An enema during labor is a procedure where liquid is injected into the rectum to empty the bowels before delivery. It was once a routine part of hospital admission for women in labor, but the practice has largely been abandoned. A Cochrane review of randomized controlled trials found that enemas provide no significant benefit for infection rates, labor duration, or neonatal outcomes, and most hospitals in high-income countries no longer perform them as standard practice.
Why Enemas Were Once Routine
For decades, enemas were given to nearly every woman arriving at the hospital in labor. The reasoning seemed logical at the time: emptying the bowels would create more room in the birth canal, reduce the chance of passing stool during delivery, shorten labor, and lower infection risk for both mother and baby. There was also a belief that it would spare women embarrassment and reduce discomfort from bowel movements after birth, particularly if they had an episiotomy (a surgical cut to widen the vaginal opening).
These assumptions went largely untested for years. The practice was simply considered standard preparation for birth, much like shaving the pubic area, which has also since fallen out of favor.
What the Evidence Actually Shows
When researchers finally put labor enemas to the test in randomized trials, the supposed benefits didn’t hold up. A Cochrane review examining the available evidence found that routine enemas during labor were not associated with reduced rates of infection in mothers after birth, infection of the newborn’s umbilical stump, more severe perineal tears, or shorter labor. In short, none of the original justifications were supported by data.
One concern that the review raised is that enemas can actually backfire in a specific way. While they may prevent solid stool from passing during delivery, they can cause watery fecal leakage instead, which could theoretically increase infection risk rather than reduce it. The review also noted that none of the trials measured the pain women experienced from the enema itself during labor, a significant gap given that the procedure adds discomfort during an already intense process.
Based on this evidence, the review concluded plainly: the data speaks against routine use of enemas during labor.
How Common the Practice Is Today
The shift away from routine enemas has been dramatic in many countries. One survey of hospitals found that only 37% had a “no enema” policy in 2003, but by 2007 that number had jumped to 88%. In the United States, the United Kingdom, and much of Europe, routine labor enemas are now uncommon.
The practice persists in some regions, though. In Taiwan, for example, enemas have remained a routine part of labor preparation in many hospitals, even as the evidence against them has mounted. Some hospitals in parts of Latin America and South Asia also continue the practice. If you’re giving birth at a hospital outside of North America or Western Europe, it’s worth asking about their protocols ahead of time.
Pooping During Labor Is Normal
One of the biggest reasons women wonder about enemas is the fear of having a bowel movement during delivery. This is worth addressing head-on: passing stool during labor is extremely common. Clinicians at the Cleveland Clinic describe it as something that happens with “almost every patient.” The reason is straightforward. During the pushing stage, you engage the same muscles used for a bowel movement, and your baby’s head puts direct pressure on the rectum as it moves through the birth canal. Stool passage is practically unavoidable.
Labor and delivery nurses and midwives are prepared for this and handle it quickly and discreetly, often before you even notice. Many providers actually view it as a positive sign. As one obstetrician puts it, if you’re pooping while pushing, you’re using the right muscles. It means you’re pushing effectively.
When an Enema Might Still Be Offered
While routine enemas are no longer recommended, there are limited situations where a provider might suggest one. If you haven’t had a bowel movement in 24 hours or more and a pelvic exam shows a full rectum, emptying the bowels could reduce discomfort during and after delivery. Some women also request an enema themselves because they feel more comfortable going into labor with an empty bowel.
If an enema is offered or you’re considering requesting one, it typically involves a small amount of liquid (often a sodium phosphate solution) administered rectally. You then use the bathroom to empty your bowels before labor progresses further. Complications from the procedure are rare, but the discomfort and cramping it causes can be unpleasant on top of early labor contractions.
The key distinction is between routine use and individual choice. The evidence is clear that giving every laboring woman an enema provides no medical benefit. But if you personally feel strongly about it, it’s a conversation you can have with your care team as part of your birth preferences.