# Enemas?



## Greaseball (Feb 1, 2002)

The poop part of Pam's story got me thinking about enemas.

Are they harmful in labor at all, or just unnecessary? Do they really work to prevent pooping, or does poop only happen when the mother has a long, exhausting pushing phase?

I have a homebirth book written in the 70s which says an enema should be part of every homebirth kit.


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## TurboClaudia (Nov 18, 2003)

From what I've read and heard, pregnant women get runnier poops the last few weeks of pregnancy anyway, so I can't imagine needing one.

It seems like a weird custom, and I don't know its origins: sterility? stimulating uterine contractions? Anyone know?

warmly,
claudia


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## stayinghome (Jul 4, 2002)

I'm a doula and I have yet to see a birth where poop doesn't come out during pushing. It's normal, and seems to happen just about every time. I think the mentality was to empty the bowels for sterile reasons. I'm glad it's not routine anymore! My mil says that it was the worst part of having babies for her. that, and behing strapped down during pushing...


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## anothermama (Nov 11, 2003)

From what I understand, the custom comes from the doctors convenience issue as well as it being thought that it would contaminate the baby.

I have a prenatal book from the 60s (!) and it doesn't mention enemas at all.

My feelings on it is that its probably not needed, that your body starts trying to take care of that business anyways ahead of time, that it doesn't harm the baby if you do......but if you WANT one, go ahead. I personally don't see the advantage to having cramps from an enema on TOP of labor but thats just me.


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## copslass (Apr 19, 2003)

My mil, after my last ds's *very poopy birth, wondered aloud why enemas aren't administered anymore.

This thread brings to mind an exerpt from Nancy Wainer's book, Silent Knife.

Woman asks: Dr. why do you insist on enemas?

Dr. replies: "Frankly, I don't wish to be shat upon."

Nancy's observation: "Frankly, he should have gone into dentistry." :LOL


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## Eman'smom (Mar 19, 2002)

I don't think they would hurt anything, other than more cramps and being even more uncomfortable. I'd be worried that they would clear everything out, if that was there intent.

There is no guarentee that you will poo during delivery anyway, I didn't with either of mine.

It just seems like one more tool to medicalize birth.


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## curlygrrl (Jan 22, 2004)

A quote from
Birth Messages

Quote:

*Description and Official Rationale*
As part of the prep, an enema is usually administered by a nurse. Medical personnel maintain that enemas reduce the chance that fecal material will be pushed out during birth, thus decreasing the chance of infection. A few whom I interviewed also frankly admitted that they do not like to clean up feces and so give enemas to all their patients in the hopes of avoiding this unpleasantness. Other reasons include "preventing hard fecal matter in the rectum from compressing the birth canal, stimulating labor progress, and avoiding the embarrassment for the woman" that might result if she expels stool during labor-- especially likely during pushing (Mahan and McKay, 1983:244).

*Physiological Effects*
Williams recommends a simple Fleet enema. In a short diatribe against the all-too-common misuse of the enema, the 17th edition of Williams states that that the "infamous 3H enema (High, Hot and a Hell of a Lot) has no place in obstetrics!" (Pritchard and Macdonald 1985:333). (This felicitous statement has been removed from the 18th edition [Cunningham et al. 1989:309]). Unfortunately, this hot water and soapsuds enema is still most commonly used in many hospitals. Soap often causes rectal irritation and other complications, and its use in enemas is medically contraindicated (Barker 1945, Bendit 1945, Lewis 1965, Pike 1971, Smith 1964).

*"A substantial portion of women in labor will have bowel movements, whether or not enemas are given," especially during both early labor and pushing (Mahan and McKay 1983:247). Available evidence indicates that enemas do not in fact decrease the chances of elimination during birth nor the incidence of fecal contamination during labor, whereas they do often cause considerable pain and distress to the laboring mother (Romney and Gordon 1981; Whitley and Mack 1980).* Moreover, the explusion of feces during labor does not seem to increase infection rates: in a study of 274 birthing women randomly assigned to enema or no enema groups, no difference in infection rates was found (Romney 1981), and the risk of neonatal infection was very remote (seven babies from each group showed signs of infection which may or may not have had to do with bowel organisms). Another finding of this study was that the two groups had similar durations of labor, contradicting the notion that enemas shorten labor.

The consensus on the enema among the women in my study seemed to be that it should be strictly a matter of personal choice. Some also felt that doctors should let women know that the self-administration of Fleet enemas at home is a viable option.

*Ritual Purposes*
The enema is readily recognizable as the obligatory ritual cleansing of the initiate traditional in many rites of passage. But because it is the lower region of the body that is cleansed, the enema also constitutes an intensification of the symbolic inversion accomplished by the shaving and the gown--from most private to institutional property. Accompanying this process (especially when the enema is high, hot, and soapy) is the clear message that the laboring woman's most private parts were internally dirty while they were private, and that it is the institution, as society's representative, which made them clean. Underlying this message is the deeper message that individuals are impure, whereas society (like Ivory soap) is pure.
Personal thoughts:
I've heard that the enema does not prevent pooping in pushing but it *does* make anything that comes out more runny and actually more difficult to clean up.

Sometimes I think about it because I did *not* have the common loose stools right before labor. I basically felt like I had to go the whole time and it made me confused about when the pushing sensation finally hit. I was terrified about my first post natal BM too, but didn't have any problems.

Tamara


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## veganmamma (Sep 10, 2002)

The reason poop comes out is because the baby's head descends and pushes poop or rather, squeezes it out. Runny poops tend NOT to be pushed out. Not saying they can't be, but they tend to be pushed out when the mother is pushing unnaturally before the baby's head is all the way down. Sorry to speak so ambiguously, I just know in a fwe posts someone will come in and say they had the opposite experience.







: I took castor oil and had runny poops and did not poop when dd was born. I pooped about 3 hours before she was born into the toilet though. Enemas do prevent you from pooping during second stage for the most part, and if it's a problem for you, emotionally, then just give yourself one . Enemas do cause uterine contractions and are a natural induction method. I would keep that in mind when you do it- that it will have effects beyond emptying your colon. My mom didn't understand her poop and was humiliated by it. I didn't care and didn't poop! She actually told me she was proud of me for not pooping! This is a deep emotional issue that I think stems from the sterilization of birth. It's normal to shit, but it can feel like a loss of control, or dirty and embarassing. So I say, do waht's right for you, ya feel me?
L


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## stafl (Jul 1, 2002)

I requested an enema in early labor. I felt constipated, I thought maybe the urge to push was because I had to poop, since I wasn't dilated far and the rushes weren't too intense yet. It didn't help.
I still pooped on myself about the time baby's head passed my cervix anyway.







ag


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## AnnMarie (May 21, 2002)

Quote:

_Originally posted by stafl_
*
I still pooped on myself about the time baby's head passed my cervix anyway.







ag*
I'm sorry, but that smiley does NOT belong at the end of that sentence. :LOL







:


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## sarahwebb (Feb 12, 2002)

I chose to give myself a warm water enema because a friend who'd birthed two at home and was very knowledgeable about natural healt suggested it. She said it could stimulate my labor and that I might feel better all cleaned out.

I didn't choose the enema because I felt dirty or ashamed about the possibility of having a bm during labor, and I administered it myself in the comfort of my bathroom.

I can't say that it accelerated my labor--which was long, but I was relieved not to have a bm for a day or so after my labor because my bum was so sore...

I'll have an enema with my next labor too, but I think it should be entirely a matter of choice.

Best,
Sarah


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## rainbowmoon (Oct 17, 2003)

i always thought an enema could stimulate labor?

I pushed for 4 hours and pooped several times, though I didn't even know it as I could not see what was going on down there, DH told me after (I could have cared less though as I'm not embarrased) and the nurses just wiped me off each time.

my doula trainer told me about 70% of women will poop some during pushing and most don't even realize it.


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## momsgotmilk4two (Sep 24, 2002)

I pooped a little both times. I wouldn't have noticed the first time except I asked dh if I did and he told me yes. They very quickly wiped it away. I didn't have enemas either time.

As far as having an enema so that you go a day or two without pooping, most women do anyway. With both of my kids it was 2 or 3 days before I pooped again and I usually go twice a day.

Edited to add that the hospital I delivered at did not even offer me an enema.


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## Dreaming (Feb 8, 2004)

I plan to give myself an enema in early labor. Since I'm doing a waterbirth, the last thing that I want to see are little poops floating around in the tub with me (I know they fish them out right away, but still...I don't want to feel as if I'm floating in a giant toilet bowl).

:LOL


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## mattjule (Nov 6, 2003)

Just wanted to chime in. I had very loose smelly stools (way too much info!) leading up to labor (turned out to be my vitamins, but what did I know? And they were from the HFS, I am just really sensitive to vitamins). Anyway, the whole time I was in labor I felt like I had to poop and I tried many times, but the head was compressing my colon and I couldn't. When I first felt the urge to push, I couldn't b/c I knew I would poop. My mw told me to just go ahead and poop, so I did (very weird to be laying on your living room floor, pooping). Anyway, I think she was surprised by the volume-she said "is this all you?" And I'm thinking "who else would it be?" It was whisked away, but it was still a little embarrassing. A small, hard poop is one thing, but a large, loose smelly one is entirely different.









So on the topic of enemas, I wished I would have done one. Since I am aware of the vitamin issue now, I don't think I will give myself one this time around. But whether or not people make a big deal of it, sometimes pooping in front of people is just plain embarrassing.


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## Greaseball (Feb 1, 2002)

Quote:

But whether or not people make a big deal of it, sometimes pooping in front of people is just plain embarrassing.
Tell me about it...I had photos that were so gross I had to throw them out! I can only imagine what the guys at the one-hour photo thought.


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## pageta (Nov 17, 2003)

I didn't have one. My initial labor pains felt like diarhea but nothing came out. I drank lots of water while I was pg so I always had soft stools. I didn't see any poo in the pictures, but my doula may just have been clever when she took them. For me, poop wasn't an issue as long as they didn't try to give me an enema. I don't want to cause any unnecessary pain. I will add that I didn't have a bm until more than a week after I gave birth. So I must have been cleaned out real good - somehow.


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## ldsapmom (Apr 8, 2002)

I had one or two small harder (regular-like) poops with my first birth. Oh, but my second! I had, the whole pushing, small runny poops, and it is all on video







. But my midwife was always there, wiping it away, etc. I was 9 days overdue, and I was very cautious the whole time about making sure I did not eat huge meals for dinner, ate a lot of soup, etc., trying to ensure I would not have this problem (like it could be helped!). But that night I was so tired I had the hugest dinner ever -- and I went into labor! Oh well!


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## Evergreen (Nov 6, 2002)

I was thinking about videotaping my next birth but now I am not so sure!


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## ldsapmom (Apr 8, 2002)

Gr8- It's not like you are sending it to Cannes, now are you







? It is entirely appropriate for the viewing audience at my house. My boys like to watch it; some very close family have seen it (sisters -- and I have been at or seen all their births, too); and a good friend who is a midwife.


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## merpk (Dec 19, 2001)

Haven't had the runny poop situation ever. Have had that constipated feeling ... which I can't stand and deal with more in life than I'd like to admit ... so chose to have enemas.

Actually didn't notice any cramps ... beyond the contractions I was already having, what's a few cramps? Once it worked, it felt like a relief to clear things up, IYKWIM, so would choose to have one again.

Still pooped during the pushing, but hey, that's why those OBs make the big bucks, ya' know?


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## ericaz (Jun 10, 2003)

i had serious concerns about pooping while birthing isadora and had considered doing an enema. i've done 'em lots before so i know what to expect with them.

that said, i got to the hospital in full on labor after laboring at home until i couldn't take it anymore. at the hospital i labored in the jaccuzi and then felt an ENORMOUS urge to poop. so i got out and headed to the bathroom where i took the biggest, most god-awful poop ever. i felt SO much better after that (sans the contractions, lol!) and ready to get the show on the road.

midwife broke my water (her head was very low and the bag of water was the only thing holding her back) and i was able to push almost immediately after that.

looking back - i'm super glad i shat before i did any pushing, however now i know that i wouldn't have known or cared had i pooped on the table. it was the furthest thing from my mind!

isadora, the cheeky monkey, shat all over us both as soon as she was born. :LOL


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## lorijds (Jun 6, 2002)

Wow, as a nurse, this is a real eye opener. I always address the poop issue at childbirth classes (poop is okay; when we see poop we are like "Yeah, mom is pushing well, baby is moving down!"). I am really surprised that it is such an issue for so many women, and that many would prefer an enema.

Enemas can stimulate contractions by irritating the intestines, which in turn irritates the uterus. I guess I have my own prejudices; I think the use of enemas during birth originated from OBs wanting that dirty area to be clean, and so I think of them as a degrading thing that was forced upon moms in labor.

I have attended over a hundred births now at our birth center, and never once has the thought even occured to me that an enema would be a good thing. Once or twice I can think of a mom who had a fairly large BM pushed out in front of the baby's head. Most moms don't pass any stool, or pass very little. We have warm compresses on the perineum anyhow at that point, so we just wipe anything off as it comes. There usually isn't even a smell, because it is covered by the cloth.

Does anyone worry about urinating while pushing? Because that happens with as least as much frequency as pooping while pushing. I hardly even mention that in my classes, just as an afterthought. Is that also something that people worry about?

Wow, this is really interesting. I guess this is just another reason why laboring and pushing on the toilet is possibly the very best place in the world! Moms make such awesome progress on the toilet, and I guess also they don't have any negative conotations with the whole fecal thing.


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## Greaseball (Feb 1, 2002)

I urinated as well, but it only happened when I vomited. So I was a big gross mess when it was over! Not like an enema would have helped with that.

The funny thing is that after the birth when the nurses were helping me get to the bathroom, they told me to bunch a sheet between my legs so I wouldn't drip blood. :LOL Why bother with that? The bed is covered in various fluids and solids, blood is everywhere, it looks like someone died in this room! Why worry about the floor?


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## beaner&tiegs (Aug 3, 2003)

It's so interesting, I was not at all worried about pooing, I knew it was normal during pushing and that the midwives have seen it a tonne of times. With my first birth, I used castor oil at two weeks "overdue", so was completely cleaned out when it came time to push! So I really noticed a difference with my second, when I could actually feel myself pooing as I was pushing the head out, and I found it VERY uncomfortable and disconcerting - not the idea of it, but how it actually physically felt. I think I would actually rather an enema with the next one, but maybe I'll do a bit of reasearch about it first? I didn't know half the concerns about castor oil when I used it (just knew that it was a family tradition through the generations - evidently we carry late for the first!) but now don't think I would use it.


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## *Erin* (Mar 18, 2002)

hm, i never even thought about it beyond the initial "hm, i could poop on myself. interesting."
i def. wouldnt want an enema. i felt violated enough by the interventionist prenatal stuff i elected to have done. oy. pooping in labor, i understood it's normal and not some freaky nasty thing, so it never bothered me. i didnt poop, to my recollection, but yk, i was so glad to be pushing i wouldnt have known or given a sh*t who i shat on.







hey wait, i did pee. i remember that. didnt care about it a bit either.


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