Shaved, Starved, and Strapped Down: The Rituals of the 1980s Labor Room
Perineal shaving, enemas, strict NPO, mandatory lithotomy. None of them helped. All of them humiliated.
Picture the scene. It is 1982. A woman arrives at the hospital in active labor. She is frightened, in pain, and hopeful. Within minutes of admission, the following happens:
A nurse shaves her perineum. She is told it reduces infection.
She receives a cleansing enema. She is told it prevents contamination during delivery.
An IV is started. She is told she cannot eat or drink anything. Not water. Not ice chips. Nothing.
She is placed on her back in lithotomy position. Her legs are placed in stirrups. A continuous fetal monitor is strapped to her abdomen.
She will remain in this position, hungry, thirsty, and immobilized, until she delivers or is taken for a cesarean.
Every step of this ritual was performed to “help.” Every step was backed by authority and tradition. Every step was standard of care at virtually every hospital in America.
Not one of these practices was supported by a randomized controlled trial. Not one survived when finally tested. The WHO recommended against routine shaving and enemas in 1996. Cochrane reviews found no evidence supporting strict NPO, mandatory lithotomy, or routine IV fluids in normal labor.
The admission ritual of the 1980s was not medicine. It was theater.
🎯 Free Subscriber Bottom Line: The standard labor admission of the 1980s included perineal shaving, enemas, strict NPO, IV fluids, lithotomy positioning, and continuous monitoring. Each was performed routinely and justified as medically necessary. Each has been shown by Cochrane reviews and the WHO to be without benefit. The labor room of 40 years ago was built on ritual, not evidence.
Below, paid subscribers get: - The evidence against each ritual with Cochrane findings and WHO recommendations - The Mendelson story: how one 1946 case report created 70 years of starvation in labor - The scopolamine “twilight sleep” era and the women’s health movement that ended it - What hospitals still do versions of these practices today - A complete table: ritual, origin, rationale, evidence against, year abandoned - The ethics of bodily autonomy in labor and why these rituals persisted.
