Week 12: Fundal Massage
Fundal Massage 101
How to Not Look Clueless at the Bedside
First time doing a fundal massage?
Yeah, same.
I remember staring at a postpartum mom’s abdomen, silently screaming:
“Nasaan ang uterus dito?!”
In the OB ward, fundal massage is one of the most frequent but most nerve-wracking tasks student nurses get. So this week, I’m breaking it down — what it is, how to do it right, and how not to look like you’re just pressing randomly.
“Nasaan ang uterus dito?!”
🟪 What is Fundal Massage (a.k.a. Uterine Massage)?
It’s the technique of massaging the uterus through the abdomen to help it contract and prevent postpartum hemorrhage.
Usually done immediately after delivery, and during your routine checks in the first few hours postpartum — especially if the uterus feels “boggy.”─────────────────────────────
🟪 Why It’s Super Important
After birth, the uterus needs to clamp down to stop bleeding.
If it stays soft or “boggy,” bleeding can continue — and that’s dangerous.
Fundal massage stimulates contractions and expels clots.
Basically: No massage = risk for hemorrhage = big problem.
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After birth, the uterus needs to clamp down to stop bleeding.
If it stays soft or “boggy,” bleeding can continue — and that’s dangerous.
Fundal massage stimulates contractions and expels clots.
Basically: No massage = risk for hemorrhage = big problem.
🟩 How to Do It (Step-by-Step Student Guide)
🔹 1. Wash hands, explain to the patient.
"Ma’am, imu-massage po natin ang matris ninyo para ‘di kayo magdugo nang malala, ha?"
🔹 2. Position the patient.
Supine, knees slightly bent, relaxed as possible.
🔹 3. Locate the fundus.
Use your non-dominant hand to anchor just above the pubic bone (to support the uterus and prevent prolapse).
With your dominant hand, palpate the abdomen from the umbilicus downward.
🔹 4. Massage in a circular motion.
If the uterus is firm → no need for massage, just document.
If soft → gently massage until firm.
🔹 5. Observe lochia (bleeding).
Note the amount, presence of clots, odor, or any gush of blood.
🔹 6. Document findings.
Ex: “Fundus firm, midline, at level of umbilicus. Moderate lochia rubra noted. No clots.”
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🔹 1. Wash hands, explain to the patient.
"Ma’am, imu-massage po natin ang matris ninyo para ‘di kayo magdugo nang malala, ha?"
🔹 2. Position the patient.
Supine, knees slightly bent, relaxed as possible.
🔹 3. Locate the fundus.
Use your non-dominant hand to anchor just above the pubic bone (to support the uterus and prevent prolapse).
With your dominant hand, palpate the abdomen from the umbilicus downward.
🔹 4. Massage in a circular motion.
If the uterus is firm → no need for massage, just document.
If soft → gently massage until firm.
🔹 5. Observe lochia (bleeding).
Note the amount, presence of clots, odor, or any gush of blood.
🔹 6. Document findings.
Ex: “Fundus firm, midline, at level of umbilicus. Moderate lochia rubra noted. No clots.”
🟨 Pro Tips (I Wish I Knew Earlier):
✔️ Firm doesn’t mean rock-hard. It should feel like a grapefruit — round and firm, not squishy.
✔️ Boggy = soft = red flag. That’s when you massage.
✔️ Always support the uterus. Never massage without anchoring your hand below — it could lead to uterine prolapse.
✔️ Be gentle, but not too gentle. You're helping her, not tickling her.
✔️ Talk to the mom while doing it. It helps them stay calm and feel respected.
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✔️ Firm doesn’t mean rock-hard. It should feel like a grapefruit — round and firm, not squishy.
✔️ Boggy = soft = red flag. That’s when you massage.
✔️ Always support the uterus. Never massage without anchoring your hand below — it could lead to uterine prolapse.
✔️ Be gentle, but not too gentle. You're helping her, not tickling her.
✔️ Talk to the mom while doing it. It helps them stay calm and feel respected.
🧠 Common CI Comments (And How to Avoid Them):
❌ “Bakit ka nag-massage eh firm na?”
✅ Only massage if the uterus is boggy.
❌ “Hinayaan mong mag-gush ang dugo?”
✅ Always monitor for bleeding during and after massage.
❌ “Saan mo nahanap ang fundus niyan?”
✅ Take your time. Find the right landmark before massaging.
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❌ “Bakit ka nag-massage eh firm na?”
✅ Only massage if the uterus is boggy.
❌ “Hinayaan mong mag-gush ang dugo?”
✅ Always monitor for bleeding during and after massage.
❌ “Saan mo nahanap ang fundus niyan?”
✅ Take your time. Find the right landmark before massaging.
To Fellow Student Nurses
Yes, it’s awkward the first few times.
Yes, your CI might hover behind you with arms crossed.
But each time you do it right, you’re literally saving lives.
“Uterine tone saves lives. And student nurses can help preserve it — one massage at a time.”
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Yes, it’s awkward the first few times.
Yes, your CI might hover behind you with arms crossed.
But each time you do it right, you’re literally saving lives.
“Uterine tone saves lives. And student nurses can help preserve it — one massage at a time.”
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