As a new mom, sometimes you can be blissfully unaware of what actually occurs once you have that perfect new baby. Labor and delivery and your postpartum experience can be really overwhelming if you don’t know what to expect. In this post, we’re going to talk about fundal massage postpartum.
A lot of new moms have never heard of this until it’s happening to them after their delivery and in the postpartum unit. So let’s talk about what it is and why it’s necessary!
Fundal Massage Postpartum: What is it?
After the delivery of your baby, your health care provider or nurse will locate the top of your placenta, called the fundus. Once your baby is born, it is typically located at or right below your belly button.
A fundal massage is performed by pressing down on the abdomen firmly, rubbing inward and downward on your fundus. It definitely does not feel like a “massage” and is not meant to be pleasant.
Often times women don’t realize because of all of the commotion going on with the arrival of your new baby. But your provider will push down on your fundus to help with the delivery of the placenta and to expel any other blood and blood clots that occur during and after delivery.
The fundal massage will also be performed throughout your stay in the hospital.
Thankfully, the massage itself doesn’t last very long (no more than a minute). You can request your nurse give you pain medication 30 minutes before the anticipated massage to help with any discomfort.
You will experience the passing of blood and possibly blood clots. So you will usually have to get up to the bathroom after a fundal massage to get a fresh pad or diaper on. The nurse will check your bleeding to ensure it hasn’t increased since the last time or that you’re not passing any large clots during the massage.
Why is it Important After Childbirth?
Fundal massages are performed to stimulate uterine contractions and prevent postpartum hemorrhage. After delivery of the baby, it is important for the uterine muscle to continue to contract to prevent any excessive bleeding.
There should be a pretty significant difference in the size and feel of your uterus before and after the delivery of your baby and placenta.
Common causes of postpartum hemorrhage include uterine rupture, retained placenta, placental abruption, placenta previa, tear of blood vessels in the uterus, and uterine atony. Excessive postpartum blood loss becomes very dangerous for the mother, who may experience low blood pressure, back pain, feeling faint, high heart rate, and more.
If a woman experiences postpartum hemorrhage, common treatment includes the use of a blood transfusion.
Uterine atony is when the uterus fails to contract after delivery. This is one of the most important reasons fundal massage is performed for postpartum mothers.
After delivery of the placenta, the third stage of labor, you may be given an IV drug called Pitocin to also help stimulate contraction of the uterus. Some women may have already been on Pitocin to induce labor. In this case, they will just continue to run the drug for an hour or two depending upon how heavy you’re bleeding.
As you can see, it’s really important for the uterus to continue to contract after delivery. This should occur for both vaginal delivery and cesarean delivery. Breastfeeding also helps to stimulate uterine contractions postpartum.
When Do You Get a Fundal Massage Postpartum?
The frequency of your fundal massages depends upon the policy of the hospital you deliver in. However, on average, a fundal massage is performed every 10-15 minutes the first hour after birth. And every 30 minutes in the second hour of birth.
If you get transferred to a postpartum unit from the labor and delivery unit (in some hospitals you deliver and recover in the same room), your nurse will most likely perform another fundal massage. This is so she can check out the firmness of your uterus and assess your bleeding for a baseline assessment.
You may hear your nurses hear the term “boggy uterus”. This is when the uterine muscle doesn’t contract as it’s supposed to and the uterus will not feel as firm as it should.
After the second hour of birth, your fundal massage will typically happen every 4-8 hours until you’re discharged from the hospital. Unless your nurse notices you’re passing larger clots or having more heavy bleeding. In this case, they would start to perform them more frequently.
Do You Get a Fundal Massage if You Had a C-Section?
The use of uterine massage is also necessary for mothers who had a cesarean delivery. Again, some hospitals’ policies are different. So if you’d like to be mentally prepared for all aspects of birth, ask your health care provider or midwife what happens at the location you will be delivering at.
Although a fundal massage can cause quite a bit of discomfort for the mother, the effectiveness of uterine massage combined with oxytocin (Pitocin) administration has shown to decrease blood loss in postpartum mothers. I hope after reading this you feel more informed and prepared for one aspect of what to expect postpartum!
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