There are hospitals that have stopped doing it, but many others continue with this usual practice when the woman is going to give birth. This is the enema and shaving of the pubic hair in the perineum area at the time of admission to the hospital , prior to childbirth .
Why are these practices carried out? Are they really necessary? Let’s see what the experts and scientific evidence say.
Pubic or perineal slit
When entering the hospital to give birth, some centers contemplate in their protocol that the nurse shave the pregnant woman’s pubic hair with a razor. It is usually done in the lower area of the vagina, around the vulva, where the baby’s head will come out.
According to the SEGO, “removing the hair from this area allows for better cleaning and asepsis and facilitates the suturing of the incision” in the event that you undergo an episiotomy at the time of delivery.
Enema before childbirth
Along with shaving, when entering the hospital to give birth and settle in the room, the nurse gives the pregnant woman an enema to empty the intestine. Not all maternity hospitals have it implemented as a routine practice, but it is still done in some.
The objective of this practice, according to the SEGO, is “to produce the evacuation and cleaning of the intestine so that, at the time of delivery, when there is great pressure from the head of the fetus on the rectum, there is no exit of feces, which is an uncomfortable situation for the mother, also contaminating the surgical field, the vulva, and even the baby”.
Clarifies that some women prefer to place the enema at home and go to the hospital with an empty intestine.
What do the WHO and the EAPN say?
To date, they are not practices recommended by the WHO , and this is detailed in its 56 recommendations for care during childbirth, for a positive childbirth experience published in 2018.
Specifically, in point 14 it says:
Routine pubic or perineal shaving before vaginal delivery is not recommended.
And at point 15:
Enemas are not recommended to reduce the use of labor augmentation.
Also in the Normal Childbirth Care Strategy, revised in 2015, the routine administration of an enema to the pregnant woman is discouraged , and it is only recommended to optionally apply prior information, if the woman so wishes.
It also advises avoiding the routine practice of perineal shaving for women in labor. And it clarifies that, optionally, if it is considered necessary in case of suture, the area can be partially shaved.
What do the studies say about the enema and shaving? Are they really necessary?
The evidence speaks against the routine use of enemas during labour. A review of studies published in the online edition of The Cochrane Library in 2013 concludes that the enema is not necessary , that it does not reduce the rates of infection due to injuries in the mother or the baby, nor does it improve the experience of childbirth for the woman.
The latter found that there were no significant differences between the rates of infections due to lesions in the perineum and infections in the babies of women who received enemas and those who did not, nor that the use of enemas has modified the rate of pediatric respiratory infections.
Regarding shaving , the available evidence is insufficient to recommend performing perineal shaving in parturients for the prevention of perineal infections. And its practice is considered unjustified due to the discomfort it causes, such as itching when hair grows back, which will be added to the typical postpartum discomfort.
In addition, various studies warn that shaving increases the risk of perineum infections, because by destroying the local defense mechanisms and the possible injuries that can be caused, they open the door to the germs that cause the infection.
In conclusion, neither the enema nor the shaving prior to childbirth are justified practices based on scientific evidence . However, the enema can be administered to the mother before delivery if, after informing her, she prefers it for comfort or has a lot of retained stool that prevents the descent of the baby’s head.
Regarding shaving, if the woman so chooses, she can shave beforehand at home, or as an option it can be done at the time of suturing the episiotomy if necessary, and the mother consents.