Enemas for childbirth

In the TV series Call the Midwife, one sees midwives preparing pregnant women for childbirth as follows:

- shaving of the genitals

- administration of an enema.

(Of course, one does not see the actual shaving and enema!)

The enema was quite large, soapy (you see the midwife whisking some kind of powdered soap into water)... as one midwife says "hot, high and the hell of a lot". Several women try to avoid the enema, to no avail.

At some point, one sees a midwife taking downstairs a pot covered by a cloth. The husband mistakenly thinks this is the afterbirth.. and she midwife says "no" without explanation. Obviously this is the enema returns.

Presumably, the pregnant woman got the soapy enema and was immediately helped onto a chamber pot by the women in attendance (thus why a lady did want to opt out from it, saying it was not "dignified"). I actually even wonder how they managed not to explode on the bed (my experience with a milky soapy enema is that I lose control of my sphincter, which expels the nozzle and solution as a reflex).

Question: until when did they do that in the UK and other countries? I'm told 1990 for shaving and enema in the UK!

In the UK I reckon that home childbirth receded after the 1950s so they happened in hospital wards, which, presumably, access to a real toilet and not a potty. But this does not suppress the discomfort and the humiliation of being helped onto the toilet...

Did they at some point at least replace the large soapy enema by something simpler, like a Fleet?

(Note: in France in recent years, my wife was told to take a glycerin suppository and have a bowel movement at home before leaving for the maternity ward.)

It WAS done as recently as the early 1990s in some places. I am about 70% sure that my Mom got an enema at a similar stage of the process when I was born. It may have already been patient option by that time. Not sure. If so, my mother was a klismo, and may well have chosen it

When I had my twins, I was already lucky to carry twins essentially to full term, and once labor started, we live in a small town 12 miles from the nearest hospital, and so by the time we got to the hospital things happened so fast there was not enough time, so the issue never came up.

Also, keep in mind here the difference between reality TV and reality!!

The term Reality TV IS an oxymoron!

LisaK: Call the Midwife is supposedly based on research on historic practices of midwives in England in the 1950s.

Granted, dramatization for on-screen performance tends to distort.

(My own mother did not discuss these issues with me. However I recall a discussion between her and other female relatives in which it was taken for granted that anything surgical happening near the stomach meant shaving the pubis... I think at some point they were discussing somebody who had been originally misdiagnosed and in the end was not operated upon and one said "she had already been shaved".)

Ah, now I understand the inquiring messages last night, Pecan.

LisaK... Call the Midwife is a series based on the Autobiography of Jenny, a real life Midwife who graduated in the late 1940's. Series one and two were as true to her words, as could be (she was still alive during the filming of series one), and was very insistent on historical correctness, and not 'glamourising for television', but showing the world how life was, in The South End just after the war. Even after her death, the producers have insisted on remaining true to Jenny's memory, and all writers (series 3 and on are not Jennys words) are reminded to be thorough in their research, to ensure historical correctness.

As for why the enemas for birthing a child.....

Enemas were introduced, birth wise, during the Victorian Period (in the UK) when sanitisation was a growing concern, within vastly over populated areas. Fecal matter can be forced out during birth, which was deemed dangerous for the baby, and the midwife. Unsanitary.

Shaving of Pubic Hair would remove lice, enable the inspection of the anus and vagina for disease, and ensure sanitisation, as the pubic hair was thought to be the holder of disease. (infant mortality due to syphilis was incredibly high)

But, Louisa, surely, if the only issue is fecal matter exiting the rectum during the birth, there is no need for a large soapsuds enema! A little water (no suds) would clear the rectum... In fact, a large enema risks yielding more water later at inappropriate times.

I read that there was a belief that the spams triggered by the large soapy enema would hasten labor.

Yes, it was believed to facilitate the labour.

As for why not just water, I think I answered that earlier, when I mentioned unsanitary conditions.

It takes a long time for a change in a populations behaviour, if the initial brainwashing was very successful.

Think of the internet....

Originally all posting was researched thoroughly, as the written online text could easily be traced back to the writer. Nowadays, it seems to be the norm to roughly scan one piece of information, on a subject, ask a few convoluted questions, of someone who appears to know the subject. Then post as an 'Oracle' on the subject. Lazy and very dangerous.

As I used to say to my pupils...'Research, research, research....In all forms of text.... and then research some more'

Pecan as you alluded, all TV programmes that are based on real life events do overdramatise events for ratings and for viewing.

As others have mentioned the use of enemas before delivery has long been abandoned. I did my obstetrics placement about 22 years ago and at that time it was already complied to history. No women were offered them and for that matter also no women were shaved before delivered as was the case previously.

Enemas are 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

In fact, the internationally-respected Cochrane Centre made the following conclusions about the use of enema after reviewing all published medical papers on the topic:

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.

As with most medical practices today, research has greatly influence it and things that were common place 50 to 60 years ago have been abandoned for more up-to-date research based. Even in my career ( Since 1990) I have seen significant changes to our practice which have come about as a result of research, better advancements in technology, medications, equipment etc.

I wonder how OB's feel about the mother discharging a stool on the delivery table. Apart from the aesthetics of it, how about the millions of enterobacter being very close to the area where the baby is going to be delivered? I have the feeling that if I were an OB, I'd want mothers in labor to have a Fleet just to empty the rectum and sigmoid. Just sayin'.

Jimmy, you must be a sadist ... a mother with labor pains and you want to give her a Fleet enema... they are gastly all by themselves,

The only enema that was definitely an ordeal, and to be avoided at all costs, although this was not possible in those days, was the one given on admission for labour. For my first child, it was given with a funnel and tube, and was too much too soon, and besides, going in to labour means you have a lot of other things on your mind, and are in a great deal of discomfort anyway.

I think practice varies today, and it is voluntary in many countries. Shaving seems to have gone by the board.

However, when I was pregnant I suffered a lot from constipation, so the enema was a frequent friend in need - but that is a different story!

Delia

I wonder how OB's feel about the mother discharging a stool on the delivery table. Apart from the aesthetics of it, how about the millions of enterobacter being very close to the area where the baby is going to be delivered? I have the feeling that if I were an OB, I'd want mothers in labor to have a Fleet just to empty the rectum and sigmoid. Just sayin'.

It's NOT a big deal, it gets quickly wiped away and other than that, the occurrence is basically ignored--just like a man's erection during an exam.

Jimmy: When my wife gave birth, the instructions were to take a glycerin suppository and have a bowel movement before leaving home for the maternity ward. At that stage, it's not uncomfortable.

Recall that a Fleet enema would mean not only getting the enema in, but also going to the toilet (not easy or impossible when you're in labor) or having a liquid bowel movement into a bedpan - which is very messy as well. In fact, I read that one reason for discontinuing the use of enemas was because there was a risk that further water and feces could go down during labor.

Times do change over the years. When my first wife gave birth to our daughter in 1976 sh was completely shaved from front to back. Then she was given a large volume enema. I missed out on seeing the shave but arrived in time to watch her get the enema. When my second wife had our two sons in 80 and 83 the full shave was a thing of the past. They just shaved between the vagina and around the anus in case stitches were needed. She did receive enemas before both births which I was lucky enough to observe.

When I gave birth to both of my children an enema was not even discussed. I talked to my mom about this and when I was born in 1977 she was only shaved and did not get an enema then.

My one sister is only a year younger than me and is also a pediatrician said that she never got an enema when going to deliver each of her 5 kids. As a doc she does claim there are times when she will tell a parent to give their kid an enema instead of a laxative. She says that many moms have no clue for how to do a traditional bag enema. In those cases she will tell them to just get a fleet instead.

We are in our 60s. My wife was given an enema for the birth of our first two kids and not for the second two. I seems that the practice changed during that time (about 40 years ago). Since pregnancy seemed to cause more constipation I gave her enemas from time to time prior to the time of labor. I found them erotic, but she definitely did not. It was just necessary.

Enemas in preparation for childbirth were once quite prevalent here also...Rural / country based hospitals probably more so than their City counterparts that still adhered to Enemas & shaving of genitalia pre-delivery...The latter falling by the wayside around the late 1970's into the early 1980's with Enemas of the larger capacity extending into the 1990's...I'd have to assume that was a matter of individual hospital policy along with State / Territorial medical guidelines applicable to maternity internment.

Not that long ago (2015) I had been reading website articles by both The Nursing Mothers Assoc in conjunction with various Midwifery groups that recommended expectant mothers avail themselves of an enema if they were concerned about "accidents"...The capacities involved were of a reduced nature....recommending something in the order of approx. 600Ml compressible disposables (plastic concertina cannisters).....naturally with the proviso & caution of discussing same with their caregiver in the event of any contra indications....some of the comments by the expectant women raised a chuckle !!

Over the past decades medical doctrine has undoubtedly changed but sometimes the simplicity of an enema is by far the most effective means of ensuring a good result.

My wife was given an enema prior to the birth of our child in the late 60s. She dreaded the enema as much as the labor. I remember as we were waiting to go in the hospital her saying "Oh God! In a few minutes I am going to be getting an enema,"

When my sister gave birth to her twin sons, she was given an enema. My mother told me this and indicated that it was the first time my sister had ever experienced an enema.

Herrdoktor: Was that recent? Which country?

It was 1960 in Washington, D.C.

My mother always talked about the prep enema she received when she had me, and when relating the story to me, which she did frequently, always went into detail about the shaving and the "big, big, enema!" they gave her. She seemed to never tire of telling the story and always spoke with a tone of awe when she described the enema. This in itself says something about the labor and delivery enemas of the 1950's because my mother was no stranger to enemas and took them all of her life on an amazingly frequent basis, but that one enema always stood out in her mind.

Had my first wife not gone into heavy labor so quickly from the time she arrived at the hospital, very likely they would have given her an enema before our son was born. It was standard practice back in 1970. She told me later that the enema she "thought" she was going to get was the worst part of the whole delivery process for her, and was absolutely delighted when it didn't occur. Obviously, enemas were never part of our sexual activities. .

My Mother never could believe how much I loved taking enemas while I was growing up. I would often beg Mother to give me one even if I was not the least bit constipated. In fact, I have no doubt that she knew that as well. Mom would just shake her head in unbelief! I remember her telling me, more than once, that she'd had only one enema in her whole life and that was right before she had me and that if she ever was to have another they'd have to catch her and that would not be easy. Mama really did not like them and I know Mother thought I was absolutely crazy to want to get enemas! But, I didn't care! Enemas felt good to me and I just wanted her to give them to me with her Rexall Victoria Combination syringe. My favorite.

I for one am very glad they don't give them anymore. Labor is so intense that anything they do that would make it more uncomfortable should have a gigantic benefit.

I had heard the "if you're worried about pooping during delivery then you probably should have an enema" bit, but if my wife had wanted one I would have strongly suggested taking care of it at home as prelabor starts. There's no reason to make a woman's life more miserable during full labor, especially for something that's mostly placebo.

I remember when my wife was about to give birth to my first born. We had gone to the hospital thinking that it was time. She was placed into a room and monitored. Another lady, a neighbor of ours, was also in the labor and delivery area expecting the birth of her child. She, however, was fully prepped.... shaved and given an enema. My wife, on the other hand, was not. She was just monitored. After several hours, both women were sent home. My wife and I laughed all the way back home thinking about what happened to our neighbor. When it became time for my first to come into this world, I do not know whether my wife was given an enema or not. She never told me and during that era, men were not allowed back in the labor and delivery area. However, when my third child was born, I was allowed back and yes my wife was given an enema prior to child birth. It was one of those "Fleet" types. Did it work? Well, she pooped a little bit. But, did it work, really? Well, during the birth, my wife pooped a whole lot more as my child was coming into this world. All the nurses did was wipe her anal area as the poop came out. It appeared to be normal activity. "Fleet" enemas, to me, are not enemas at all..... Well, according to the dictionary, I guess, they are, but really? Anyway, when I got the itemized bill from the hospital, do you have any idea how much that 25 cent, at the time, enema cost? $55.00.... WOW! Talk about inflation!

Prior to the birth of my first child, my mother told me that I would probably be given a large soapy enema in the labor room. The thought of an enema under those circumstances did not thrill me but I was not afraid of an enema. Once it was determined my labor was real, the nurse told me it was time for my enema. She gave me a Fleet instead of the expected large volume enema. I don't really remember much about it because I had other things on my mind at the time.

For my second, I probably waited too long at home before going to the hospital. Once I got there it was rush-rush and everything was over in just a few minutes. No time for an enema, or anything. When I was packing up to leave a few days later the nurse put a Fleet in my bag to take home. I asked her what that was for. She said every labor room kit has one in it. I paid for it, so I might as well take it home because some day I will need it.

I have heard they no longer give enemas prior to childbirth.

Cheryl: When my wife gave birth (twice) in France, the leaflet advised her to take a glycerin suppository and have a bowel movement before leaving home for the maternity ward. Some women have a Microlax, which is like a micro-enema - I suspect liquid glycerin.