# Post partum fundal massage - necessary?



## Pepper (Jan 25, 2004)

I'm finalizing my birth plan tonight and realized that I never got around to researching this issue.

I recall being vigorously and painfully massaged after my first birth but then pretty much being left alone except for one gentle massage after my second so how important is this?

I'm birthing in a hospital but have *no* problems whatsoever with telling them exactly what I want or don't want and will gladly tell them not to massage me at all if that is best. Or perhaps I can do it myself?

What are the guidelines for doing this? Dependent on amount of bleeding, I would assume? What do I need to be on the lookout for?

Share with me your experiences, mamas.


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## pamamidwife (May 7, 2003)

I dont' know about the hospital - it's pretty hard to get them to NOT do stuff like that. Especially because they view it as "necessary" and dangerous if they don't.

I don't often do massage. I will check right after the placenta is born sometimes to see if the uterus is firm, but I tell women what to feel for and let them know that if they ever feel too much blood coming out, they should reach down try to massage their uterus.

Then again, in the hospital, there are so many distractions and things that occur during third stage that the risk of bleeding is much higher. I would assume that if you were bleeding alot, some fundal massage would be necessary to keep your uterus contracted.


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## bethanyclaire (Dec 17, 2004)

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.


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## applejuice (Oct 8, 2002)

I think I would agree that you can tell them not to be so darn rough if a fundal massage becomes necessary. AS the PP said, she massaged her own uterus, but probably more lovingly and gently than some OB who does it all the time just because he does it all of the time.

Looks like it is one way they have of getting back at you for something, so be on your guard.


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## Full Heart (Apr 27, 2004)

I massage my own. Sometimes your body tells you too and it actually feels good to do. Like massaging a sore muscle. If its contracting fine I don't see a reason to. I was really scared of hemmoraging after it happened once so I always make sure my uterus isn't mushy or enlarged.

Michelle


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## Belle (Feb 6, 2005)

Hmmm. I didn't have a fundal massage. But they did check a couple times to make sure my uterus was contracting. That was kind of painful because it had contracted so much on it's own that they couldn't find my fundus. They poked around an awful lot looking for it.


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## ZeldasMom (Sep 25, 2004)

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.


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## ZeldasMom (Sep 25, 2004)

Just thought of one more thing...

If you haven't already, you might want to check and see if Henci Goer says anything about this. I just went over to her web site www.hencigoer.com but didn't see an article about fundal massage/prevention of post partum hemmoraging. I got The Thinking Woman's Guide to a Better Birth from the library when I read it, so I don't have a copy. And I haven't read Obstetric Myths Versus Research Realities. But maybe one of these books has some info that might help.


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## Pepper (Jan 25, 2004)

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









Quote:


Originally Posted by *ZeldasMom*
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







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..


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## pamamidwife (May 7, 2003)

also, just a reminder: fundal massage is not only done right at the birth, but often by postpartum nurses for the first 24 hours after birth - often every couple hours. be sure to get your doc to ok the NO FUNDAL MASSAGE and sign off on it so you don't have to get into it with every RN that comes through your door.


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## AngelBee (Sep 8, 2004)

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









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


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## Baby Hopes (Jul 15, 2004)

My sister warned me about the rough massages, so I was all prepared when my doc came in to check on me. He gently pressed on my stomach a few times, checked my perinium (had stitches) and smiled. Told me I was doing great! And left.

I kept thinking, "What about the massage?" LOL


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## Pepper (Jan 25, 2004)

Quote:


Originally Posted by *pamamidwife*
also, just a reminder: fundal massage is not only done right at the birth, but often by postpartum nurses for the first 24 hours after birth - often every couple hours. be sure to get your doc to ok the NO FUNDAL MASSAGE and sign off on it so you don't have to get into it with every RN that comes through your door.

Will do. Thanks for reminding me of that pamamidwife.


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## Artisan (Aug 24, 2002)

Fundal massage/afterpains were the worst part of my birth. By far. Pushing out a ten pound baby was better than the fundal massage. I am going to make sure I discuss this at length with my new midwife when I have a third. Avoid it if at all possible!


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## wendy1221 (Feb 9, 2004)

Quote:


Originally Posted by *bethanyclaire*
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.

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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## cottonwood (Nov 20, 2001)

You might find this interesting reading:

http://www.gentlebirth.org/archives/...g.html#Massage

Definitely do not let them do it before the placenta is out. Dangerous. After... well, like any intervention it should not be done _routinely_, only if the situation warrants it. If you really feel it should be done, best to do it yourself, _gently._


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## Thmom (May 4, 2004)

with my first I had a horrible *massage* (what a name for it) second, same hospital nothing, 3-5 were UC where when I felt the need I did it. Like others have said it did help with the after pains.


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## orangebird (Jun 30, 2002)

Quote:


Originally Posted by *pamamidwife*
also, just a reminder: fundal massage is not only done right at the birth, but often by postpartum nurses for the first 24 hours after birth - often every couple hours. be sure to get your doc to ok the NO FUNDAL MASSAGE and sign off on it so you don't have to get into it with every RN that comes through your door.

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.


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## cozymama (Apr 27, 2004)

.


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