This doc makes me very uncomfortable . . .

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We have this one doc with the group that gets all the unassigned pts and he does this in ALL of his deliveries: When he comes to deliver the baby, he puts a sterile drape on the mom's tummy, puts both his hands up there, and pulls on her fundus while she pushes. It freaks me out when he does this. What I want to know is, is this dangerous for the pt, or am I getting all worked up over nothing? Is this no more harmful than using a vacuum or cutting an epis? And I mean, this is a big, muscley guy and he really puts his back into it. It just makes me nervous, and I want to know if it is justified.

Thanks!

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

If he is truly putting pressure on---really pulling, report this to your manager (if he/she does not know it already---and perhaps this needs to be elevated to your perinatal committee); this is very ill-advised oldschool methodology. AND IT IS VERY DANGEROUS.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Meant to say:

fundal pressure when mom is pushing the baby out is ABSOLUTELY CONTRAINDICATED!!!!

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Specializes in Cardiac.
Meant to say:

fundal pressure when mom is pushing the baby out is ABSOLUTELY CONTRAINDICATED!!!!

I worked as a tech in L&D about 7.5 years ago and when the baby was in distress and needed to be delivered they had us push on the fundus to help get the baby out. Sometimes they didn't even need to be in distress, really, now that I think about it. I can recall plenty of times that fundal pressure while mom is pushing was done. :(

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

fundal pressure or suprapubic pressure?

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Specializes in Cardiac.
fundal pressure or suprapubic pressure?

Fundal

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Specializes in Cardiac.
Fundal

We did suprapubic as well, but for the fundal I would have to get on a chair and lean of the top of the baby and push down towards the lady parts.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

i know that used to be done, but it is NOT standard correct practice NOW and we HAVE refused when a certain dr told us to do this.

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Specializes in Cardiac.
i know that used to be done, but it is NOT standard correct practice NOW and we HAVE refused when a certain dr told us to do this.

What about suprapubic pressure? Is that contraindicated as well? That doesn't seem as dangerous...

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

no, using suprapubic pressure IS employed to relieve shoulder dystocia.

you obviously know ob cardiac!

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Specializes in Labor and Delivery.

Suprapubic is acceptable. Fundal is INEXCUSABLE in a court of law!

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Specializes in Cardiac.

I loved it! If I weren't so worried about being sued 21 years later, I would go into that! I loved how autonomous the nurses were, and how they would really take care of the pt and the Dr would just come in at the last moment and do what he had to do. A nurse delivered my nephew because he couldn't wait, and she did just fine. In fact, nurses aren't in some ridiculous hurry so they won't try to rush you through your delivery. I am so excited because I rotate through OB this semester! Once upon a time I was also NRP cert.

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