question about post partum uterine massage

[luckymama]

hi! when i birthed my son three years ago, it was in a hospital and the nurses had (and still have) a rule whereby if you decline the pitocin injection after delivery, they come in every 10-15 minutes and perform a very painful, very aggressive massage of your uterus in order to "prevent hemmorage."

i am planning a midwife attended birth at the same hospital (they did not have midwives when i was there before ... this is new for them). i took a tour of the hospital, and my m/w said that this procedure is still in effect, even though she does not agree with it.

so i was wondering if the uterine massage is a normal protocol? is it necessary? can anyone explain this more fully to me.

the one thing i do recall is that it was horribly painful, much moreso than the childbirth itself. so i figured, perhaps if i understood it better, it wouldn't be so awful this time around.

thank you in advance for any insights and thoughts!

[ckhagen]

Ugh... they did that to me after my c-section of all things. Talk about feeling like you're going to burst wide open... Luckily I showed results quickly so they didn't have to do it more than once or twice.

[zoe398]

Slightly OT....
The massage performed in the hospital is certainly less than gentle, here's some info on Mayan uterine massage.



http://www.arvigomassage.com/rosita.html

[nonnymoose]

I had a hospital birth w/ my son, and refused the pit afterwards (never actually said "no," just pointed to the baby hanging off my boob ), I don't recall anyone trying fundal massage (that's what it's called, btw) on me . I can see them wanting to do it if you're bleeding more than you should be, but not otherwise.

eta: I guess with a c-section mom is out of luck. going to be hard to talk them out of it when there's a uterine incision involved.

[maxmama]

Fundal checks are routinely done in hospitals, but massage should only be done if the uterus is boggy. There's a HUGE difference between a fundal check and a uterine massage, but if someone is bleeding excessively, stopping it is frankly more on my mind than the fact that a fundal massage hurts.

[kerikadi]

I had two hospital births in 92 & 95 and two homebirths. My uterus has never been massaged. Can't you just say no? Maybe if you have a hospital birth you can leave before they have a chance to do it.

Keri

[ckhagen]

Interesting. I did not have any excessive bleeding...
They told me as they were prepping me that after the section two nurses would come and do this and to be prepared for it because it would probably be painful. Holy heck yeah it was painful! They did it while I was holding DS for the first time in the recovery room.

[savithny]

Never heard of it.

Two hospital births and never had such a thing.

I think I did end up with a shot of pit after baby #1, but I know I didn't after #2 and no one messed with my abdomen (other than to show me my abs were separated and how to do crunches holding them together!).

[courtenay_e]

Here's the thing. You can require that they do a fundal check before they administer pitocin, AND before they do fundal massage. You can also do the check yourself occaisionally. Your uterus (while laying down) should feel like a firm grapefruit, in both size and shape. If it feels like this (especially if you're breastfeeding, which causes the release of NATURAL oxytocin, and makes your uterus clamp down...), you shouldn't NEED pit OR fundal massage. It doesn't matter what "policy" is, you have the legal right to refuse any and all medical procedures. If you don't feel that the massage is necessary, you have the right to say no. It makes complete sense that they do a fundal check at every fifteen minutes for an hour or two, to be sure that you don't bleed out. However, if you're clamped down, there's no reason they need to treat you in this manner, except to PUNISH you for annoying them by refusing to follow protocol. Just my two cents...

[boscopup]

They did the evil fundal massage (and "massage" is NOT a good word for that!) on me a few times after my hospital birth, and I DID have pit after the birth! : I was not breastfeeding (baby was too young and in the NICU), but I was pumping. I did not have unusual bleeding or anything like that. The nurses didn't just check the uterus - they went straight to "massaging", and yes, it hurt worse than labor! Ouch ouch ouch. That is probably the BIGGEST fear I have of ending up in the hospital again.

At the time, I didn't realize that this "massage" was not necessary, so I didn't know to decline it. Next time, if I have to be in the hospital, I will definitely tell them NO MASSAGE unless it's necessary (ie, the uterus is boggy). I didn't realize how much "fundal massage" would hurt until they did it, and it's just not something I had researched before my first birth!

[Marlet]

I had it with DD. I wasn't offered pit after the birth and they did it only a few times. I thought it was to help expel any clots and to help it get to shrinking again? My sister had one as well and told me about it so I was prepared. I had thought it was neccessary. Guess not.

[sciencemama]

The nurses at my hospital came in and showed me how to perform a fundal check myself but they never did anything aggressive or uncomfortable.

[bradleybirth2mom]

Just refuse it.

If you are not hemorrhaging (soaking two pads completely per hour) and are actively breastfeeding, there is no need for it. Tell the nurse no. She won't be happy, but it will save you the unnecessary pain.

[Autumn_Breeze]

I had the post partum massage almost hourly after my first child was born. I felt very bruised from that, haven't had it done with my second child thankfully. It won't be done with this one either.

[cfiddlinmama]

I've had it with all 4 of mine. 2 in the hosp. & 2 @ home. It's HORRIBLE. I didn't know it was unnecessary. My CPM is so good, yet she's done it twice. Why isn't it necessary? I knew to refuse the pit, but can y'all give me some good reasons to refuse the fundal massage besides the fact that it hurts so much?

[maxmama]

Hurting is pretty much it. If someone's not bleeding excessively, I don't massage.

Fundal checks do seem very reasonable to me, and though they can be uncomfortable for the ten or so seconds it takes to do them, they're also very helpful in assessing whether your bladder is too full (some mamas, even after an unmedicated birth, just don't feel the urge to pee when their bladders are very full -- maybe because they're so used to a baby sitting on it).

[pamamidwife]

what about talking with your provider about having YOU check your own uterus? It's so different - there's no need to have any touch your uterus unless you're bleeding too much.

[Peppamint]

so i was wondering if the uterine massage is a normal protocol? is it necessary?

Ugh, I had that with my hospital birth (I had lots of stuff done to me ). I did NOT have fundal massage with my two homebirths. My mw did ask to feel my fundal height but that was it. She didn't even do anything to me at all... with ds I asked her to check me for tears because it happened so fast but this time I didn't even have her check me for tears or anything. After my hosp birth I had nurses I'd never met before coming in to check my stitches (episiotomy) and such and it was very degrading IMO.

I can't tell you how much it means to me to get care where I'm asked before someone does something to me or I just ask if I want to be checked.

[kerikadi]

After thinking about this I do remember that in both the hospital and at home with my MW my uterus was palpatated and both times it was declared 'back to normal size' in less than 24 hours after all of my birhts. Maybe that is the reason they did not massage it?

Keri

[luckymama]

thank you everyone for all the responses! what a help for me!

i do not recall anyone saying that i was bleeding excessively. i don't even recall anyone really doing a check, so much as plunging right in ... WHILE the doc was checking me for rips and tears and my new baby was trying to latch on. poor kid was feeling and pulling, and there i was screaming from the surprise of the pain. so this time, i think i'll figure out how to get checked or check myself and go from there. golly i wish i'd had you all around last time i had a baby.