Hands off the hoo!

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Specializes in Nurse Leader specializing in Labor & Delivery.

I've got to say, working with residents, one of my biggest pet peeves is when they "conduct the orchestra." If you're an L&D nurse, you probably know what I mean - taking their first two fingers and running/pressing it repeatedly around the lower rim of the perineum as the baby is descending/crowning.

It drives me crazy that they do that. Especially when they do it repeatedly, for hours of pushing. The worst cases of perineal edema have been as a result of that.

The midwives don't ever do that, and yet, the babies still seem to come out okay.

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Specializes in General Surgery.

Ouch! I'm going into my first semester of nursing school next semester so I'm always perusing the forums here and although I haven't had a child yet, goodness, that sounds painful!

Do the mothers ever say anything to the resident or can they not differentiate since the baby is crowning and there's a lot of stretching/pressure anyway?

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Specializes in Nurse Leader specializing in Labor & Delivery.
Do the mothers ever say anything to the resident or can they not differentiate since the baby is crowning and there's a lot of stretching/pressure anyway?

Yeah, that. But mostly, most moms don't know what's normal, what's not, and assume that everything being done to them, is being done because that's how it's supposed to be.

The first place I worked was a community hospital with OBs, and I assumed that's just how you did it. So on occasion when there was an RN delivery and the OB wasn't there, I did that, too (not to the extent that I've seen some residents/docs do it, though). It wasn't until I started working at a facility that had midwives that I realized it wasn't necessary.

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Specializes in Professional Development Specialist.

I remember watching my friend labor when I was her coach, and that seriously looked more painful than anything else she was going through. That doc pulled like he was yanking the life out of her and the baby wasn't even crowning Ouch! As for the mom, we are usually in so much pain otherwise (or numb from an epidural) that nothing else is important or isn't felt.

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Specializes in maternal child, public/community health.

Many doctors feel like they need to do something so they do even when things are going well. The midwives I have worked with a much more comfortable letting nature take its course and only intervene if necessary. They understand that the mom gives birth and in most cases need encouragement, not interference, from those around her.

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I heard it was to help stretch the skin so the woman doesn't tear as bad. Interesting!

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Specializes in Nurse Leader specializing in Labor & Delivery.
I heard it was to help stretch the skin so the woman doesn't tear as bad. Interesting!

Apparently many new doctors have heard that too.

Perineal massage has gone the way of the dinosaur, especially doing it constantly for an hour+.

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Specializes in chemical dependency detox/psych.

I've gotta say, Klone, that the title of your post totally made me laugh. :lol2:

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Specializes in Aged Care, Midwifery, Palliative Care.

Klone I'm a student Nurse/Midwife and I was in the delivery room with a mum (aussie spelling for mom) having her 4th baby. The DR (a reg) was yelling at her to push, meanwhile I could tell she was waiting for her contraction to feel like pushing... then when she was trying to breath the baby's head out, HE put his whole hand on the bub's head... The mum started screaming in pain, I'm sure he was pushing it back in... this mum knew what she was doing, and he should have let me catch that baby. The peri had no signs of tearing and the mum was doing a brilliant job at breathing the head out. I was so dissapointed in the DR. Can't wait until I'm registered, I'll quietly push his hand away then.

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Specializes in Aged Care, Midwifery, Palliative Care.

And I'll tell him, Klone said keep your hands off the hoo. :D

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Drives me crazy! Recently I was doing a delivery and my backup doc was in the room. I was told later that I should have been doing that from the beginning of pushing because it would hasten delivery. Smiled and nodded... "Hot dog buns" is what I like to call the result of all that pulling and stretching.

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our facility just made it easier on us...new policy...perineal massage is not recommended. amen. period. hands off. a baby will come through there without you reaming them out. lol

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