I am perpetually afraid that some resident doctor will use fundal pressure to aid childbirth and cause a serious complication for a woman in labor or her baby. So when I saw a very short and thin woman in the postnatal ward and learned that she had delivered normally, I asked my residents “did you make fundal pressure to deliver her?”
“No, Sir! We don’t make fundal pressure” they said.
“Shall I ask the patient and verify?” I asked.
“Yes, Sir!”
So I turned towards the patient and asked, “did you get tired during labor, trying to push the baby out?”
“Yes” she said.
“I hope the doctors were helpful” I said.
“Yes, they were quite helpful” she said.
“Did they put their hands on your abdomen and push so that you could deliver?”
“Yes” she said.
“So you did make fundal pressure” I said to my Registrar.
“No, Sir. It was not fundal pressure. We just tickled her abdomen to stimulate uterine contractions.”
“Tickle her abdomen?” I said. Then it came back in a flash. When I was a resident doctor, the midwives had taught me to make flicking movements on the woman’s abdomen with the tips of the fingers to stimulate uterine contractions. We used to do it even if we had not read anywhere that it was effective in stimulating uterine contractions. My lecturer of that time, who has passed away long since, did that herself too, or if not at least never told us it was useless. We stopped doing that when we knew better.
“How does it stimulate uterine contractions?” I asked.
“Only in the second stage of labor” he confided.
“OK, only in the second stage of labor. How does it act?” I asked.
He smiled but did not answer.
“It is probably a right-brain conviction” I said.
