holding legs during pushing

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Need some input as to what others are doing ....most of our patients have epidurals and we hold legs while pushing, sometime for 2 hours or more...!! we try to labor down as much as possible but sometimes the physician wants us to push as soon as the patient is complete. a couple of nurses that have worked at other facilities have said that until they came to my facility they did not hold legs until the physician was in the room and the baby was almost delivered! we have new beds that have stirrups attached so we don't have to go hunting for them but we never use them. we have several people on workers comp and others complaining of various aches and pains. need some info to take to staff and get them to stop this practice. thanks

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we have several people on workers comp and others complaining of various aches and pains. need some info to take to staff and get them to stop this practice. thanks

I have been a L&D nurse for 10 years. My right upper arm is starting to have some constant pain. I think it is from using it during pushing and vag exams. I stopped holding legs a few years back. I try to get the patient to have her husband on one side and another family member on the other side to hold legs. I also use nursing students to hold legs when they are there. This job is very physical and I noticed after this many years that it is taking it's toll on me physically.

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Specializes in L&D.

Many hospitals have banned the practice of leg holding just because of the frequency of staff injury. Use the leg stirrups or the foot stirrups, use all the pushing positions the bed offers (contact the company that makes the beds for their suggestions on positioning their bed for pushing; some have educational programs on this topic).Often Mom can hold her own legs if a family member helps her get them up. Just remember the family member needs to be taught how to do it safely (don't drop the leg, don't hyper flex it so much you damage the hip joints). And if you use the student to hold the legs, be sure to teach her good body mechanics as well as patient safety so she doesn't injure herself.If you use the leg stirrups, remember the longer their legs are up, the greater the chance of developing a thrombus. Put her legs up at the same time (have help) and take them down at the same time to avoid dislocating a hip.

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Specializes in L&D.

Those looky-loos in the room doing nothing to help mom out with her labor contractions -- guess what? They get put to work during pushing. They get to hold mom's legs!

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Specializes in L & D; Postpartum.

After shoulder surgeries on both shoulders, I won't do it anymore. Or the old tug of war with the towel Or blanket either. Several of my coworkers have shoulder issues and have had surgery also.

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Specializes in OB.

What the other posters said...I generally do not hold legs. I use the foot pedals if they have good control, and the stirrups if they do not. I definately involve family members, that way I can sit on the end of the bed to help coach mom. I also have mom pull back on her legs, this helps a lot.

Of course, I work nights, so all my patients labor down. It's a lot easier when there's no doctor doing the exams :D

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Specializes in ICU, Home Health, Camp, Travel, L&D.

About the legs...I don't usually hold them. I either use foot pads or let mom pull back on her own legs. Many times I'll have mom put feet flat on bed, knees bent and close to body while pushing.

About not laboring down...I hear you. I will say that if our docs don't know the patient is complete, they can't very well order us to start pushing ;).

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Specializes in Community, OB, Nursery.
About the legs...I don't usually hold them. I either use foot pads or let mom pull back on her own legs. Many times I'll have mom put feet flat on bed, knees bent and close to body while pushing.

About not laboring down...I hear you. I will say that if our docs don't know the patient is complete, they can't very well order us to start pushing ;).

Some of our L&D nurses think like you do too. "She's a rim, Doc." :)

I'm surprised to see no one has mentioned side-lying pushing yet. Obviously not everyone can do it, but in labor I found it a lot easier to hold a leg myself that way, and I only had to hold one.

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Specializes in Labor and Delivery.

Hi! Just wanted to say where I live the norm is the mother holds her own legs. I am only a student but I've done OB as well as had my own children and I had to hold my own legs when I pushed and the hospital I did my rotation thats what we did as well. Sorry to but in this thread since I am just a student but I LOVE OB :)

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At my facility it is our policy that nurses don't hold legs...and I don't. I will support a leg and help my pt's with epidurals grab their legs, but I will not hold it for them.

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As a manager, I have written policy in two hospitals forbidding nurses to hold legs, just due to nurse injury -- I know several nurses who have had either shoulder or back surgery from this practice. Families can hold legs, or the leg rests (don't use the word "stirrups" ) can be used, but nurses can NOT hold them.

In one place I had some push back so used the hospital's Risk Manager to help push the policy through, along with the Employee Health Manager, who wanted the practice stopped due to the high cost of Workman's Comp injuries.

When docs object I tell them of the risk for nursing injuries and ask them to hold the patient's legs for awhile - it usually ends there.

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