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Nurses pushing on stomach after birth - help.

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pregnancy
29K views 228 replies 43 participants last post by  Katie8681 
#1 ·
I'm going to have my 4th baby in April (3rd VBAC). 5 years ago I had my 3rd girl which was an all natural hypnobabies birth at a hospital. After I had her, the nurse literally pushed over and over and over again on my stomach getting more blood to come out each time and citing that it was "necessary" to do so. I felt that she was using as much pressure as she could with both hands on my stomach pumping vigorously and more than a bit EVIL! My thought was that the blood would eventually come out on its own - wouldn't I be bleeding for weeks anyway? It hurt so badly and felt like torture to me. I literally wanted to jump out of the bed and smack her. I'm wondering if this practice is really necessary, why it's done as it wasn't done to such extremes with baby #2 which was also a VBAC and how to prevent it from happening in April. We are going with a midwife this time and a different more natural birth friendly hospital, but I want to be prepared in case it happens again. And again, this was the nurse that was doing it - not the OB. Thanks for any help!
 
#2 ·
Yeah- they did that to me too each time in the hospital. And now that I think of it- my hb midwife (baby #4) did NOT do this one bit! I would ask your midwife why and if they do that where you will be delivering. Could it be to get the placenta to detach quicker? I don't know- I know that I had to deliver the placenta at the hospital right after the baby way born- and when I was at home the placenta didn't come for about 30 minutes or longer- which was awesome to have a nice break. I don't know if that is the reason- just my guess.
 
#3 ·
I gave birth in the hospital and they did this a little after my vaginal birth, but after my c-section it was really bad. It had nothing to do with the placenta, this is in recovery, later. I was told that it had to do with checking on the blood clots, because if they are a certain size that would be a safety issue. I assume it was worse after the c/s because I'd just had a major surgery in that area!

I'd talk to your MW about it and call the charge nurse in your hospitals L&D dept. That's who would be able to explain the reasoning for that and discuss your choices with you. If it is about clots, perhaps there are other things they can do. I understand your fear, because it was pretty horrible my last time. For some reason it wasn't too big of a deal with my vaginal birth, but it was over really fast that time. Good luck in coming up with a plan you feel more comfortable with!
 
#4 ·
Fundal checks and fundal massage.

http://community.babycenter.com/post/a4182425/why_do_they_massage_belly_after_birth

This is what &D nurse wrote above

"I'm a postpartum nurse and the one doing the fundal checks. Labor and delivery nurses do fundal massage in the first hour or so after the birth to ensure that the uterus clamps down like it should to slow the bleeding. This can be uncomfortable. This helps to dispel clots and placental/amniotic fragments and such as well. During this time, you may also receive pitocin through an IV, an injection in your leg, or a suppository if your bleeding is heavier than they would like. We also do fundal massage if your bleeding is too heavy, if your uterus is lax, or if you pass large clots for the same reasons. Once you are stable and there are so signs of heavy bleeding or clots, we generally only do fundal checks 2-3 times in 24 hours to catch potential bleeding complications before they start. These fundal checks and massage are much easier than the alternatives if you are bleeding! You could opt out, I suppose, but it would make it very difficult to do our jobs of making sure that you are safe, healthy, and able to care for yourself and your baby. The uterus does shrink back on its own, but sometimes needs encouragement and that is what we are there for!! "
 
#5 ·
As unpleasant as this is I was told by my midwife that this is something she does somewhat regularly to prevent excessive bleeding. They aren't just pushing blood out they are helping the uterus clamp down after the fact to stop too heavy of bleeding. I had it done after my first 3 pgs and hated it but never thought much more about it. Then came number 4. He was an unexpected UC delivery, he just came so fast no time for the midwife to arrive. Before he was completley out I already knew something wasn't normal cause with each push lots of blood would come out. Then once I delivered him I just kept bleeding very heavily. We ended up calling the paramedics who were idiotically obsessed with the fact that the baby's cord hadn't been cut and acted like it was life and death if that that wasn't done immediatly. So even though I mentioned the heavy bleeding they didn't pay much attention until we got into the ambulance where I started hemmoraging and thats the last thing I remember for some time. Long story short after i retold the events to my miwife she had told me that if she had been there she would have "massaged" the uterus and it most likely would have stopped it from getting to full blown hemmorage. I don't know your situation but maybe the nurse didn't like the amount of bleeding she was seeing and wanted to be proactive before things got out of control? Just a thought.
 
#6 ·
I just gave birth (hospital) on 2/1 and I can feel your pain...literally! I don't remember them doing that with my first 4 years ago but they probably did. It DOES feel like pure torture and I also wanted to smack the nurse. If only pushing really hard once wasn't enough, she kept doing it over and over again to get all of the blood and urine out. I never knew why she had to do that so thanks for asking this question! I am learning a lot as to why they need to do it. I just think using the term "massage" is a little misleading, however
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#9 ·
I had some bleeding, enough that my mw told my dh to feed me iron rich foods for dinner and a while (thus broccoli beef, yum). I think there was even thought of transfer, but no one mentioned anything to me.

My MW never did any fundal 'massage' (if you can call it that)

I figure if I start bleeding too much I'll take a bite of my placenta. That should stop things pretty well.
 
#11 ·
My first two births were with my midwives, and I can't quite remember if I have fundal massage after their births. I had some pretty bad bleeding with my first, nearly passed out and had to have an IV, so I'm rather certain that's what they did. It was almost 12 years ago (my baby is so big! lol) so I can't recall exactly. #2 is kind of a blur as well. I know with my son in the hosptial they definitely did it, but I had an epi so I didn't feel much. I do remember that it was very uncomfortable and doing a lot of the massaging myself. I didn't bleed excessively that time, though.
 
#12 ·
One of the midwifes I had for my last baby prepared us in class for it- it is called fundal massage, but she would joke and say it is "more like fundal punching." Maybe the nurse or midwife you had probably should have warned you first what they were doing. A little "I'm going to massage your uterus to make sure it clamps down and slows bleeding. It will be uncomfortable." would go a long way in warning you about what needs to be done.
 
#13 ·
I've never had excessive bleeding, but I can totally understand that if there IS excessive bleeding, or the uterus doesn't seem to be shrinking or contracting the way it needs to, or suspected retained placenta, or whatever *abnormal* thing is happening, that unpleasant measures might need to be taken which, though unpleasant, are better than, say, bleeding out and dying. That said, never, in 3 births (1 c-section, 2 hbac) has anyone ever done more than very gently feel for the location of my fundus to verify that it was firm and shrinking. It has never been painful or even uncomfortable. Since everything was normal, nothing else was done.. as it should be.. if its not broken, don't fix it.
 
#14 ·
I'm only in my first pregnancy, so I can't offer any advice or direct experiences. My friend (a true trooper in the delivery room!) mentioned that the nurses "pushed" on her stomach afterward, but she didn't present it as a big deal. Thank you for your insight; I'll be sure to mention to the nurses in the beginning stages of delivery that I'd appreciate a heads up and/or gentle massage rather than hard pushing. I can see that massages are necessary (or helpful), but I'm sure there are different ways to do it.
 
#15 ·
This was done to me with my last 3 births. And though I was in a hospital, it was midwive who were caring for me. The one that started it, I bled very badly, so from now on they do it preventatively.

Yes, it hurts. This last time they did it very mildly to start with, but because of the amount of blood and size of the clots, they got more vigorous. It was seriously as bad as labor. But I would rather that than bleed out. And because I knew what the midwives were doing, and the reasoning behind it, I was OK with what was going on.
 
#16 ·
The thing with it was that she never said I had excessive bleeding or that it was too much blood to be comfortable with. I wasn't even lightheaded and yet, she was like a nazi about it. It was not a massage - punching was a more accurate term!
 
#18 ·
When the placenta detaches from the uterine wall, the blood vessels that have been supplying it for the past 9 months are still open. They are interwoven with the muscle fibers of your uterus, so if your uterus contracts down, you will not bleed too much. If the uterus does not contract down well, the blood vessels will continue to bleed freely. When a nurse or midwife checks your uterus after birth, they are feeling for the tone of the uterus - firm or boggy. If it does not feel firm, the first thing they need to do is to cause it to contract, which is what fundal massage does. If your uterus is boggy, it's going to hurt more than a uterus that is clamping down nicely - unfortunately, if you need it, it's going to hurt. Sometimes, more vigorous massage is necessary to expel clots that can block the cervical opening and cause concealed bleeding. Also, anything in the uterus can prevent it from contracting effectively, so the clots need to come out. So that's the deal with the fundal massage.
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#20 ·
I don't recall having this done to me. But my OB did gently massage my belly as she pulled my placenta out. Maybe she didn't need to be rough because I breastfed immediately?? Since BF makes the uterus contract I wouldn't think it would be necessary to do a rough massage.
 
#25 ·
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).
 
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