Enemas during labor or pregnancy

My two children are in their mid-40s. Their mother was a registered nurse. She was prepared for labor and took care of her needs before going to the hospital. My younger daughter's labor was induced; her sister was two weeks late and so her mother was ready when labor began. As a result, she did not have enemas in the hospital -- one small; the other, a large urban medical center -- before either delivery.

I have seen the conclusions of the internationally-respected Cochrane Centre concerning the use of enemas given to women in labor. My question is when the Cochrane Centre did the study, were the same kind of labor enemas given to the patients that were given back in the 1940s though the 1960s, that is the 3-H soapsuds enema. Or were they giving them a Fleet Enema and trying to compare the results of the Fleet Enema to the results of the traditional 3-H soapsuds enema used back in the 1940s though the 1960s. Unless they were comparing the effects and results by using the same kinds of enemas, I wonder if the study's conclusion can really be said to be valid. Does anybody know what kind of enemas were used in the Cochrane Centre's study?

My wife gave birth in 1984, 86, and 90. All three times she was given an enema and completely shaven before she gave birth. What a turn on to watch her being prepared!

Back to one of my favorite PBS series, Call the Midwife, which takes place in 1950s England. The cute blond midwife, Trixie, is offered an evening activity. She says "That'll be a nice change from giving enemas." The series was based on the written memoirs of a midwife of that period. Enemas figure very prominently.

Hoss said: "My wife gave birth in 1984, 86, and 90. All three times she was given an enema and completely shaven before she gave birth. What a turn on to watch her being prepared!"

Did you enjoy the births as well?

As Beachrock said, did you enjoy the main event too? I hope so.

I gave birth in 2000 and 2002 . Not once was there ever any talk of an enema or suppositories for that matter.

They are never used in hospital settings anymore during labor.

As a physician I can say without a doubt that enemas are never given by the delivery room now. They were given when I was a student in the early 1970s. That is in the U.S. though.

Both my daughters were born in the '80s. No enemas either time. I was still fairly new to enemas and, frankly, do not think I would have "enjoyed" them!!

Highndry the Cochrane Center is a global independent network of researchers, professionals, patients, carers, and people interested in health. Many of the contributors are world leaders in their fields - medicine, health policy, research methodology, or consumer advocacy - and their groups are situated in some of the world's most respected academic and medical institutions.

As such it was a review of research that utilized Randomised controlled trials that met the selection criteria and from the review of the literature/research they produced their findings:

1. The use of an enema does not lessen or increase the infection rates for mothers or babies.

2. It does not shorten labour.

3. It does not ensure that an episiotomy wound doesn't break if the mother needs to pass a large bowel movement after the delivery.

Prior to publishing their findings :

Enemas were commonly believed to:

1. Speed up labour ( help with inducing contractions and helping to bear down ( pushing))

2. Make the delivery cleaner for those caring for the mother in labour

3. Diminish the newborn's and mother's chances of picking up infections

4. Reduce the discomfort of passing a large bowel movement soon after giving birth

5. Minimise the chances of breaking open an episiotomy wound from passing a large bowel movement soon after the delivery

If you would like to know more please follow the link below:

http://www.cochrane.org/CD000330/PREG_enemas-during-labour.

I have just realised that in my whole career as a midwife I have never given an enema. They don't come up in community practice.

During birth, it's common and totally normal for women to poo! Any fecal matter in the anus gets pushed out as the baby's head descends. Along with vaginal flora it helps colonise the baby's gut flora and immune system and the e coli helps the baby to synthesise vitamin K. Enemas used to interfere with this!

When I was in the hospital for delivery and they were prepping me I remember they put a catheter in and at some point a nurse came in mentioning enema. I asked if that was mandatory and she says no.

I did not want to have enema and my wish was respected.

They put a catheter in for a vaginal delivery? ? ?

I never heard of that. How long ago was that and in what part of the country?

A catheter? Yikes! I've never heard of it either. Was there something you didn't mention?

Catheters are necessary with epidurals. Women often can't feel their bladders to void, and often produce a lot of urine when given fluids with an epidural (standard practice to prevent blood pressure from dropping from the drugs). If there is even 30ml of urine in the bladder it can get in the way of the baby's head and make birth more difficult. The catheter is taken out immediately prior to birth, when the woman is pushing, or just before.

In-out catheters are also used if women in normal labour are unable to urinate (i.e. if the baby's head is blocking normal bladder sensation) and there is likely to be urine in the bladder making the baby's descent difficult.

Indwelling catheters are used during caesarean surgery and only come out when a woman has recovered enough and has enough pain relief on board to get up and void herself, usually about 12 hours after surgery, give or take.

In-out or indwelling catheters are also used postnatally, during haemorrhage, because even a small amount of urine in the bladder can prevent the uterus from contracting and prolong the haemorrhage.

Catheters are common in childbirth for a range of reasons!

They are definitely not used in the US, maybe in Australia where you are.

Yeah Susie is absolutely right here. The only time women get catheters here is when they have c-sections. I was sectioned twice and had a catheter both times. While I am sure there are exceptions, catheters are almost never placed here in the states during labor. Medically speaking there really isn't any need, again there are exceptions to this, but generally speaking not at all necessary just like enemas and shaving the pubic area.

Mashie

Interesting! Catheters are definitely routine for women in labour with epidurals in Australia. The main reasons being - they can't get up to pee, they can't feel their bladders, urine slows the descent of the baby/makes it more difficult, and women are loaded up with fluid.

Is this not an issue in the USA?

I had an induction and after I got the epidural they placed the catheter in but I know it was taken out right before delivery. That was in U.S. few years ago.

All my patients who had them hated them. My mom had them and said it was the worst thing about the whole process. Also "birthing " is making a verb out of a noun. It's birth. Unless it's Gone With the Wind and you're Scarlet O'Hara. This is described as verbing by Jim Watterson in Calvin and Hobbes.

"My sister who is in her early 60s had what would best be described as copious enemas just prior to child birth at the hospital. She has talked about 4 or 5 soap suds enemas that equaled more then a gallon a piece, I kid you not, as a way to speed up the delivery according to the doctors at the time, back in the early 50s. Personally I don't know how she tolerated them, they sound awful."

Wait a minute. If she's sixty now she'd have been prepubescent then.

It's birth. Unless it's Gone With the Wind and you're Scarlet O'Hara.

It was Prissy that said "I don't no nothin' about birthin' babies!" In Gone With the Wind. Then Scarlet belted her.

My wife had one during labor for our second child. She has the misfortune of a 37 hour labor of which during that time she was not able to have a successful BM. So the doctor ordered her to have one to help clear her intestines before beginning to push.

To RN1993:

I have read the conclusions of the Cochrane Center above, but they did not answer my basic question, which was what kind of enema did they give the women in the study. Was it a Fleet Enema or the large volume 3-H soapsuds enemas they gave in the 1940s through the 1960s. Unless they gave them the same kind of enema used in the old days, they really can't conclude that those old 3-H enemas did not accelerate labor.

To docinny45:

In your earlier post you say that "Enemas are NOT routinely done anymore in L&D and haven't been since around 1950.", and that may be true where you practice, but I can tell you for certain that it was not true for South Central Texas in the late 1960s & early 1970s. When my wife checked into the hospital in 1967 to deliver our baby, she was taken to Labor & Delivery where she received a full pubic and perineal shave and then was given a large volume soapsuds enema. I know this to be true because she told me so as I helped her to the bathroom and asked if she was sick and she said, "No, they gave me an enema." Then after delivery by emergency C-section, the day she was to be released from the hospital the nurse gave her a discharge enema of at least one liter. I know this to be true for I walked in the room just as the nurse was pulling the plastic enema tube from her rectum. The nurse stood up straight, curled up the plastic tube, put it in the bucket, then stowed the 40 oz. plastic Enema Administration Unit in the nightstand and left the room immediately, while I helped my wife to the bathroom to expel.

Then in 1970 our second baby was born by C-section and while visiting my wife, I was at the nurse's desk late one night talking to the nurse about my wife and was able to read in an open 3-ring binder another doctor's instructions for the nursing staff to perform when a new patient checked into Labor & Delivery. His instructions stated that the woman was to be given an enema.

So enemas were commonly given to women in labor in two hospitals at least back in the late 1960s and early 1970s in this part of the country.

Old fart warning!!

when my kids were born 30or so years ago my wife was given a fleet, which has screwed up my home enema programme. child 2 was born so quick the fleet was still on the counter. shaved for first,second arrive so quick the S O was 5cm dilated when we hitL andD. they have alarms when that happens and people appear form g.o.k.

Highndry I have managed to get the following information regarding the enemas used in the 4 studies:

In the Drayton 1984 study the participant group received a low-volume disposable phosphate enema during the first stage of labour.

In the Kovavisarach 2005 study the participant group received a (Uni-ma enema) which consisted of sodium biphosphate and sodium phosphate 118 ml.

In the Cuervo 2006 study the participant group received a 1 litre Travad® 2.5% sodium chloride solution enemas applied by a nurse assistant prior to been taken to the labour wards.

In the Clarke 2007 study the participant group received a standardised enema soap solution within 30 minutes of enrollment into the study.

The Cochrane article was a review of the studies and what they concluded. The authors (Reveiz L, Gaitán HG, Cuervo L) concluded from the evidence provided by the four Randomised Controlled Trials ( RCTs) shows that enemas do not have a significant beneficial effect on infection rates such as perineal wound infection or other neonatal infections and women's satisfaction. These findings speak against the routine use of enemas during labour, therefore, such practice should be discouraged.

I don't think enemas are routinely used during labor anymore. but certainly, if one feels constipated or wants to avoid defecating during labor and delivery, the woman might consider asking for one.

Here, no enemas, but the hospital advised inserting a glycerin suppository and having a bowel movement before departing for the maternity ward.