Are enemas making a comeback?

[caregiver1977]

My friends often ask my advice when they are pregnant because I have had 5 children. They know they are only getting my opinion, or can only share my personal experience. Anything more, they need to clear it with their healthcare provider.

I was recently asked if labor/delivery units still routinely give laboring women an enema. At first, I was telling my friends that I don't think that happens anymore. Recently I have heard from a friend of mine in Texas that some hospitals are starting the practice to either get labor going, or to "clean out" the patient. I was also told that it is not offered as an option, that it is "doctor's orders."

Does this happen at your hospital? If so, is it better for her to have an enema? I didn't get one with any of mine, and don't think I would have been able to hold it with strong contractions. I have my personal opinion about labor enemas, but I would like to hear from the experts first!

[Sun0408, ASN, RN]

I am no expert but I did have one with my first child 19 years ago. With my second and third baby, this was not done and considered "old" practice. I'm sure some hospitals still do them while others don't. As for it being optional, no matter if it is ordered or not, a pt can refuse.

[VivaLasViejas, ASN, RN]

As a mom who has had the highly unpleasant experience of getting an enema (and having to hold it in!!!) during strong contractions 5 minutes apart, I HATE the idea that doctors are reinstating this barbaric practice. What old-school rituals are they going to try next---strapping women down flat on their backs with legs in the air? Shaving off all pubic hair? Vertical incisions for C-sections?

I understand the reasoning for clearing out the lower bowel IF the woman is constipated or ate a huge meal before going into labor. But any OB who orders enemas routinely ought to be given one while he's trying to pass a kidney stone.....and maybe he'll get the idea of how very uncomfortable and undignified this is.

[tntrn, ASN, RN]

Not common at all where I work....and of course as a patient advocate, I might let my mom know that she can refuse. I have zero problem calling a doc to say "your patient has refused the enema order. Goodby."

[caregiver1977]

I understand the reasoning for clearing out the lower bowel IF the woman is constipated or ate a huge meal before going into labor. But any OB who orders enemas routinely ought to be given one while he's trying to pass a kidney stone.....and maybe he'll get the idea of how very uncomfortable and undignified this is.

I understand them for early, early labor to get labor started (an enema beats pitocin or a c-section ANY DAY, in my book), but I have heard to many stories of an enema being given to a woman already in active labor and those "enema contents" ending up all over the bed or pushed out everywhere while pushing out the baby. That is highly humiliating for the patient, and in my opinion, extra work for the nurses when they are probably already very busy anyway.

If a person is going to have a bowel accident, which is embarrassing enough, isn't it better for it to be a solid one than a liquid one?

[PinkNBlue, BSN, RN]

Just to reiterate the obvious but it is an option just like any procedure in a hospital; if someone doesn't want an enema, they don't have to have one so tell your friend that even if the hospital routinely does this, she can opt out. An enema is not a life or death procedure. We do not do them at our institution and I don't think we plan on doing so.

[melmarie23, MSN, RN]

not where I work, thank goodness!

[MomBabyUnitRN]

Not where I work, either. Thank goodness!

[Elvish, BSN, DNP, RN, NP]

Not where I work.

I have heard of some midwives (no OBs I know) suggesting castor oil to kickstart labor. I've had a couple friends swear by it and many others say it did absolutely nothing except make them miserable. But still....no enemas, ever.

[serenity1]

We do not do them at my facility, and if we did, I would absolutely let the patient know she can refuse it.