Why is an internal exam so bad?!

[Oorki Galoorki]

a vagina is completely sterile.. so inserting things introduces germ(even when wearing gloves)
How will you feel when he says your cervix is long and closed up tight?
most people get upset they are going through pre labour pains and there is no change in their cervix.

he also may be inclined to do a S&S.. considering you will only just be 38 weeks if it makes you go in to labour your bub might not be ready.

no one's judging your choice but often those choices we get "warned" about come back to bite us on the bum..

[Lulu]

For me it's keeping foreign objects (such as hands) away from the perfect, sterile environment my vagina provides.

Doudou brings up a good point though - how will you feel if there is no change or imminent signs of change to your cervix? Will you feel disappointed or deflated?

[~Raven~]

I do understand the curiosity though as I've had it and I can vouch for being deflated when an internal revealed I was 1cm at 39 weeks, especially after a stack of strong BH's.
I asked for a S&S to which to OB obliged and it hurt like the blazers (I mean really hurt) and didn't do anything anyway but stain my knickers on the way home as it dislodged a bit of show.

[Erin_25]

I can understand both opinions, but at the end of the day it is your decison & I think it's a shame when you actually tell people what you "have"decided they don't just accept it. If you asked for their opinion...like now for exp then fair enough.
I guess if you are happy for them to do so & so are they then that's all that matters.
My doc was very old school (don't get me wrong.....a great Doc), but he always did an internal at around that time for all his patients & will say I left that appt feeling the most "violated" I have ever, ever felt. It was horrible, but that's my experience.

[Taurean]

That thought has crossed my mind - what if things haven't started moving down there? Will I be disappointed? Hmmm. I guess I can always think about it over the next week and not do it if I change my mind.

I see your points on the 'sterile' environment but I don't honestly think it's any difference to DTD during pregnancy. At least the OB would be gloved and using some sort of antibacterial gel before entering unlike my DH who I definitley don't make 'scrub-in' before DTD.

My OB isn't keen to get labour started, he's more than happy to see how I progress on my own, so he's not doing a stretch and sweep so other than those factors, is it just a case of 'what's the point'?

[The[cookie]Doctor]

How will you feel when he says your cervix is long and closed up tight?
most people get upset they are going through pre labour pains and there is no change in their cervix.

I had weeks of prelabour pains. The day I moved house (36 weeks), which was the worst, I thought I was in labour. As it turns out I was less than 1cm dilated and not even fully effaced 9hrs after being in early labour at 39.4. Turns out my body did all the work on that day as my son was born another 9 hrs later.

It IS your body and your choice, but people do warn you for a reason. You don't have to agree with that but it isn't unhealthy to hear. The better way would be to focus on the fact that regardless of whether you are dilated or not - these pre-labour pains are there for a reason. That reason might not be evident yet and that is why the internal could be disappointing.

[Lulu]

Aside from the hand/sterile thing, the possible deflation is the reason I rejected an internal (in labour) with my 3rd - actually I did have one about an hour before she was born but asked that the middy didn't say ANYTHING about my progress.

I have fast labours, every time but even knowing that when I was told I was only 4cm with my 2nd it totally did my head in. He was born 2 hrs later but I felt like it really set my head back.

Tis up to you chicken xxoxo

[Taurean]

Aside from the hand/sterile thing, the possible deflation is the reason I rejected an internal (in labour) with my 3rd

I'm starting to see this as a good reason not to do it. I probably would be deflated and if I don't hear what I would so love to hear, then there really is no point. I only told my DH and sister the other day that I don't want updates on how far dialated I am during labour as the middy at our antenatal classes said it's not really a good indication of where you're at or how long you have to go. I only hope I have fast labours too and as they run in the family, it's likely. Fingers crossed!

[Visitor8]

Simply because it is not needed.

There is no reason other than your own curiosity to be sticking things up there is there? Your not due, there isn't anything wrong with bub, why interfere with it?

Bubs will come when he/she is ready, your body has these contractions (prelabour/BH) to get ready for labour. Why not just go with it?

FWIW I never once had or was offered an internal until I was in labour. So I don't know why you think that it's routine? I have seen MANY different OB's and MW over the course of all 3 pregnancies (more than I can count) and it wasn't even mentioned.

[Smoke Jaguar]

FWIW I never once had or was offered an internal until I was in labour. So I don't know why you think that it's routine? I have seen MANY different OB's and MW over the course of all 3 pregnancies (more than I can count) and it wasn't even mentioned.

Mel's right - internals haven't been 'routine' for quite some time across the profession. I've only heard of some 'old schoolers' who still do internals and present them as 'routine' or even expected to patients. Your 'people' are probably concerned that this might be how an internal has been presented to you, too, because there is no medical necessity for it otherwise.

[Taurean]

Mel's right - internals haven't been 'routine' for quite some time across the profession. I've only heard of some 'old schoolers' who still do internals and present them as 'routine' or even expected to patients. Your 'people' are probably concerned that this might be how an internal has been presented to you, too, because there is no medical necessity for it otherwise.

Maybe it is more common in the OB world then as most of my friends have seen private OB's for their pregnancies. This could explain why my two midwife friends questioned it but it still doesn't answer why they think it is so bad that I have asked for the internal - not the OB. I honestly think it is just another case of my midwife friends V's the OB. I've copped it quite a bit, especially from one of them, throughout my pregnancy. It's just driving me a little nuts as I really like my OB and am very pleased with my choice of care.

[Toomanytoomany]

Here are my thoughts on internals for no clinical reason:

1. They don't give you any useful information. You may walk around effaced and 3cm for weeks - it doesn't mean anything. You can be long and closed on Friday night and in full labour on Monday morning. It really doesn't mean anything. You might be elated to find out you are a bit dilated, but then still be here three weeks later. That is terribly depressing.

2. It has risks. When you are dtd with your partner, it doesn't generally involve lots of poking around inside the cervix. Before labour, your cervix is quite posterior and this protects it from some of the excesses of intercourse. There is a small risk of infection with an internal, a risk of premature rupture of membranes, and as someone said, it can also be the beginning of a cascade of interventions (even if that is just, "Well, you are really ready to go, why don't we break your waters if you aren't in labour by your due date?").

3. If you are already having a lot of Braxton Hicks, an internal can stir things up uncomfortably, even for days afterwards, leaving you mentally and physically more exhausted, not to mention kicking you into that high gear "is this it????" mentality that makes the end of pregnancy so difficult!

4. It brings medical management of your pregnancy and labour just that little bit more to the fore. For many women, it's really important to avoid that, to keep the mindset that the body is doing what it needs to do, and doesn't need checking or measuring or feeling up by a third party to make sure it's performing correctly.

(As an aside, I always get a bit frustrated when I hear about doctors doing internal palpations to "check up whether anything is happening" when a woman is threatening premature labour... way to stir things up if they are happening, or increase the risk of a PROM in the case of an inevitable labour. Use a speculum exam to check for dilation or an ultrasound, for goodness' sake!)

[Taurean]

TMTM - some good points, thanks. It would have made a lot more sense if my friend had phoned me with this sort of info instead of just texting me and questioning me over and over and simply saying 'what would I know, I'm only a midwife' but without actually giving me any reason for the 'don't do it' comments.

Thanks everyone. It's been a very interesting discussion in the end! I will chat to my OB about it at my next appointment and I may just no do it. I know he'll be supportive of that given I was the one who suggested it in the first place.

[cherie26]

At the end of the day it is your decision. I have been going through the same as you and am up most nights with prelabour since 30 weeks and I am now 37 weeks (contractions get to 3 mins apart then stop!). It is exhausting and I have decided along with my ob to induce so he will be doing an internal at my app on friday.
Same thing happened with my last pregnancy and he checked me every app from 34 weeks and I was induced at 38 weeks by which time I was already 6cm dilated.

Goodluck with the rest of your pregnancy and relax.

[Sagres]

I guess from my experience internals give you information, and I'm a bit pressed to see how getting information is a bad thing. A lot of discussion here has been about being disappointed. I find this point a bit weird....I do lots of things to find out more information. When I had high blood pressure during pregnancy I had urine and blood tests, and I was very disappointed with the results. But I'm a big girl, I dealt with it, I much preferred to know and be disappointed than not know. If you are in a similar frame of mind I don't see why it should be a problem.

So with my situation, I was in labour and had an internal at about 2:30am and was 2-3cms. At about 3:30am I opted for some pain relief (epi) as I was not coping and I was likely to be in labour for a long time yet. An internal at 4am revealed I was 10cm. The point being it I had of had an internal and got the information about how my labour was going at 3:30 I would have not had an epi at that point in time. I thought what I was feeling was 2-3cm type pain and there was no way that I could see myself doing that for several more hours, when what I was experiencing was actually transition and something I could have dealt with if I had of known pushing could be a few minutes away.

I think you've hit the nail on the head with the midwife vs. ob point, I think your midwife friends are taking the context they want to from your situation to push their own agenda and ignoring the facts i.e. you requested it and are happy for it to occur. I have absolutely no problem with some one giving me information about my options but if in the process they are being unsupportive and unhelpful - well that's not helping me and I'm probably not going to be as receptive to their point of view.

[Indadhanu]

Cos it fricken hurts! lol!

And what everyone else said too LOL. I had an internal while in labour, and not only did it hurt BIG TIME but I was that disappointed by my 'failure to pregress' that I ended up hysterical.

Unless theres a medical reason, I wouldn't have one, as its real unnecessary. And well, you might feel really let down that these pains havn't lead to anything, which is more than likely true.

[Visitor8]

omg they do really hurt don't they. I had one when I was induced with Ash and OMG the paaaaain. I was in tears

[Erin_25]

Cos it fricken hurts! lol!

And what everyone else said too LOL. I had an internal while in labour, and not only did it hurt BIG TIME but I was that disappointed by my 'failure to pregress' that I ended up hysterical.

Unless theres a medical reason, I wouldn't have one, as its real unnecessary. And well, you might feel really let down that these pains havn't lead to anything, which is more than likely true.

yeah I totally forgot, not only did I feel violated from my internal when I was only 38wks....the only time I yelled when in labour was when the doc did an internal. Something along the lines of "get your f*****n hand out of there" eeeek such big hands too.