Evidence from scientific research no longer supports the routine use of enema before or during labor, as it does not have any beneficial effect in reducing the risk of maternal and neonatal infections (1).
But why is the use of enema during labor still in practice, even though it is not recommended? We will tell you about it in this MomJunction post on the use of enema during labor, when it may be used, and why it is not always recommended.
Why Is Enema Not Recommended Before Labor?
- Discomfort: Some hospitals support the routine use of enema during labor, even when it is not required. This can cause discomfort for some women, and hence, it is not recommended for all
- Increased delivery cost: Enema before labor is known to increase the overall cost of delivery, which is not feasible for many.
- Ineffectiveness: Enema has not shown any effects on reducing the duration of labor; hence, WHO does not recommend routine use of an enema to reduce the duration of labor. There is no evidence supporting the use of enema to induce labor.
Why Is Enema Still Given for Some Women During Labor?
Doctors may recommend enema for those who have constipation before labor. Passing stool is a normal occurrence during labor or delivery. Around 25% of women may experience what is called fecal incontinence or accidental bowel movement when they are in labor (4). To avoid this and save themselves from the embarrassment, some women prefer to get enema during labor.
Here are a few reasons why enema could be given during labor.
- Reduces fecal contamination: According to a study, pregnant women who were given enema had reduced fecal contamination rates compared to those who did not get an enema. Fetal contamination could cause neonatal infection and perineal wound infection.
However, another study found no difference in the fecal contamination rate between the enema and the non-enema groups (5). The risk of fetal contamination doesn’t hold for all pregnant women, which is why enema is not necessary for everyone.
- Shortens labor period: Giving enema before the onset of labor could shorten the duration of labor as the back passage becomes empty, creating more space for the baby to move out. But there is no proper evidence to prove it (2)(5).
- Relieves bowel problem: In case the bowels have not opened for 24 hours, enema could ease out that discomfort before the beginning of labor. If not done so, the bowel movement after the process of delivery could cause discomfort to the women, especially if she has an episiotomy. Moreover, if the mother is having a cesarean section, enema will be useful as they don’t have to put pressure in passing the stool.
There are several pros and cons of using enema. As there are no proven benefits, it cannot be recommended for all. However, some doctors say that there are no major side effects. Pregnant women should discuss with the doctor about her options.
Do you have any experiences to share? Tell us about them in the comments section below.
2. WHO recommendation; The WHO Reproductive Health Library
3. Effects of high-volume saline enemas vs no enema during labour; BMC Pregnancy And Childbirth
4. Managing Incontinence During Pregnancy And After Childbirth; National Association For Continence
5. Kovavisarach and W. Sringamvong; Enema versus No-Enema in Pregnant Women on Admission in Labor: A Randomized Controlled Trial; Journal of the Medical Association of Thailand (2005)
6. Constipation; Virginia Mason Hospital and Medical Center