c. Cleansing Enema.
(1) A cleansing enema may range from "mini-" or "Fleets" to a full,
soap-suds enema. Giving an enema is no longer considered routine. There must be a
physician's order to perform this task.
(2) The patient must be evaluated to determine if she has had a recent
If a cleansing enema is given, it is usually a small fleet.
Some physicians consider giving fleets to:
(b) Cleanse the bowel. This provides more room for fetal passage.
Stimulate uterine contractions.
(5) Some physicians consider not giving fleets because the following factors
may be present or begin:
Presenting part not engaged.
Abnormal presentation--breech or transverse.
(e) Already rapid moving labor.
Membranes are ruptured or danger of prolapsed cord.
(h) Results of enema may produce unmanageable amounts of loose
stool at delivery.
d. Evaluation of Uterine Contractions Continued.
(1) The purpose of this evaluation is to assess the ability of the uterus to
dilate the cervix, help in determining the progress of labor, help to detect abnormalities
of uterine contractions (such as lack of uterine relaxation), and help to evaluate any
signs of fetal distress.