Post partum fundal massage - necessary?

I also had an excruciating pp "massage" after my first baby was born. I was not bleeding excessively but because I have a tendancy to bleed the OB thought it was necessary. He does it routinely to all of his patients. I also think he used it as an excuse to "get back at me" somehow because he was angry that I had a birth plan and wanted to stick to it, so it was extremely painful... more painful than any contraction.

With my daughter's birth (just last week) I had a lovely CNM in the hospital when my homebirth plans had to change last minute. Even though I had to be in the hospital because my clotting factors were too low she did not do a uterine massage at all. She checked to feel my uterus and said it felt fine and like it was contracting well. No massage at all.

That said, about an hour or so after her birth I did a gentle massage myself. Not because the bleeding was bad but just because I wanted to and it felt right. It seemed like a nice way to thank my uterus for 9 months of hard work! It also felt good when the afterpains started while I was nursing. I did it ocassionally for the first few days and I think it made the nursing cramps much more bearable.

They wanted to give me a shot of pitocin right after DS was born, just to be on the safe side to get my uterus to shrink down. Nothing was going wrong at that point and DS latched on right away to nurse (which also helps your uterus contract down). Later when I was talking to my doula she said she was very surprised that my midwife was trying to get me to take the shot of pitocin, because she had never seen her do that before (she wondered if maybe my midwife had had someone hemmorage recently and was feeling spooked). In any event, I said I did not want the pitocin unless we saw signs of a problem that required it.

And nobody massaged my uterus, except when the nurses felt my belly periodically to check how my uterus was doing. Like some pp, I massaged it myself though (and tried to get DS to nurse as much as possible--which is a good thing to do anyway ), because I did not want that shot of pitocin. I think the massage hurts less if you do it yourself.

Sounds like you are being very thorough with thinking things through for your birth. This is one thing I did not plan for when I had my son.

Thanks everyone for the input. I also have on my birth plan that I do not want any routine pitocin after I birth the placenta unless it's truly warranted. And of course, I plan on trying to nurse asap and often

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Thanks I'm trying. It really helps that this is my third because I'm pretty familiar with all of the details of what happens and what I do and don't want. I have no problems stating my wishes either

..off to go check out Goer's site..

I hated that. It happened with my first two as "routine" pp care

With ds2 no massage....and no problems!

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What bleeding disorder do you have? We had a big scare earlier this year when our local lab severely screwed up ds2's bloodwork. They told us he had hemophilia and sent us to a hemophilia center. My dh has von Willebrand disease, type 1. Before the hemophilia center did their own labs, they asked me family history type questions and I called my dad and found out a bleeding disorder (not identified, but it sure sounds like vWD) also runs in MY family. Ds turned out to only have type 1, and actually had normal levels of everything but vWF, which was only a little below the normal range (sounds like he will take after dh, who has never had a single problem, and not his uncle who had problems, which is why dh found ou he has it as well.) But I was already pregnant, and still nursing anyway, so I couldn't be tested. So I'm still slightly worried that I have vWD also and this new baby might have a chance of having type 3, which is a really scary thought.

Anyway, I had abnormal bleeding w/ my first 2 babies and no one caught it. I didn't know it wasn't normal to have a period-like flow for a full 6 weeks, so didnt tell my OB's. At my initial interview at the hemophilia center, the nurse or doc asked me right out what kind of pp bleeding I'd had. She said that was abnormal and a sign that I could have a bd, like my dad (my dad was told he had a bd when he was a kid, but then his doc told him he "outgrew it." ) No wonder I got so anemic after each birth! So what precautions did you take for your bd? My midwife has never had anyone w/ a bd avea homebirth w/ her before. I know she did a bunch of research on her own and feels it's safe for me to have a hb and she's prepared. She has pitocin and we are less than 10 min away from the hospital (and that's if there's traffic.) ANyway, I never talked to anyone w/ a bd who considered hb before, so I was just wondering about your experience (even though I might not even have one.)

And on the original topic, I had a light massage after my first was born, and then later that day and the days following, I had some not so nice nurses give me hard massages before realizing my uterus was already so small, they had trouble finding it. After my 2nd was born, I had a more vigorous massage than I remember having w/ ds1 and it was excruciating! I think it had more to do w/ the pitocin I was being given though (even though my birth plan said NO PITOCIN unless necessary and I said no pit!) After that, the nurses were very nice and checked my uterus, but didn't massage it. It was always back to almost pre-preg size 24 hours later. I assume that's the norm for nursing moms, so I also don't understand the routine hard massage!

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I'm a bad nurse. I never massage their funduses unless there is some good indication. I feel to make sure it is contracting down appropriately and if it feels anywhere within the normal range I let the poor mom be. I also don't look at her bum every time I come in. I ask her to tell me what she feels is going on, bleeding wise, swelling wise, and tell her if at any time she wants me to take a look I will but otherwise I leave her alone. Breastfeedin or not, I don't do it routinely, just as needed, which honestly is hardly ever. They would probably kill me if they read this (nurse managers) but I just don't follow all the protocols exactly. With my own baby, my fundus was never massaged. The MW checked it and I knew what to look out for and would have massaged it if I needed to but I never did. I don't understand why it shoud be standard. I don't understand why alot of things are standard.