Massaging the fundus after delivery is an important part of postpartum care. Fundal massage, also known as uterine massage, is a technique used to reduce bleeding and uterine cramps after delivery or after an abortion. It is used to treat uterine atony, a condition in which the uterus lacks muscle tone and is soft to the touch rather than firm. The massage causes the uterus to contract and squeeze downward to stop bleeding from the wound inside the uterus where the placenta was located.
Background massage is when the nurse presses on the abdomen and firmly massages the uterus, specifically the fundus of the eye, or the upper part of the uterus. The reason for this massage is to reduce the risk of postpartum bleeding and to help the uterus shrink back to its pre-pregnancy size. Pushing and rubbing the uterus will cause contractions, also known as back pain. These contractions won't be as painful as the ones you just suffered, but they'll still be unpleasant.
Bottom massages are performed to stimulate uterine contractions and prevent postpartum bleeding. After the baby is born, it is important that the uterine muscle continues to contract to prevent any excessive bleeding. A fundus massage, also known as a uterine massage, is a normal part of postpartum care. This usually occurs soon after birth and can continue for hours or days, depending on the patient's needs.
The nurse will check the bleeding to make sure it hasn't increased since the last time or that you're not expelling any large clots during the massage. If you are transferred to a postpartum unit from the labor and delivery unit (in some hospitals you give birth and recover in the same room), the nurse will most likely perform another massage of the bottom of your abdomen. A uterine massage is often done while you are doing skin-to-skin with your newborn and is done to prevent postpartum bleeding. To determine its effectiveness, studies have been conducted that compare oxytocin (pitocin) with or without fundal massage in reducing blood loss after delivery and associated morbidity and mortality.
The results showed that oxytocin combined with fundal massage was more effective in reducing blood loss than oxytocin alone. Fundus massage is performed by firmly pressing the abdomen, rubbing it inward and downward against the back of the eye. This massage is also described as “harder” than the massages you're used to, since your doctor, nurse, or midwife works to stimulate the uterus. You'll usually have to go to the bathroom after a thorough massage to put on a new compress or diaper.
If proven to be effective, uterine massage would represent a simple intervention with the potential to have a significant effect on postpartum hemorrhage (PPH) and maternal mortality in low-resource settings. Therefore, it is important for healthcare providers to understand how fundal massage works and when it should be used in order to provide optimal care for their patients.