mom in labor, full bladder, can't pee

[JessicaE]

What can be done for a mom in labor who can't urinate?

Example: mom has been drinking plenty of fluid to stay hydrated, birth teams gets her on the toilet at least once an hour to empty her bladder, but at a certain point she feels she just "can't go." We tried running water, time alone, relaxation on the toilet, trying to pee in the shower. She was eventually able to go, but not a great deal. She ended up with quite a distended bladder, which her doc thought contributed to a retained placenta.

Other ideas? Another doula suggested a few drops of peppermint oil in the toilet.

[Ahimsa]

I had this problem when I was in labor with my son. It was preventing my uterus from contracting back into place after he was born.

My midwife had to gently push on my bladder to get the pee out and empty my bladder.

[JessicaE]

Thanks, Ahimsa. I'm sorry that happened to you, but glad it was resolved.

Anyone else? I'm really scrutinizing whether there was something more I could have done as her doula. Her medical team was aware that she'd been drinking water and that at one point she wasn't able to pee. She did go a bit after that when we tried again, but I guess it must not have been much.

Pushing on her bladder probably would be outside my doula scope, but maybe asking her to have her nurse or OB check? This was a transfer birth from a smaller hospital so she didn't have a choice in care provider. I don't think her OB really knew much about natural birth so she may not have thought to check her bladder.

[paquerette]

Did you try the peppermint oil? I have not had an opportunity to try that but I have heard good things.

[nashvillemidwife]

I'm really surprised they didn't use a catheter. I would have if all else was failing. I'm not talking about placing an in-dwelling catheter, just a simple straight in-and-out to empty the bladder and then let her back on her merry way to having a baby.

[DoomaYula]

I've heard peppermint oil.

during my labor with dd1, as soon as I was able to pee I felt the urge to push.

[loudmama]

I second the catheter! I had a client whose baby was not moving down well because she had a full bladder & just couldn't empty it. Put a catheter in & we started to see the baby's head!

I wonder if this is what contributed to my c-section with my DD. I just could not empty my bladder. I think with some women that everything just gets swollen & its hard to isolate the right muscles. After my VBAC with my DS, they had to put a catheter in to empty my bladder. I couldn't empty it enough & my uterus wasn't shrinking evenly or well enough.

L

[Doula Dani]

I am in a rush and didn't read everything, but did she try peeing in the bath tub (rather than the shower)? Sometimes it's a bit easier. I also remember a trick about lifting the uterus (this was actually for overweight women whose uterus's can sometimes 'fall forward' and need to be pushed back to get the baby to descend) but I wonder if using a scarf of some sort under the belly and lifted from behind to help relieve the pressure of the uterus on the bladder. Never tried it, but maybe worth a try?

[Jane]

warm pack on the bladder
peppermint oil in the water or on a kleenex under the nose
rocking forward and back on the toilet
facing the tank of the toilet
peeing standing up
mama lifting the belly with the hands
catheter

[JessicaE]

Thanks for all the feedback and good suggestions. Part of the trouble was she said for awhile that she couldn't go, we kept trying every 15-20 minutes, and she eventually did go shortly before she started pushing (so we thought things were OK). But apparently she didn't go very much, relative to how full her bladder was. She wouldn't allow anyone in the bathroom with her.

We didn't try "straight" peppermint oil in the toilet, but I did have a peppermint aromatherapy spray that we were using because she was nauseous, and because she was worried about the smell in the bathroom after a bowel movement. So there was peppermint in the air.

So some of you have used catheters even on an unmedicated mom?

No one knew/realized her bladder was so full, including the doc. I'm not sure the doc even thought to feel/notice her bladder at any point (I'm SURE she works mostly with epidural moms). The doc did cath her, but only when she took her into surgery for the D&C, and only as a routine matter, I think. She told us after the surgery that she removed A LOT of fluid and that the placenta detached more easily after the bladder was drained.

I will be much more aware of this issue with future births, although I certainly thought we were on top of the peeing issue. I'm not very easy on myself when things like this happen.

[rere]

I had a catheter(just in and immediately out) at my homebirth.An amazing amount of urine was released and I felt much better.As much as I didn't like the idea when my midwife brought it up I was glad I trusted her and that we went ahead with it.

[onlyboys]

It sounds like she would have benefited from a catheter. I've seen one placed (just inserted, lots of pee, removed) on an unmedicated mom who was close to complete. She didn't complain of the pain. I think in this case, the benefit outweighs the risk maybe.

[Jane]

You can use lidocaine on the catheter for a local anesthetic.

Sometimes there is delayed gastric emptying (ie, the food and drink stays in the stomach) that means there is not as much pee as you think.

[anjichurch]

Pepermint EO

Hi there,
I am a midwife and certified as an aromatherapist. I am not sure if i misunderstood the thread but thought I would make a clarification. Peppermint EO is put in the toilet because the "fumes" from it entice the urethra to open. Peppermint Essential Oil is the only way to have this response. Aromatherapy scents do not work the way the Essential oils do. Peppermint EO inhaled would not benefit in a case of full bladder in labor.

Hope this helps...keep up the great work ladies!

[JessicaE]

Thanks for the clarification that the peppermint works on the urethra, Anji, and not through the nose!

[alexisyael]

I had a distended bladder during my homebirth as well... we tried most of the above suggestions (minus the peppermint oil! That's a good one to know for future births). We even tried lifting my extremely heavy abdomen, thinking that was causing the problem (I still feel like it is what caused it, my leaning forward caused the abdomen to squish my bladder shut...) but to no avail. I remember thinking as I was pushing how ridiculous it would be to have to go to the hospital just because I needed to pee! Luckily, that didn't happen

I didn't end up cathed, but in retrospect, it would have been a good idea... I did squats around my kitchen floor, trying to pee on the wood floor (I was serious about it!) but in the end, we decided that I should just push the baby out so I could pee...

I did end up with an internal hematoma (very bad, it required stitches and HURT for weeks) that might have been caused by the distended bladder and also bleed a little more than my MW would have liked... but she knew it was coming and had all the herbs ready. My placenta detached pretty readily, and then I spontaneously decided to eat part of it, which she hadn't heard of, but I had (I just hadn't planned on doing it!) That stopped the bleeding almost instantaneously.

I actually took some uristat (peridium is the generic name, I think?) which helps with UTI pain because even after the birth, I still couldn't pee and I felt like that would help. Which it did.

Next time *if I have another* I'll get a catheter at home, if that is an issue again. (My MW agrees.)

[JessicaS]

Yes, but mine was due to bladder compression, dd's head somehow caught my bladder against my pelvis.They did use a catheter and it did help relieve that feeling of needing to relieve my bladder but by then it was full of blood.

Er..I am not a birth professional I saw this in new posts and wanted to comment as needing to relieve the bladder late in labor is a horrible feeling.

[Doula Dani]

Originally Posted by anjichurch

Hi there,
I am a midwife and certified as an aromatherapist. I am not sure if i misunderstood the thread but thought I would make a clarification. Peppermint EO is put in the toilet because the "fumes" from it entice the urethra to open. Peppermint Essential Oil is the only way to have this response. Aromatherapy scents do not work the way the Essential oils do. Peppermint EO inhaled would not benefit in a case of full bladder in labor.

Hope this helps...keep up the great work ladies!

That's what I was thinking when I read it...like the peppermint would sort of 'tingle' and get things working. Makes sense. Thank you for sharing this!

[bcrn]

i just had a mom pp full bladder,increased bleeding,u+2 and deviated to the right. sat on the potty x2 pofluids all during l+d, did the whole waters running, declined shower, peppermint tea,privacy, etc...no go she asked what else,i said we could wait a little longer or i+O cath. she was afraid of the pain, i told her that she just had a natural birth in 3 hours and its not so bad,after 400cc she agreed! Everyone is different. 2 hours ambulated to the br and #1 no problem!

[mwherbs]

Originally Posted by Apricot

warm pack on the bladder
peppermint oil in the water or on a kleenex under the nose
rocking forward and back on the toilet
facing the tank of the toilet
peeing standing up
mama lifting the belly with the hands
catheter

Apricot's list is my list the with these things added
have mom do some kegels
have the mom whistle
sometimes alternating cold and warm packs on the bladder
running water in the bathroom
hops tea- ( it has a fairly bitter taste)- a little beer same effects
in the summer a bit of watermelon-chew up the seeds too
sometimes with the belly lifting you do a downward light stroke across the bladder