Hamilton maneuver to induce labor: what does it consist of?

The Hamilton maneuver is a technique to induce natural labor without the use of drugs. It is a controversial practice, as it generates certain risks and does not seem to have clear benefits for initiating labor.

What is done in the Hamilton maneuver is to stimulate the uterus for a natural release of prostaglandins. These promote the dilation of the cervix. In this technique, the amniotic membranes are manually separated from the walls of the uterus.

The doctor or midwife inserts the index finger through the uterine canal. Once it touches the amniotic membranes, it makes gentle. Circular movements separate from the uterus. After the application of the Hamilton maneuver, labor begins naturally in the next 24 to 48 hours.

In which cases is the Hamilton maneuver indicated?

The Hamilton maneuver should only perform in term pregnancies; that is, from week 39 on. It is attended when it is necessary to induce labor for medical reasons, such as pre-eclampsia, poorly controlled diabetes, or placental insufficiency.

Likewise, the Hamilton maneuver It can be recommended when the mother has reached the 40th week of gestation and still does not show labor signs. Either way, the baby should already be fully formed.

Other clinical criteria

The Hamilton maneuver can only perform if the amniotic sac is complete. In other words, the mother must not have broken waters. Also, the cervix should be soft to reduce any discomfort and facilitate the procedure.

The more dilated the uterus, the higher the chances of success and the less likely complications. This maneuver should not perform until the cervix has dilated at least 1 centimeter. The Bishop test is a reliable tool, and the pregnant woman should obtain a score greater than 4.

The Hamilton maneuver is contraindicated if there is bleeding active. It should also not be practiced when there is a placenta previa or the presence of group B beta-hemolytic streptococcus, gonococcus, or chlamydias.

In summary, this type of maneuver should only be practiced if there is a medical criterion that justifies its performance. The pregnancy is at term, and the cervix’s conditions favor dilation.

What risks can it have?

The Hamilton maneuver is not without risk. To start, whoever carries it out must have great expertise to carry it out conveniently. However, even if done correctly, complications can still arise that put mother and baby at risk.

The most common risk is light bleeding. This is usually pink or brown in color and is caused by a capillary rupture during the manipulation of the uterus. This area has many blood vessels, and it is easy for this bleeding to occur.

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Another common risk is the presence of pain. There is almost always some discomfort during the procedure, but sometimes it escalates and is felt more intensely. This occurs during the intervention and even several hours after it is carried out.

Other risks

In addition to the unwanted effects that have already been mentioned, there are also other risks caused by the Hamilton maneuver. The most common are the following:

  • Rupture of the amniotic sac prematurely. This leads to the loss of amniotic fluid and prevents the Hamilton maneuver from continuing.
  • Infection. By breaking the baby’s protective barrier, the risk of infection is higher.
  • Intensification of contractions. Contractions can become more intense, excessive, and uncontrolled, as well as more painful.
  • Expulsion of the mucous plug. The Hamilton maneuver can lead to this happening before labor begins.
  • The partial detachment of the placenta.

There are no studies available that reliably prove the efficacy of the Hamilton maneuver. As has been seen, this is not free of risks and complications either. Therefore, the medical justification for carrying it out must be obvious before carrying it out.

A maneuver to apply in few cases

If the pregnancy proceeds normally and has not reached week 40, there is no reason to support the Hamilton maneuver’s performance. It is important that the expectant mother talk to the doctor about it, obtain information, and express her opinion about the topic.

Although the Hamilton maneuver is not a complicated procedure, it requires informed consent before carrying it out. This is because, as we have seen, it also creates risks.

The mother must inform in detail about the procedure and its possible effects. The reason for which this practice is to be carried out and its benefits and risks must explain. The pregnant woman must decide if she agrees to undergo the Hamilton maneuver and express her decision before this practice.

In the last weeks of gestation, anxiety about holding the baby in her arms usually arises. Advancing labor naturally is always a good option. Read more “