I have thought it necessary to tell you about the Risks of the Kristeller maneuver during labor (more specifically in the expulsion), after giving several turns to a tragedy that happened last month in Careggi (Italy). A 36-year-old woman who went to the hospital, ended up with a ruptured spleen, an injury that could have been caused by the aforementioned maneuver, although other causes are also possible.
Annalisa had had a normal and healthy pregnancy, but after being discharged (and with the baby at home), she had to go back to the emergency room due to the complication presented. The facts are being clarified, so we will not delve into it. What is the Kristeller maneuver? (or invisible maneuver)
It consists of the realization of pressure (with the hands or the forearm) on the uterine fundus; is used in order to make the expulsion shorter. I will say that, despite its frequency (one in four vaginal deliveries in Spain) the WHO and the Ministry of Health advise against it, taking into account the risks that both the mother and the baby present.
Kristeller: Why take the risk?
If the performance of the maneuver is not without risks, and benefits are not associated with it (according to scientific evidence), then? As I have already mentioned, it is intended that the baby's head approaches the vagina, or that it begins to come out (depending on the position in which it is). It seems to me that childbirth is a physiological process and the only thing that interventionism achieves is to interrupt or modify it, in the interests of the professionals who attend. I call that obstetric violence.
It was Samuel Kristeller who "invented" the maneuver in 1867, but today the Ministry of Health has a very clear standard regarding its frequency: 0 percent, and yet it is the order of the day. Is invisible because it is not recorded in the clinical history, and is done without the consent of the pregnant woman.
Kristeller risks.
In Parto es Nuestro, a campaign called Stop Kristeller, whose content is still current on the web. Among the risks to the baby are cited: hypoxia, bruising, humerus or rib fracture, shoulder dystocia (and associated complications), increased intracranial pressure. And regarding the dangers for the mother: bruises, premature detachment of the placenta, uterine rupture and inversion, increased risk of perineal and vaginal tears ...
You can avoid it by presenting a Birth Plan, gathering information and interviewing the establishment where you plan to give birth. Keep in mind that you have rights to assert. I am left with the data that according to the EPEN campaign: 29,1% of the interviewees asked to stop during the maneuver that was carried out, although in 90% of these cases, they were ignored.