ways to avoid fundus massage after delivery ?

[chrysalyde]

Hello,
After each of my deliveries, the midwives massaged my uterus to avoid hemorrheage (sp ?) and clots from forming. It is the most painful experience ! I hate it ! I just want to say "I've suffered enough to have this baby, now I don't want to be in more pain !". Is there any way to avoid doing this, while preventing just as well the hemorrheaging ?

[boysmama]

I'm with you. I just don't want any other person's hands there...
I learned to do it myself and it doesn't hurt as bad. Also it isn't necessary to massage vigorously. Gentle pressure works  for normal deliveries. Maybe if you are hemorrhaging  vigorous action would be required. Getting the baby latched on and feeding is one of the best ways to get the uterus tight. If breastfeeding is not an immediate option, nipple stimulation will do the trick.

[brigonia]

Well, you could have an unassisted homebirth!      I don't massage my fundus. 
With my assisted homebirth I don't even remember my midwife doing fundal massage.  She was pretty hands off though. 
I like to lay on my tummy to sleep and I can really feel my uterus clamp down when I am laying there.  I think the weight of my body and the rhythm of breathing gives a very effective massage.  I also like to use one of those heavy heating things which you microwave to warm up on my tummy while I am nursing to help with cramps.  The weight of it feels good on my uterus and probably keeps it firm. 

[ManyWeavers]

  I usually massage my own after a birth. I agree that gentle but firm seems to do the trick and doesn't hurt half as bad as that vigorous pummeling you get from some midwives.

[chrysalyde]

To those of you you massage yourself gently : how do you know it's "doing the trick" ? How firm do you do it ? Is your limit how bearable it is ? Also, how do you politely tell the midwives/doctors that you're taking care of it yourself ?
When the midwives did it to me, it actually made big clots come out. Now that's pressing down pretty hard to get all that stuff out...

Otherwise, does anybody know of herbs or something that I could take to avoid needing to do the fundus massage ?

[sarajane]

I let my mid-wife do it. She said that if it wouldn't come out that she would have to go inside so I was like "Press away!" It was uncomfortable but after everything I was happy to get it done and over with and know that I wouldn't have any troubles just because I didn't do that one last thing.

[jacknjill]

We planned on a midwife-attended birth, but ended up in the hospital. The female Dr. who delivered the baby massaged me. It wasn't painful at all to me, just like firm pressure. I think she just knew what she was doing! My midwife also recommended massaging my belly every time I went potty for several days to loosen any remaining clots. I think the Dr. did a good job--I only had a couple clots. So....I would say it's probably the best idea to massage after the birth, but maybe someone other than your midwife would be better at it?? What about hubby? Mine is great at being firm but gentle! Maybe you could research the "method" of how it's supposed to be done, and let him do it? Doing it yourself would be an option (especially if you knew what you were trying to do!)...personally, I'm too exhausted after the birth to be that physical!

[boysmama]

It's pretty easy to feel when the uterus is all tight. About softball size and just as hard. If the uterus is slack it feels more like a balloon. Kinda like you can poke a finger in and make an indention where as if it's tight and you poke, the whole thing moves.
Make sense?  It doesn't hurt as much when you do it because you have more feedback. Not that you neccessary stop if more is needed, but you can keep off of the other organs.
Being able to use gentle pressure may be not be universal.  Just gentle pressure or even changing positions and mine cramps right up. Also can't stress enough how important getting the baby nursing is. It releases oxytocin which contracts the uterus... Just like nipple stimulation will sometimes get labor going. Some midwives will give a shot of pitocin immediately after delivery to do the same thing.
My midwives usually check once or twice to make sure I know what I'm doing.
 My first was born in the hospital and my mom leaned over while they were getting the baby suctioned (possible meconium which wasn't ) and whispered to me that if I would massage my own uterus I'd like it much better than letting them. Boy was she right!!! The nurse came over "let me check you honey" and promptly ground away like she was trying to screw my belly button through my back.    Why all the trauma on all the other organs that live in that space?    Next time I said I think it's tight and the new (and darling  ) nurse says "I think your right!" after a brief feel. Whew!!!!
Yeah, rather let them massage than bleed to death, but if I can help it I'll take care of my body myself - thank you very much! 

[Mrs. B]

It's funny how we all have different hospital experiences with this....
I've only had 2 babies, and while I've been a RN for all of my adult life, I've only worked in OB a handful of times.
I don't believe ANYONE ever checked my fundus following delivery even with my first.... and with my second a girl I knew happened to be my nurse and I mentioned that no one had checked me in the 2 days I had been there post-delivery... so she did a thorough job, but only because I mentioned it.
I actually did spot check my own fundus and it was pretty low and hard...
You generally want it about 2 fingerbreadths below the navel right after delivery (if I remember correctly) with it going down 1 fingerbreadth per day.... It should feel firm as boysmama described.... you mainly don't want it to be squishy and above the level of your bellybutton.
And the few times I've done fundal massage on others has allowed me to learn that there is ALWAYS a gentle way of doing things..... the thing may not be pleasant, but it can be done with care.
I also advocate nursing asap... I did have pit with both of my deliveries, but I also nursed both within 10 minutes or so of birth and I never had issues with a boggy uterus.

[chrysalyde]

Thanks for all that info Mrs B and boysmama ! It really helped me understand what the massage is for and how to achieve its purpose.

[petrimama]

Good posts.  I agree completely about being gentle!

The nurse came over "let me check you honey" and promptly ground away like she was trying to screw my belly button through my back.   

My midwives always do this as well right after I deliver, but not to massage the uterus.  They do it to squeeze all of the blood & possible clots out of the uterus immediately, and it does help even if it is excruciating for about 10 seconds.  After my most recent birth the midwife pushed so hard she literally lifted off the floor!  ~L

[sarajane]

Nursing definately helped. But I actually found the nursing hurt my uterus a whole lot more than the massage did! I was crying at one point. I was just so tired of pain and well, tired.

[boysmama]

Oh, I agree that nursing hurts probably more because it lasts longer! I cried alot this last baby for 3 days.    Sooo... hard to try to relax and get the baby nursing well. The trade off for me is very short recovery - bleeding only a few days and lochia for less than 2 weeks.

[boysmama]

Good posts.  I agree completely about being gentle!

The nurse came over "let me check you honey" and promptly ground away like she was trying to screw my belly button through my back.   

My midwives always do this as well right after I deliver, but not to massage the uterus.  They do it to squeeze all of the blood & possible clots out of the uterus immediately, and it does help even if it is excruciating for about 10 seconds.  After my most recent birth the midwife pushed so hard she literally lifted off the floor!  ~L

What I'm wondering is if those clots aren't meant to be there? designed to seal off and then self clean in small pieces the first few days? Maybe I'm lucky because even the last baby when the cord got pulled pretty hard I had only minimal bleeding and (I think) normal clots. My placentas have all been huge. Does that make a difference?