HOT, HIGH AND HORRIBLE - SHOULD ROUTINE ENEMAS STILL BE GIVEN TO WOMEN IN LABOR

The effect of a soap enema on the progress of labour was studied in 16 0 women admitted for delivery in Esigodini District Hospital. The stud y was set up as a 1:1 randomised case control study in 200 women. It w as changed to a 1:3 case control study after 82 subjects had been stud ied, when it became apparent that the midwives were no longer willing to follow the study protocol. Forty women received an enema and 120 di d not. Two focus group discussions were held with 16 women who had an enema. The 12 hospital midwives were asked to give their opinion on en emas. Focus group discussions were also held with 28 traditional midwi ves. Dilation of the cervix was 2,19 cm/hour in the non-enema group (9 5pc confidence interval 1,86-2,52) and 2,00 cm/hour in the enema group (95pc confidence interval 1,38-2,62). The difference is not significa nt (t-test: p-value = 0,58). Pregnant women did not like enemas, midwi ves preferred not to administer them and were not concerned with conta mination during delivery. Traditional midwives do not use enemas in la bouring women and consider the possible contamination as normal. It is concluded that there is no benefit from routine enemas in labour.