ENEMA ANYONE?

The use of enemas during labor is common practice among attending physicians. However, enemas can also cause discomfort for women and increase the cost of delivery. The Systematic Review, which made use of the Cochrane Pregnancy and Childbirth Group trials register, Database of Abstracts of Reviews of Effectiveness, and Medline dated from 1966 to December 2006, by Cuervo et. al in the Clinical Epidemiology unit of the Universidad de Javeriana in Columbia, showed that there were no significant differences in the incidence of lower respiratory tract infections among those who used enema during labor after one month of follow up (2 RCTs; 594 women; relative risk (RR) 0.66, 95% CI 0.42 to 1.04) or newborn children (1 RCT; 370 newborns; RR 1.12, 95% CI 0.76 to 1.67). The authors further concluded that there is not enough evidence to evaluate the use of routine enemas during the first stage of labor. Enemas therefore should only be on a per request basis and not routine.