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Nurses pushing on stomach after birth - help. - Page 2

post #21 of 229

 I have read delivering the placenta in a vertical position will aid in the uterus clamping down as the weight from your organs above helps. Of course that is not always an option in some settings or with epidural.

post #22 of 229

Depends on the nature of the epidural...

post #23 of 229

I thought walking epidurals were not allowed in all hospitals?

post #24 of 229
Quote:
Originally Posted by Buzzbuzz View Post

Isn't that one of the advantages of an epidural -- that fundal massage, if needed, isn't painful?

 

No, since it's something that's done postpartum.

 

 

post #25 of 229

Actually, isn't it usually done almost immediately post-partum?  A friend says she had it performed while the epidural remained in place (also remained in place for a short while after delivery to deal with afterpains).

post #26 of 229

I don't know how I stumbled upon this thread but...

 

This didn't happen to me.  I was hemmoraging because I take blood thinners but no one massaged me, they just kept checking and changing my pads.  Could they have not done it because it might release too much blood?

post #27 of 229

I've had two homebirths and have never had this done.  And no one ever pulled my placenta out either; I just pushed it out all on my own.  Afterward, I almost immediately started nursing my baby, and we just checked periodically to make sure the uterus was clamping down ok.  

 

My dad is a doc and has delivered a few 1000 babies ;) - and he has told me of a few times where he's had to do fundal massage in order to convince a lax uterus to contract appropriately.  But he's never mentioned that being standard protocol - he did it only when there actually was an issue, not as a preventative measure.  The uterus, when left to its own devices, generally gets things right.  But if you are pulling on the placenta to get it out, I can see that you may need to do this, since it's not being given time to do its own thing.

 

Reading the nurse's explanation - it seems like just one more thing they think they MUST do to ensure your safety.  Really, it seems to me that simply checking that the uterus is clamping down periodically and educating the mother on what normal bleeding looks like (which is what my midwife did) should be sufficient to ward off issues. 

 

 

post #28 of 229

Fundal massage is standard protocol, and should be done in all births. It's a part of the "active management of third stage" which is encouraged by the WHO. It prevents uterine atony and PPH. It is an imperative part of the birthing process, unless you want to lose an uncommon amount of blood. It can hurt, but it's very important. Nurses and midwives don't push on your belly to hurt you, they push on your belly to control postpartum bleeding.

post #29 of 229
Quote:
Originally Posted by holly6737 View Post

Fundal massage is standard protocol, and should be done in all births. It's a part of the "active management of third stage" which is encouraged by the WHO. It prevents uterine atony and PPH. It is an imperative part of the birthing process, unless you want to lose an uncommon amount of blood. It can hurt, but it's very important. Nurses and midwives don't push on your belly to hurt you, they push on your belly to control postpartum bleeding.


I saw an ob/gyn about 12 hours after my UC, and he commented about how nicely my fundus had contracted down. He also didn't seem to think I was losing or had lost an uncommon amount of blood. I delivered baby and the placenta in upright positions, nursed my baby, and took sheperd's purse after. No fundal massage. shrug.gif

 

Personally, this type of healthcare - an exam/procedure is indicated or necessary sometimes for someone in some circumstance = everyone must do in every case all the time, is the kind of care I am seeking to avoid.

 

 


Edited by slmommy - 4/6/12 at 11:46am
post #30 of 229

Quote:

Originally Posted by slmommy View Post

I thought walking epidurals were not allowed in all hospitals?


At my hospital, I was told that it was ultimately up to the anesthesiologist. 
 

post #31 of 229
Quote:
Originally Posted by slmommy View Post


I saw an ob/gyn about 12 hours after my UC, and he commented about how nicely my fundus had contracted down. He also didn't seem to think I was losing or had lost an uncommon amount of blood. I delivered baby and the placenta in upright positions, nursed my baby, and took sheperd's purse after. No fundal massage. shrug.gif

 

Personally, this type of healthcare - an exam/procedure is indicated or necessary sometimes for someone in some circumstance = everyone must do in every case all the time, is the kind of care I am seeking to avoid.

 

 

 

It's fine with me if you don't want to do fundal massage. I'm not sure how you would do it on yourself anyway since you UC. The fact is, though, that the World Health Organization recommends fundal massage after delivery of the placenta and they are a very evidence-based organization. You can choose to not follow the evidence-based recommendation if you'd like. It's your uterus.

 

 

post #32 of 229

eh, I'm not arguing against the importance of fundal massage in some situations, I just don't see why it would always be necessary following every delivery. And if I did not need it, I would not want it. If I had a hcp for next birth, I would like someone who could make that call based on my situation at the time, guess that is just me.

 

WHO recommends a lot of things that American maternity care does not always follow... from what I remember, c/s rate should be under 15%?, more mws, cautions against routine use of arom, episiotomy, oxytocin... it's been a while since I've looked into it.

post #33 of 229
Quote:
Originally Posted by slmommy View Post


I saw an ob/gyn about 12 hours after my UC, and he commented about how nicely my fundus had contracted down. He also didn't seem to think I was losing or had lost an uncommon amount of blood. I delivered baby and the placenta in upright positions, nursed my baby, and took sheperd's purse after. No fundal massage. shrug.gif

 

Personally, this type of healthcare - an exam/procedure is indicated or necessary sometimes for someone in some circumstance = everyone must do in every case all the time, is the kind of care I am seeking to avoid.

 

 



Yeah, the bolded. I will not sit here and say that fundal massage is always unnecessary...but I'd also like to suggest that many it's not necessary every single time. This idea that it is totally necessary every time, for every woman, is nothing more than another way in which the medical model seeks to assert that, if left alone, the body will surely fuck up and kill you at some point during/directly after your birth. It's nonsense. If you need it...you should have it, it could save your life. If you don't need it and don't want it, you shouldn't be subjected to it because it damn well hurts like hell. It's not like it's black or white...you can just check the uterus and see if it needs help and give the help it needs...ONLY if it needs it. Doesn't that seem reasonable?

I've had two intense, but peaceful, 90 minute out of hospital births here and no fundal massage either time. I know that my MW did touch my uterus to try and determine if it was having trouble clamping down (and, being at home and far from a hospital, I don't mind being checked to make sure I'm not bleeding "uncommonly")...but that was NOT immediately post partum and my uterus was doing a fine job, so there was no massage of any kind to "help it" clamp down.

Furthermore, were in my home OR at a hospital and someone came along and started doing something to me that hurt me very much and I didn't know the reason why..they would be stopped immediately and told to back the F off and explain to me what was going on. Nobody just walks up to me and starts doing anything to me that feels anything like torture without fully explaining themselves and if I don't understand or I think it is unnecessary, I'm not going to allow them to do it. What are they going to do? Strap me down and assault my fundus? That's ridiculous. Completely ridiculous.

 

 

OP, I have heard many women say that they are not in any way fearing birthing pain or any other aspect of their birthing time...EXCEPT the massage after the fact. I know it's brutal...I'm sorry it happened to you! Maybe they can just check you out this time and see if you actually need it?
 

 

post #34 of 229
Quote:
Originally Posted by holly6737 View Post

 

 

It's fine with me if you don't want to do fundal massage. I'm not sure how you would do it on yourself anyway since you UC. The fact is, though, that the World Health Organization recommends fundal massage after delivery of the placenta and they are a very evidence-based organization. You can choose to not follow the evidence-based recommendation if you'd like. It's your uterus.

 

 


My, what a nasty tone you've taken. ROTFLMAO.giflol.gif

As far as the WHO is concerned...yeah, I think some of what they say makes a lot of sense...and that a lot of what they say makes *some* sense...and that some of the things they say/recommend are complete and shameless bullshit and make no sense at all. "Evidence" comes from research...shitty research makes for shitty evidence...so, there is such a thing as a WHO recommendation based on shitty evidence...therefore, "shitty recommendation" - I'm not saying that the recommendation that fundal massage be AVAILABLE to all mothers who have given birth is shitty. The bottom line is, there is no one organization on earth that you can look to for the "ultimate truth" every time. The fact that the WHO "said so" means about jack to me until I see the research behind it. Have YOU personally seen the research that provided the evidence upon which this WHO recommendation is based?

The simple FACT of the matter is, not every woman needs it every time. Can't you agree to that? A competent birth worker/woman can check the uterus, observe the bleeding, inspect the placenta and make a more than reasonable guess as to whether or not it is needed.

I do not object to unnecessary fundal massage just for the sake of being contrary...I actually prefer, based on research/evidence/experience, to allow my body to function unhindered when it is doing it's work well. I do not believe that nurse-nosy and her torture hands knows how to clamp down my uterus better than my uterus, until my uterus is not doing it right.

 

post #35 of 229

active management of third stage also includes pit and pulling on the cord to yank the placenta out. should both of those procedures be part of every birth as well??? 

post #36 of 229
[quote name="holly6737"  

It's fine with me if you don't want to do fundal massage. I'm not sure how you would do it on yourself anyway since you UC[/quote]

Actually it's easy to do on yourself. I have worked in places where women are shown how to check their own fundus and massage if necessary.

post #37 of 229
Quote:
Originally Posted by fruitfulmomma View Post

active management of third stage also includes pit and pulling on the cord to yank the placenta out. should both of those procedures be part of every birth as well??? 



Exactly.

post #38 of 229

For those who were saying they felt fine and things seemed normal when all of a sudden the intense fundal massage was done: I had a PPH and it was a serious bleed. Baby was at my breast after my non-augmented, non-medicated, spontaneous placenta birth, and suddenly I felt a gush and said so. It honestly didn't feel like much. I certainly didn't feel lightheaded or anything, since becoming symptomatic often only happens once a PP mother has lost a _great deal_ of blood. My midwife and my husband told me later I had been absolutely gushing bright red blood. I totally trusted my midwife and nurses to do what was necessary, and asked the questions later. I would encourage people to ask their care providers afterwards what the heck happened. Some nurses/midwives/docs are too rough, it's true.

post #39 of 229

It sounds like your 1st was a c-section (if your second was a VBAC) and this is simply much more painful after a c-section and most nurses are a lot more aggressive with it after a c-section. When I asked about it after mine I was told that it's not unusual for the uterus to fail to contract down as it would in a vaginal delivery and it needs a little help. I suppose this makes sense in a scheduled c-section where there were no contractions to begin with. But wow does it hurt.

post #40 of 229

with my second I just wasn't stopping bleeding, slow hemorrhage, my MW had me sit on the toilette, pee, and she pushed on my fundus, and I passes a fist-sized clot that had been keeping my uterus from contracting fully. but she only needed to do it once, and all was well. if they're doing it again and again then either they're doing too much, or your uterus isn't contracting like it should be. 

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