Kristeller Maneuver: Guidelines, Damages, and Consequences

Kristeller's maneuver, which has always been much discussed due to the damage and consequences it can cause during and after childbirth, has returned to the fore in the last period due to the video-reports broadcast by programs such as Striscia la Notizia and Le Iene .

However, there are also many women who claim to have been helped by this particular maneuver and that, without it, their children would never have come into the world. How to reconcile such statements with the very different position of the many mothers who have denounced, on television and not, the danger of Kristeller?

Let's try to understand it together, first of all dwelling on what this maneuver is, how it arises and what it consists of, then examining the consequences and damage it can cause and, finally, discovering the guidelines of the World Health Organization about it.

If you are about to give birth, in the meantime, do not miss our Nanny Simona's advice on what to put and when to make the bag to take to the hospital at the time of delivery:

What is the Kristeller maneuver?

The Kristeller maneuver, also known as "Kristeller squeezing", takes its name from the German gynecologist Samuel Kristeller, who first described it back in 1867. It is an obstetric maneuver that is performed during the so-called "operative" birth, at the moment contraction.

It consists of a thrust applied to the level of the bottom of the uterus in order to facilitate the exit of the baby's head, when the birth is already at an advanced stage. The doctor or midwife who performs this maneuver places himself on the woman's side. lying on the bed supine and with the legs open and resting on the leggings.Pushes with the forearm on the highest part of the uterus, consequently pushing the baby in the direction of the exit channel.

Are we sure, however, that this technique, born in a historical period in which there was certainly no medical-biological knowledge of the female reproductive system and its functioning that we have now, does not involve risks for the child and for the woman in labor?

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Damage and consequences of the Kristeller maneuver

The Kristeller maneuver is very delicate and can lead to very serious consequences if not performed correctly, with considerable damage for both the mother and the baby. For starters, it can involve rupturing of the ribs, inversion and rupture of the uterus, vaginal and perineal injuries, or placental abruption itself.

The latter can cause lack of oxygenation for the baby in the moment of passage in the birth canal, when he would need it most, with often irreparable damage.

The risk of having to resort to an emergency caesarean section, especially in the case of a rupture of the uterus, is another of the possible consequences. Unfortunately, long-term problems cannot be excluded: prolapses, incontinence due to injuries, chronic pains.

For women, moreover, it is experienced as a real violence due to its aggressiveness, especially if it is not felt before the doctor proceeds. Furthermore, there are many cases in which it is performed - with all the risks that it entails - without it being really necessary, with both physical and psychological complications for those subjected to it.

Kristeller's maneuver: the guidelines of the World Health Organization

The World Health Organization, in its guidelines updated in 2018, defines the Kristeller maneuver as not recommended. The damage it could cause, if not performed with the right pressure and force or in the most adequate way, is infinitely greater than the alleged help that the maneuver would give in speeding up the timing of the expulsion.

As a result of these considerations, countries such as Spain and England have declared it completely illegal and the doctors who practice it are punishable by law. In Italy, on the other hand, the issue was at the center of a parliamentary question in 2013, in which, however, the Senate stressed the difficulty in being able to evaluate a case with such different outcomes and whose consequences were not always clear (often the damage seemed to be able to be attributable to other problems occurring in the delivery room).

The Kristeller maneuver, therefore, has never been prohibited by law in Italy, but it has been recommended not to use it in labor assistance and, on the contrary, to work on a professional update regarding assistance so that we do not have to get to the point. to use it. In short, although not prohibited by law, the maneuver would be completely avoided, except in absolutely extreme cases.

According to the statistics of 2017, however, as many as 22.3% of women declared that they had undergone this maneuver in the delivery room, and - if we consider the myriad of cases in which it is not recorded in the medical record, as underlined by Striscia la news - the cases would be many, many more! Not surprisingly, it is called the "invisible maneuver" ... So try to get as much information as you can about it: about the medical staff of the hospital where you will give birth and, above all, about your rights.

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