Why is an internal exam so bad?!

[Taurean]

I've just had a really good appointment with my OB and as I've had heaps of prelabour and terrible hip and back pain, I've asked for an internal at my next appointment in a week. My OB agreed. His actual words were 'At 38 weeks, I'd be ok with that'.

I made the mistake of texting my close friends an update on my progress mentioning I was having an internal next week and two of them, both midwives, questioned why 'he' would want to do that! I replied that I had asked for it as I desperately want to know if all this pain I've been experiencing has started anything down stairs. One of them was horrified that 'he' would do such a thing at 38 weeks (I had told her a second time that I had requested it) and she then went on to give me the full ear bashing about induction, c-sections, etc.

I know some OB's routinely do internals from a certain point in the third tri - mine doesn't. Is it really that bad that I'm getting one done next week? He knows I've been going through hell with all my aches and pains but he's not inducing me, just taking a look. What is so bad about that?! I've never been bothered by internal exams in the past (ie pap smears, gyno appts, etc) so I'm not worried about being uncomfortable or it hurting.

I feel so deflated after such a good appointment. It's my body and my baby so why does everyone have to judge my decision? Are internals really that bad for me/us???

[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.

[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'?

[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.

[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]

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.

So true but what is so bad about it? They are warning me about what exactly? Is it likely that I'll go into labour? I don't think so. I just got the impression I was receiving another ear bashing about OBs with no substance to the argument, if that makes sense.

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.

And that is a fantastic point, thank you! This pain has got to be doing something but maybe you're right, an internal may not show that and may be pointless after all.

Keep it coming girls. The feedback is great, thank you!

[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!

[Lulu]

So true but what is so bad about it? They are warning me about what exactly? Is it likely that I'll go into labour? I don't think so. I just got the impression I was receiving another ear bashing about OBs with no substance to the argument, if that makes sense.

Quite right! What DID they mean, what point were they trying to make. I've learnt that if someone is down or tries to "warn" me about something, I directly ask them WHY it is a problem.
If they are genuine they will give you a genuine answer, if not they will have nothing further to say. These are often the people that like to tell you how horrible giving birth is, how they had 8000 stitches and laboured for 4 days

[Epacris]

I asked my ob to do internals for me from 38 weeks with my DD (baby #2). I was having heaps and heaps of prelabour and was expecting a quick active labour. I wanted to know where I was at (approximately of course) so I could be practically and mentally prepared. I found the actual internal procedure and my obs comments about what was happening excellent, calming and very reassuring. Maybe because I got the answer I wanted Would I have felt differently if the answer was different??? In my case having internals (I had two with DD) was a very positive experience for me. But my positive experience seems to be quite different compared to the majority.

[amberj]

I was just thinking, if you did get an internal and even if you did hear the news you would like, it might actually set you up for more disappointment. I mean, regardless of whether you are actually dilated or not, it will happen when it happens. Your dr could find you are not dilated at all and then WHAM, it just happens suddenly. Or he could find you ARE dilated, but you still hang out in pre-labour land until 41 weeks, in the meantime getting more and more upset because it "should" be happening soon. I could just foresee a whole bunch of disappointment either way. That doesn't mean you shouldn't do it, but just be prepared for all potential outcomes.

GL either way! I am sure you will make the right decision for you!

[Smoke Jaguar]

One of my main concerns leading up to term and labour was having to fight off internals if I went over the 'clocked' time once in the FBC. For me it was about the cascade - do the internal, possibly see something that would officially worry the staff because of hospy policy and pressure me into something else I didn't want to do. I was also keen to have my privacy preserved as much as possible, not believing that it was necessary to have intrusive inspections to get my baby out - and that good midwives don't need to 'look' to know what's going on, using body language and verbal cues to know where you're at (which they did, in the end, as we discussed after the birth) That and wanting my belief that uninterrupted labour and birth to be absolutely respected - with my self-preparation teaching me that interruptions like internals can prolong labour and interrupt natural, mammalian processes if everything else is going normally, otherwise. As for internals outside of labour, I saw no clinical reason for these to occur and wanted to be left well enough alone, which was totally supported by the FBC staff, anyway. These were my reasons and these are the ones I'd give if someone were to ask me about internals and their merits.
If someone were to mention they wanted an internal, I would certainly ask why they wanted it and discuss it with them - not write it off without explanation or rolleyes at the caregiver (not until I'd heard the reasoning, and it turned out to be that caregiver's professional, unquestioned habit to do internals!).
So, yes, ask these same people why they object - they may give you another perspective from the ones given here

[Feathertop]

I had one today (34 wks) and also had one when I had my threatened PTL scare at 29 weeks. I was asked if that was ok and they explained why they wanted to do them and I had no problem at all. Because bub would be prem if born now, the dr just wanted to see if these contractions were making my cervix do anything at all - basically we were all hoping it was long and closed! And closed it is! I felt pleased at the end of it actually!

[Smoke Jaguar]

Oddly enough, I've felt that I have dilated back and forth a bit in the last week (just a guess)! Between SPD (and this pesky loose ligament) and the baby bouncing on my cervix (midwife can feel the baby is all the way down already) from time to time, it's possible that I have. Apparently this is normal enough to happen, too
Feathertop, in your case you're on meds and had that scare a few weeks ago, so it seems like a clinical reason to check on things - glad all is well!

[fionas]

I had an internal when I was pretty keen to know if anything was happening because I'd started having sporadic contractions and DP was potentially going to be out of town and I wanted to know whether I should get him to stay IN town.

TBH, it wouldn't have deflated me if there was nada going on but I was pleased to know that I wasn't imagining things.

Actually for someone who has always hated having paps done, I'm very blase now about internals because for me, I want to know.

[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.