left lateral recumbent position. This position is beneficial for several reasons.

Firstly, the left lateral recumbent position helps to optimize uterine perfusion and blood flow to the placenta, which is crucial for supporting both the mother and the fetus during labor. By positioning the woman on her left side, you're also reducing pressure on the inferior vena cava, which can help prevent supine hypotensive syndrome—a condition that can occur when a pregnant woman lies flat on her back, compromising blood flow and leading to decreased cardiac output.

Additionally, placing the patient in this lateral position can aid in alleviating discomfort and can help in managing the presentation of the arm during labor. This position allows for gravity to assist with fetal descent while simultaneously providing a stable and robust position for potential interventions.

The other positions listed would either compromise maternal blood flow or may not offer the necessary support for labor complications. For example, Trendelenburg could exacerbate hypotension and isn't suitable for a delivery scenario, while positioning the patient on the right lateral recumbent side could also lead to compression of major vascular structures. The position of comfort is less