What is the Hamilton Maneuver? Is it a good option?

Pregnant woman

When arrives the last weeks of your pregnancy Your midwife or gynecologist may ask you about the possibility of performing a maneuver to induce labor naturally. This is known as la la Hamilton maneuver.

Many moms who have already had other babies, when they reach the end of pregnancy, even request it to try to shorten the pregnancy somewhat.

Today we are going to see what the Hamilton maneuver consists of and what complications it can have.

A Little History

There have always been births that were difficult to "start". Pregnancies come to term after week 37, but it is not convenient to wait without limit time until labor starts spontaneously.

Throughout history, the most favorable situation for babies has been studied, assessing the complications that appear in childbirth and in babies when pregnancy lasts more than 42 weeks.

Over time it has been estimated that the ideal situation is that the baby is born between week 37 and 42. Finally, a consensus has been reached and all scientific societies advise inducing labor ten days after leaving accounts, that is to say at 41 weeks and three days.

It was not until well into the twentieth century that synthetic hormones began to be available, very similar to the natural ones and that they could be used quite safely, which in recent years have changed in the form of application, until achieving high security compounds, both for mom and baby.

On the other hand, until the middle of the last century births occurred at home and no technology was available. So we had to find ways to help the births start in a way that more naturally and quickly as possible, with some simple and comfortable technique or maneuver to perform that, in addition did not need technical means or transfers to hospitals, out of reach of the majority of the population.

The Hamilton maneuver is one of those methods and it has been used for many years as an induction method.

What is the Hamilton maneuver?

The Spanish Society of Gynecology and Obstetrics (SEGO) catalogs this maneuver as a method of mechanical induction of labor.

The Hamilton maneuver consists in performing a vaginal examination and through the cervix try to reach the lowest area of ​​the bag of waters and gently turning the finger, try to peel off the membranes of the amniotic sac of the wall of the base of the uterus.


This is intended to stimulate our body to released naturally hormones, prostaglandins, at the level of the cervix and are produce cervical ripening necessary for labor to begin.

Can it be done at any time?

It is important that we understand no attempt is made to dilate the cervix manually, that's a different possibility.

To make it possible to perform the Hamilton maneuver it is it is essential that the cervix is ​​"favorable". This means that there has to be some dilation, at least one centimeter, that allows us to introduce the uterus through the cervix without problems. In addition, it is necessary that the cervix something has softened, if this is not the case, performing this maneuver may be complicated for the professional and truly annoying for the mother.

Another important condition is that the pregnancy is full term. That is, we are over 37 weeks. Although, in general, the Hamilton maneuver is not usually performed never before week 38, the usual thing is to do it between 38 and 39 weeks.

Who performs it and where?

This maneuver usually performed by the gynecologist. The usual thing is that it is carried out in the last pregnancy visits, after you have one of the last monitors done before delivery.

No special preparation is necessary. They will surely perform the monitor and after evaluating the results they will perform a vaginal examination. So if the cervix has adequate conditions they will give you the possibility to perform this maneuver.

Can they do it without my consent?

As a general rule, any intervention carried out by us it must be with our consent, It is not necessary that it be in writing, but it is important that they briefly explain what they are going to do so that you give your verbal consent.

It is important that we explain the technique concisely, It is a somewhat committed moment, but that is not an impediment to a brief explanation. The professional who performs it should tell you what the maneuver name, make it clear that this is the Hamilton maneuver, what is, what is it done for, if there are other alternatives, what happens if it is not done and what risks does it have

Is it effective? Will I go into labor?

In theory it should trigger contractions between 12 and 24 hours after the maneuver is performed.

But its effectiveness is not 100%. There are many times when this This maneuver has no effect and finally, it is necessary to use a pharmacological induction method.

So why is it done?

If its effectiveness is limited and we cannot ensure that it works, why use it? The answer is simple, because is a much less invasive method, with far fewer side effects and complications than any other method with which we can try to induce labor.

It is a good option to try that labor starts naturally when the date is coming and it seems that our body does not finish deciding for itself ...

The Hamilton maneuver it is done in the consultation and the mother knows you can go home with ease. It is generally annoying, it can be a bit painful and generally causes some bleeding that sometimes makes us a little nervous and scares us.

This bleeding is normal to appear in the next 24 hours to have a vaginal examination performed, whether it is accompanied by the Hamilton maneuver or if it is a simple touch to assess if you have any dilation of the cervix.

The color of the bleed ranges from intense red of the first hours after the touch to the dark brown at the end and you will also notice the expulsion of the mucous plug or the remains that may remain of this mucous plug.

In the consultation before leaving you will have explained possible reasons for alarmIf you don't notice any, calm down.

The usual thing is that you leave the consultation somewhat bothersome, perhaps with little bleeding, but you won't have any more symptoms. Contractions will surely appear throughout the day.

If, finally, the Hamilton maneuver is not effective and labor does not start spontaneously before 41 weeks and three days, there will be no other choice. to resort to another method of induction.

Possible complications

They are quite rareIf any of these appear, they are the most frequent:

  • Rupture of the bag of waters
  • Partial detachment of the placenta
  • Uterine hyperdynamia. That is, the uterus responds with excessive stimulation and contractions appear very followed and very intense.
  • Infection.
  • Heavy bleeding from the cervix.

Reasons for alarm

  • Heavy bleeding, such as a menstruation or greater.
  • Sensation of fluid leaking from the genitals, it may mean that you have broken the bag of waters.
  • Intense pain and that does not yield in the lower abdomen.
  • Very often contractions, with almost no rest time between one and the other.
  • Not noticing baby movements. If you stimulate him by talking to him, caressing him and he does not respond, it is reason to go to the emergency service of your motherhood.
  • Fever and malaise

Remember, if at the end of pregnancy if you are raised the possibility of performing a vaginal examination, ask if they intend to perform this maneuver. Listen to the professional's motives to do it and if he does not finish convincing you, explain it to him and make it clear that you do not want have it done for you.


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