Internal during contraction.. why?

[~Debbie~]

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?

[TwinsMummy]

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...

[AliBaby]

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.

[Mildez]

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.

[Liz]

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.

[visitor1]

I was having one when a contraction hit.....middy went to move her hand and i screamed at her to leave it as it helped with the pain! LOL

[Julie Doula]

As an RN, I sometimes had to do some pretty mean things to patients in the course of their care - like, injections, wound dressings, manual evacuations ....

We were taught that if we take hold of a peron's wrist to take their pulse, without explaining what we're about to do or obtaining their consent, it is assault.

For procedures more painful and personal than that, it's even more important that there is respect, gentleness and patience, and that you don't push beyond the patient's consent, willingness or endurance.

It's good to hear about VEs done with this sort of professionalism. But I'm so sorry about the situations in which this has been lacking. Especially if they were completely avoidable in the first place.

It's procedure / I'll get into trouble with the Consultant if I don't / It's been a while since the last one / I have to write it in the notes that I've done it / I have to follow protocol so I don't get into trouble professionally etc - are not valid reasons to do a VE, especially if the mother is averse to it.

There are, of course, times and reasons when a VE is advisable. (Even then, if the woman says no, no means NO, and to push and push her to accept the VE is coercion and assault.) Time will tell.

I remember one (hospital) midwife who said, "You can tell how dilated she is soon enough - when you see head on view. Then you know how far she is dilated."

[Inertia]

Julie - I don't doubt those mean things are as hard for you as they are for the patients. I have had problems with VEs since my PPH. They did manual removal and while I can cope with the absolute necessity of it at the time - I have still never felt so horribly violated in my entire life.

Do you think that if I mention this to my eventual MW that it might make it easier to express no means no without the guilt trips?

[Inanna]

I haven't read through responses so I apologise in advance if I am repeating myself.

When you sit and watch and listen to a woman in labour she will "tell" you how far dilated she is. Unless for a medical reason there really isn't any good reason to be thrusting gloved fingers into a womans vagina during labour.

Having said that - when there is a lip this can be flipped over during a contraction and can save more invasive procedures. So there is a place for it if an anterior lip is believed to have happened.

I have only ever had one VE during labour with my fourth and it hurt like hell! I asked for it as I wasn't progressing as quickly as I thought I should... Anyway I was 7cms - very depressing for me. With the next contraction Eva was born. Soooo...

Anyway - I believe watching and listening are the best "crystal balls" to how a labour is progressing.

[Indadhanu]

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...

[Michelle71]

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

[Alan]

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.

[Michelle71]

Alan - that's why we need to clone you

[Reborn]

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!!

[Inertia]

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.

[Maybebabie]

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.

[Tobily]

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