Enema before delivery?! Apparently it's "standard" at my hospital

[gherkins]

Hi,

Just got back from my 2nd antenatal class, and we were told by the midwife leading the class that women delivering at our hospital will be given an enema when they arrive at hospital.

Is this usual? I've never heard of this happening before. Well, actually my Mum said she was given one before having me, but that was back in the 70s! I had no IDEA this was standard - first I'd heard about it

Is this really standard procedure? If so, what's it like?

I'm rather morbidly fascinated

I don't think it is standard procedure, and you can refuse, of course. But I think it probably isn't a bad thing. It's either that, poo in labour, or restrict the passage causing more pain.

what country are you in?

definitly NOT standard in the UK any more. Enems just make you leak fecal stained fluid for hours and hours rather than just popping out when needed.completely unnecessary.

Is that in the UK? Very 1970s.

If so, it doesn't matter if it is standard - you can still say a (polite and firm) "no".

No,definitely not standard practice. I would politely decline.

Quite common still in some American hospitals.

i would decline. not standard practice.

you won't necessarily poo in labour either.

Offer to have it only if the midwives all have one too

Tell them to stick it where the sun don't shine.

Nope, I gave birth in the UK two years ago and it definitely wasn't even given as an option!

Plenty of women soil themselves in labour, if it happens it will be dealt with and it's part of a midwife's job to deal with it. But plenty of women don't, as well.

What? are you in the uk? I'm a student mw and this is certainly not standard if fact much disdain from us as well as the lecturers was shown when we were taught about how it used to be standard.

Anyway I hate the way they imply you have to have it just because it may be 'standard' doesn't take away your right to decline!

Hhhmmm. Now I'm suspicious!

I'm in the Middle East, but the hospital is private, staffed by people from all over the world, and many Westerners here use this hospital.

The explanation given by the midwife was that the bladder and bowels sort of surround the uterus, so in childbirth if your bowels are full, it can restrict labour.

But leaking fecal fluid does NOT sound fun.

Surely there will be enough poking around in that region during childbirth anyway, let alone having to cope with a tube up my backside as well!

I might decline, but this is the sort of place where women's wishes tend to be ignored, one gets the feeling... A kind of doc-knows-best mentality. Might be something to mention in the birth plan!

me23, X-posted with you.

Why is this procedure now treated with disdain by medical staff in the UK, out of interest?

Also, while we're on the subject, she also mentioned episiotomies tonight...

Midwife said that as you come to crown, the doc/midwife will 'assess' your pelvic floor muscles, and if they are deemed not to be strong enough, then they will give you an episiotomy to prevent a tear. Is THIS normal or standard in the UK?

I know sometimes a decision is made to cut in order to prevent tearing, but this whole 'assessment' of the muscles (apparently the midwives are specially trained, they put their hands inside you and dig around a bit) seems a tad weird.

But this is my first, and I have no idea what to expect!

Certainly not standard in the UK -- in fact, as mentioned above, not even something you are offered.

In childbirth if your bowels are full it won't restrict labour, but you will poo during labour/delivery. In the UK things are all set up so that the midwives expect that and remove the evidence quickly, efficiently and discreetly, but if you're giving birth somewhere where having an enema is standard then they may be less quick/efficient/discreet.

Put in your birthplan that unless you are extremely constipated you will decline.

there's a place for an enema - if you haven't been for a week and you are full of poo blocking the way out but chances are once labour starts you'll naturally have a good clear out and if not then once that babe's head starts pushing out then if there is poo in there it'll come out too. some people do some people don't - it just doesn't matter but it's a damn sight easier to catc if it's coming out as a poo rather than a watery drip.

Eeeeeew! I think I'd rather just poo in labour, and the thought of that sends me wobbly!

sounds like a throwback to the 1950s. No reason for enema, nor for an epiduaral to prevent tearing. A tear can heal faster and better than a cut since it might only tear through the top layer - not through all the layers of muscle etc. The thinking that all first timers must surely have an episiotomy went out of favour in the 1970s, for a very good reason!

I was given glycerine suppositories just before I was induced with DS - this was meant to be like a gentle enema - didn't work though and just made me feel all weird in that department! This wasn't in the UK...

Ask for good quality, research based evidence that either of these practices improves birth outcomes.

If they can't provide it then say 'no thank you'

Anecdotally, my friend who had a baby poo'd during labour and despite everything still felt really embarrassed afterwards in front of her husband.
As someone who doesn't even fart in front of my other half i really don't want to poo in front of him!
Is it better to have an enema if it is offered? can you minimise the poo? sorry to hijack.

Trust me, if there's poo in the rectum it will be pushed out by the advancing head. It certainly won't restrict the labour. As for the bladder, well you should be encouraged by your midwife to pass urine regularly during labour and if you can't and you have a full bladder it's not unheard of to pass an in/out catheter to empty the bladder if its causing a problem.

"Why is this procedure now treated with disdain by medical staff in the UK, out of interest?"

Research. Enemas, pubic shaves, lying on our backs, episiotomies - all used to be standard UK hospital practice until the research started to be done. The research is very clear that NONE of these practices benefit the mother or the baby. I would suggest asking your midwives what research papers they are basing their current practice on - are they, in fact, using evidence-based practice?

Generally speaking, a tear will heal better than a cut.

And a midwife can - through observation of the perineum - sometimes tell whether the tissues are going to stretch nicely (as most do) or whether a bad tear is likely (in which case a controlled cut might be preferable). Once the baby's head is on the perineum, the pelvic floor is out of play so I've no idea why the midwives are relating the state of woman's pelvic floor to whether she needs a cut or not - sounds very strange practice! Pelvic floor muscles are inside - perineum is the last "barrier" to the baby being born and is the part that will stretch, sometimes tear.

HTH

On the episiotomy front, midwife said that if a woman is left to tear, she will (or at least might) tear right down to her anus and that obviously this is not great.

She said if your pelvic floor muscles are deemed strong enough they will let you deliver without cutting, and you then risk only a very small tear, which will be higher up (i.e. not heading downwards).

Does anyone know what the standard procedure (in the UK!) is for an episiotomy? When would a doctor or midwife decide to do this? Is it only as they see you are about to tear? Or do they also 'check your muscles'.

It's all very confusing...

I'd been on painkillers for SPD before going in to labour, so I was quite constipated. This meant that I was in horrendous pain with every contraction, so I was given an enema and it was such a relief!

I didn't leak anything after that (I checked while I popped my piles back and I didn't poo in labour either.

The good thing as well, was that it was a good 3 days before I needed to poo again, which gave my 3rd degree tear a chance to heal a little.

Oh, and I did it myself - they gave me a tube and brief instructions, and then left me in a toilet for 20 minutes in peace.

Apologies for TMI!

This is the sort of place where if you start asking for scientific facts or research-based evidence, the staff get irritated because you're questioning their superior knowledge. Sigh.

This is also the same hospital where I was told - categorically - by a consultant that 'All women ovulate on Day 14'. When I pointed out that actually this isn't the case, and that plenty of women (myself included) ovulate later in their cycle, I was asked in a very patronising tone whether I'd been 'reading stuff on the internet'. As if the internet cannot be a place to read up on current medical research!

Oh buggery. Maybe I should come home for the birth after all!

I would just like to know what is usually standard in terms of enema/episiotomy in the UK. When armed with this knowledge, I will feel more confident in telling the midwives to piss off with their enema tubes and scalpels!