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Thread: Internal during contraction.. why?

  1. #1

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    Default Internal during contraction.. why?

    Have been reliving my last labour.. and i very strongly remember having a internal during a contraction. It hurt like ell, and, i wonder why the midwife gave an internal then, as opposed to waiting to do it between contractions..



    Any ideas?

  2. #2

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    thats quite unusual not sure why she did that buit all of them are different and do weird things. You poor thing must have been in so much pain...

  3. #3

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    I remember I had an internal during a contraction (well one hit whilst I was having one) and the midwife said it was good because whe could see where I was at when the contration hit. Ie. when no contraction was ther I was 4cm when the contraction hit the cervix would widen to 5-6cm but close back up a bit after the contraction was gone. Hope that made sense.

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    I don't have any answers, my first thought was maybe so it didn't hurt so much (like, combine to pain in one...)...? But then, its late, I'm tired, and that doesn't realy make all that much sense in my head... so ...? I but just wanted to say she's lucky you didn't kick her across the room! I'd be interested to know the reasoning...

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    Yes every midwife is different. Mostly an internal is done inbetween contractions although sometimes if you want to break the waters its better to do it during a contraction as it brings the baby's presenting part down so its well applied to the cervix and reduces the risk of a cord prolapse. There can be a big difference between an examination during a contraction and one when there is not a contraction. Sometimes it might be necessary if you are needing to push and the midwife/dr wants to speed the delivery up by trying to push the cervix over the baby's head to facilitate birth when you are not already fully dilated. Obviously this would only be done if the baby needs to be born quickly (fetal distress) or in some case for the benifit of the mother with her consent of course. By the sounds of things these things I have just mentioned were not the case with you but thats some reasons I know why an internal might be done during a contraction. Other wise the midwife is nasty or thinking to save you two pains seperately you might have one larger pain so you can have the inbetween to rest.

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    My midwife did an internal at 8cm when I said I felt like pushing. She stayed there during the contraction and then told me I was fully dilated so I could push any time I liked. She may have given the cervical lip a little nudge at the same time but it confirmed I was ready to go - just as my body told me I was

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    Unfortunately many internals are done either because the hospital policy says that they should be done, the doctor wants one done or the midwife wants to see what is going on. Personally I don’t do internals unless the woman asks me to check or prior to giving morphine/pethidine. I prefer to watch a woman in labour, if you watch closely then you can usually tell within reason how well that woman is progressing and give a reasonably accurate estimation of how far she is dilated.

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    Alan - that's why we need to clone you

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    When I was in labour the doctor did an internal during a contraction without warning me. First time in labour and some guy sticks his hand up my ....... It hurt and was uncomfortable and until now I thought it was normal. Geez I'm never going back to that hospital!!

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    Quote Originally Posted by ~Debbie~ View Post
    Have been reliving my last labour.. and i very strongly remember having a internal during a contraction. It hurt like ell, and, i wonder why the midwife gave an internal then, as opposed to waiting to do it between contractions..

    Any ideas?
    There is no need for that whatsoever. I'm so sorry you had to experience that

  11. #11

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    Quote Originally Posted by Alan View Post
    Unfortunately many internals are done either because the hospital policy says that they should be done, the doctor wants one done or the midwife wants to see what is going on. Personally I don?t do internals unless the woman asks me to check or prior to giving morphine/pethidine. I prefer to watch a woman in labour, if you watch closely then you can usually tell within reason how well that woman is progressing and give a reasonably accurate estimation of how far she is dilated.
    Thats It! I's moving to QLD. You arent busy around tax time are you, Alan? LMAO.

    I know they say you need to leave your dignity at the door, but that to me does not mean that they don't need to reserve at least a modicum of common courtesy.

  12. #12

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    I had 2 internals done by ob ealier in the day. once first thing as i was admitted the night before(no internal) and to confirm that waters were completely broken.

    Second was about 8 hours later to check progress.

    I only had one internal done by the midwife when I said i was ready to push. I think she did strecth out cervix before giving the okay to pushing.

  13. #13

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    I had a contraction during an internal and it hurrrrrrrrts
    I hardly laid on the bed for labour so just being there at all hurt, let alone when a contraction hit during an internal, owwwwch.

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    Going back to see my ob for a check up on the 28th anyway, so, will ask him why. I remember telling my DH to "get her out of me".. maybe it was to save the pain by getting it over and done with in one hit, but, it was just horrid. Much more painful then the contraction on its own.

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    It is, I agree. I have had 4 AROMs, which is done during a contxn so that the membranes are bulging and the babies head is pressed down to avoid cord prolapse. It is basically an internal during a contraction and it really stings!

    But I have had regular internals where she just "waited it out" which was even worse IMO! Could you get your hand out of my personal space while I scream in pain - please! Its entirely possible it was just bad timing on her behalf. I just hate internals all together. They are innacurate and not actually medically necessary 99% of the time, so I am not permitting any this time. Thats going to be fun...

    Definitely bring it up with your ob and let him know you would at the very least prefer that VEs are not done during contractions. Thats the least they can do for you!

  16. #16

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    Mags you are so right - my midwife in labour kept telling me to turn over while i was pushing so she could see if babies head was crowning (mind you my 2nd stage was about 10-15 mins). I was on all fours at the time saying im having this baby but she made me get on my back so she could see, she should have known! DF said my anus was pushing out and even she said there was pressure there was no way she needed an internal then...

    Debbie I really think it all depends on their policy and it can be so hard to find someone that listens and respects you. The best way to avoud VE is to stay at home as long as possible that way you have one on arrival and hopefully that's it. Good luck with impending labour and birth, Aiden must be so excited!

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    I totally agree with Alan. I've seen him in action at homebirths, and I know he's right about how you can quite accurately tell how a woman is progressing without VEs.

    I'm really sorry about some of the experiences described in this thread. To my mind, it is tantamount to assault. It's not right. No VE should be done for routine reasons, without the woman's explicit consent, without her being ready, and if at any point, the woman says, that's enough you need to stop the exam now, the careprovider should cease and not continue the exam. It is a violation of your basic rights when you are at your most vulnerable, in a position where you should be able to trust your careproviders. To my mind, this is actually birth rape.

    Please know that you can request your birth plan that you do not give your consent to VEs, and will only have one if YOU specifically request one. All good careproviders know how to assess the progress of labour without VEs. I have seen midwives perform a VE gently, with the woman's consent or at her request, and gently stay there during a contraction to see what's happening. The understanding is that the midwife would end the VE immediately if it was too much for the woman. But some of the incidents described here don't have that gentleness and patience. I'm really sorry, I don't think that's right.

    You could think about a different model of care the next time - choosing a careprovider who does not do routine VEs, but only at a mother's request, and after careful discussion with the mother.

    Another thing that might help, is learning about the signs of progress yourself, and learning how to examine yourself and observe for changes. You're allowed to do that, and you're allowed to say no to other people's fingers! Here's one article called 'External signs of progress' by Gloria Lemay.
    Last edited by Julie Doula; April 25th, 2009 at 11:41 AM.

  18. #18

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    Quote Originally Posted by Emmy83 View Post
    Sometimes it might be necessary if you are needing to push and the midwife/dr wants to speed the delivery up by trying to push the cervix over the baby's head to facilitate birth when you are not already fully dilated. Obviously this would only be done if the baby needs to be born quickly (fetal distress) or in some case for the benifit of the mother with her consent of course.
    This is why my OB did it, and yes.. it hurt! Well.. the initial internal during contractions didn't hurt that much.. it was pushing the cervix over the head that hurt!! For quite a while I was pushing & dilating at the same time. I told the midwife this.. I could tell it was both. The internal showed me moving back & forth from 6cm to 8cm & back again. Both mine & DD's heartrates were up quite high, and DD was prem, so I would think that's why we moved things along a bit. Once she was out of the cervix she crowned and was out within a couple of contractions.

    ETA: Interesting link Julie. I was bearing down like I was trying to get her out with each contraction. I wonder how a trained eye would have seen me. I think the midwife knew what was going on.. and I told her what was happening anyway LOL. I've never felt forced into VE's or violated by them. Maybe my midwives & OB had good bedside manner LOL.

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