Scientific research does not support the use of enema during labor anymore because it believes that the technique is ineffective in preventing maternal and neonatal risks of infections (1).
That said, doctors may still recommend enemas to women based on their conditions. For example, it may shorten labor pain, relieve bowel issues, or benefit women with constipation before labor. However, since each pregnancy is different, you should discuss your issues with your doctor and decide whether you need an enema or not.
Read this post to understand why enema is used during labor and why it is not recommended for all women.
Why Is Enema Not Recommended Before Labor?
Administering enema during labor is not recommended due to the following reasons (2) (3).
- 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.
The administration of enema during labor may vary each time and for each woman. Although there is no scientific evidence that enema assists in labor, a few hospitals may suggest it relieves any gastrointestinal discomfort before the delivery. However, due to the limited studies on the proven efficacy of enema, it is up to you and your medical professional if you should receive it. Therefore, talk to your gynecologist before the delivery date arrives to know if an enema would be a viable option for you.
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