"Shakes"

1. What causes the "shakes" right before and right after delivery? I've heard that the "shakes" after delivery is caused by a shift in fluid or something like that. Does anyone know for certain?

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2. 

   About Cali

   Joined: Nov '01; Posts: 192; Likes: 29
   RN

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3. 
   Jun 23, '03

   I don't know for sure, but I think before delivery, epinephrine has a lot to do with it. After delivery - hormone shift, blood loss, severe strain on the body.
4. 
   Jun 23, '03

   Really, this is due to a complex combination of fluid shifts, increased cardiac outputs, (dramatic right after delivery) and also circulating maternal catecholamines. The "shakes" also can occur BEFORE delivery, remember. It is common for me to see moms develop this phenomenon in the transition stage of labor (about 8-10 cm). What can we do? Provide her a warm blanket, position her comfortably, help her maintain a healthy breathing pattern, and relieve her anxiety is all a nurse can do. That, and telling her this is NORMAL and will PASS it also important. Hope this helps.
5. 
   Jun 25, '03

   I think it is facinating how women that have epidurals and aren't feeling any pain may still get the 'shakes' with transition.
   Greyhorse
6. 
   Jun 25, '03

   If you read the above responses, you can see how an epidural may actually make the "shakes" worse. (added fluid boluses/shifts). I have seen women with or without them shake equally. The above responses seem to explain why this phenomenon can occur in the presence of regional anesthesia.
7. 
   Jun 26, '03

   it is true that epidurals can make the shakes worse. the shakes are more related to hormones and fluid shifts than it is from pain.
8. 
   Jul 7, '03

   What do you tell moms when they say "OMG, my legs are shaking?" I'm a new grad orienting on a maternity unit, and though I'm specifically orienting to postpartum right now I've been in to a few deliveries and every one of the moms has commented on that.
   
   Thanks!
9. 
   Jul 7, '03

   tell them what we said here. it's normal. then explain WHY. in terms they can understand.
10. 
    Jul 9, '03

    Originally posted by SmilingBluEyes
    tell them what we said here. it's normal. then explain WHY. in terms they can understand.

    Thanks- do you have any suggestions for a quick and simple "why"? It's not something I fully understand myself (I'm fresh out of school, my head's still swimming from the NCLEX, lol)
11. 
    Jul 9, '03

    I've always just assumed it was like a stress reaction . . . or extreme fatigue. Now reading the above posts, I'll definitely go read up on it.
    
    I experienced it with my first three . . normal vag deliveries w/o epidural. Not with the fourth . .. .ended up with a cesarean.
    
    I've never liked the way labor feels . . . .your body is out of your control and doing things all on its own. It is a very weird feeling.
    
    steph
12. 
    Jul 9, '03

    Sarah no prob---congrats by the way!
    
    Just tell them their bodies are undergoing huge hormone and fluid shifts. The cardiac output is at least 50% greater right after delivery than normal. (that's a lot of blood pumping all over which is why PP hemorrhage is such a HUGE deal). Hormones ("fight or flight" types) are circulating during transition and immediately after delivery that cause the body to "shake" in response. This is normal and will resolve very soon. Then try the interventions I suggested above, reassurance, warm blankets, coached breathing, etc. Your reassurance is the MOST important intervention in this case. I hope this helps you.
13. 
    Jul 10, '03

    Thanks Deb, both for the pat on the back and the info! Much appreciated
14. 
    Sep 3, '03

    I tell my pts to try not to fight the shakes...this tends to make them worse...Usually works and they are able to relax.

    Last edit by winterblue on Sep 3, '03

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