Sunday, November 13, 2011

Fundal Pressure during delivery

There are three possible ways of delivery

  • Normal delivery
  • Vaginal delivery ( Instrumental delivery including ventouse and forceps)
  • Caesarean section
Normal delivery without any intervention is the best one if one can achieve it.I am now rather tired of mentioning this very obvious fact again and again on by blog.I wish not to mention it but after conducting a vaginal delivery I feel as I am the odd one out in our current scenario.
Why am I writing this post? I am agitated at the ignorance of our health care professionals including gynaecologists,paediatricians and neonatologist and nurses in Indian setting who think that caesarean is a safer and better option for the baby.I am not saying that 100% of the healthcare givers feel that way but majority of them do.
A ventouse or forceps delivery is looked with horror.I am ashamed to write as I know my blog is read by a much wider group than just Indians,that in India including the best of set ups gynaecologists,nurses  as well as paediatricians consider something which is condemned in civilized work  as a safer option of delivery rather than a safely conducted instrumental delivery.Pushing the ladies uterus hard to deliver the baby in order in avoid the assisted delivery is considered safe.They forget that this fundal pressure can lead to rupture of uterus,spleen,liver and ribs of the pregnant lady and in long run can lead to uterine prolapse
.Agreed it requires no technique ,just brute force,but how does that make it safe? NEXT TIME YOU FIND YOUR OBSTETRICIAN OR HER ASSISTANT PUSHING YOUR UTERUS DOWN STOP THEM!!!!!!!!!!!!It can lead to grave injury to you.(there are two conditions where uterine pressure is justified .One is at the time of delivering the baby out at the time of a caesarean delivery and another one when there is shoulder dystocia).
If any of you wish to correct me regarding this fundal pressure thing................please feel free to leave a feedback with evidence regarding the same.
And caesarean at the drop of the hat might be right thing to avoid a medicolegal process from a gynaecologists point of view but what about the various risks of future  that the Lady is left with,like Placenta praveia,accreta,adhesions,infertility.


Pousumi said...

Informative blog and a very interesting article. Please keep posting more articles like these so that would be parents like us can make informed decisions. Its a big help as we do not always have the precise questions to ask during the consultation.

Hayley said...

Very good article but.. fundal pressure for shoulder dystocia can actually cause the shoulder to become more impacted and is not recommended. Suprapubic pressure is what is recommended for shoulder dystocia.

Dr Kaushiki Dwivedee said...

Very correct Hayley...that is why I have written Uterine pressure and not fundal pressure for shoulder dystocia.A non medical person won't be able to differentiate between a fundal pressure or suprapubic pressure just by reading this blog.The idea is to make them aware that uterine pressure is wrong and they should question their obstetrician.