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Mashing on uterus, pulling cord???

1K views 4 replies 4 participants last post by  geeweemama 
#1 ·
I am a new Bradley teacher and I just attended my first hospital birth.

Wow! What an experience. The birth was beautiful, as I'm sure all births are, but the midwife was very hands-on and talking incessantly. She also did several things that I wasn't familiar with (ie: was horrified with).

Can someone please explain?

The mother, late 20s and very healthy, had a quick labor and delivery. No drugs. Was GBH+ and refused the IV antibiotics. The baby was anterior with his hand on his cheek. He latched on, like an old pro, immediately after birth.

1. The midwife said, "Now, I'm going to birth the placenta." And pulled on the cord. Hard! Why?

2. Mom was nursing and said she was feeling contractions. Then, the midwife mashed - hard- on the uterus. So hard that the mother cried out. And 10 minutes later the L&D nurse did some more mashing. Why?

I was in shock, speechless. I knew my Bradley training was minimal, I knew I was going to have some surprises, but these two things were so foreign to me. (I had a homebirth with very hands-off direct-entry midwives, my placenta detached about 30 minutes after birth - no pulling or tugging. And no mashing on my uterus!)

3. Are there any circumstances under which these procedures should be done? Can I tell future students they are able to refuse these procedures? As little as I know, these procedures were all about speeding up the afterbirth.

4. One more question: Should all tears be stitched? Is this something a mother could choose not to do?

Thank you so much! Many of my students will be birthing in this same hospital and I want them to be prepared. The mother looked at me when they were pulling on the cord and mashing her uterus and I told her, "I'm so sorry I didn't tell you about this. I didn't know."

This makes me feel like a bad teacher, especially because I told them that my goal as a teacher was for my students never to think "I didn't know that would happen" during their births.

Warmly,
Mary, mom to Goodwin (2)
 
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#2 ·
Awww, I send you big hugs -- the first hospital birth is a shocker! Nearly all the hospital births I've attended have been like that: beautiful labor, beautiful birth, and then the third stage is INSANE.

1. Pulling the cord is something I see a lot. It makes me cringe. It's just to get the placenta out faster. Have I mentioned that it makes me cringe? I've seen a cord detach from the placenta and then the midwife or the doc has to manually remove it, which is basically inserting her hands into the woman, basically up to her elbows ::cringe::

2. Mashing -- that's a good way to put it. Here they call it "massaging" but I'd say mashing is a better visual. I believe the reason behind it is to get the uterus to begin contracting, but all I've ever seen is that it makes mom hurt and bleed. So, obvs the uterus will contract and get smaller, and then the nurse comes in and "measures" it, via more mashing. It's really gross and also makes me cringe.

3. As far as refusing, sure, the mom can definitely speak up and say NO CORD TRACTION and NO FUNDAL MASSAGE. I have no idea how the hospital "policies" would come into play. It's stuff that happens so quickly in my neck of the woods, and usually the mom is a little busy, having JUST HAD A BABY, that she's not in the right frame of mind to object. Ugh.

4. Yeah, not all tears need to be stitched, usually anything less than a 2nd degree or a mild second degree don't need to be stitched. I think it's a provider thing -- some providers are more willing to let things heal on their own.

It took about 5 births at the same hospital before I could basically recite the policies to all potential clients. It's very valuable, especially for a primip, to know exactly what's going to happen from the minute she steps in.
 
#3 ·
Pressing on the uterus/fundus before the placenta comes is not good. Some midwives keep a hand on the top of the fundus so they can feel if there is a concealed separation- but no pressing or mashing/massaging, it could cause partial separation which is not worth "saving time".

Not all tears should be stitched... 1st degree tears generally heal quite nicely if just left alone and if mom takes good care of herself in the postpartum period.
 
#4 ·
It's pretty lucky even to have a nice birth in the hospital. To have a decent third stage and/or postpartum is next to impossible. Routine + fear + stupidity = hospital suck


Usually none of those things are necessary, but they're often done anyway.
 
#5 ·
Wow! Thank you all so much for this information. I will pass it all onto my students. I have already ammended my sample birth plan outline to include NO cord traction and NO fundal massage.

What a surprise that birth was for me, I wish more women in my area would consider a homebirth for their first birth.

Thanks again for your help!

Warmly,
Mary, mom to Goodwin (2)
 
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