Why is an internal exam so bad?!

[Cassius2]

i think the gist of the thread is about internals conducted outside of labour. it is becoming increasingly common for ppl to get internals done in the final weeks of pg as an indicator of progress. so for example if a woman feels that she has been having heaps of pre-labour and is feeling really exhausted and frustrated because of it (totally normal!) then she may request an internal to see if there has been any change to her cervix that may indicate progress (ie effacement and/or dialation).

some issues that can (CAN) stem from this is that before labour is established the cervix can undergo heaps of changes (you can have an internal done one day to see that you are 1cm dialated, then at the next appt have 0cm dialation). and this is okay...you're not in labour yet and your body is still prepping itself. the only problem there is with this information may the psychological/emotional one. the woman MAY feel let down (by her body, by the exhaustion etc) and become demoralised or increasingly stressed. BUT on the other hand, if a woman feels that she can cope with the knowlege that things may not look favourable 'down there' then i dont really see it as being an issue to request an internal. that said, i dont really think that it is necessary to have an internal as par for the course (ie if it is a standard policy by the OB). it is a woman's choice to have/not have one.

as for internals in labour: once in labour the nature of internals is different. it can be an effective tool (if a labouring woman wishes) to guage how her labour is progressing. of course, it can also be used as a demoralising moment when you have laboured for 4 hours and 'only' dialated 1cm (for example). HOWEVER, again, if you are OKAY with the knowlege that things may not have progressed as fast/smoothly then i dont really see having an internal as a big issue (UNLESS of course you know that the time of labour has been put 'on the clock' by the hospital/OB...then i would delaying for as long as possible LOL!).

I for one had 2 internals in labour. one about an hour in (i was 4cms dialated) and then again about 6 hours later (and i was 6.5cms). i found this a good gauge for me and i wasnt at all bothered that in that time i had 'only' dialated a smallish amount. labour was established the contractions were good and strong. and an hour later i was fully dialated (didnt need an internal to know that...bubba had def started her descent! LOL).

the only thing that really threw me as a first-timer was the realisation of HOW MUCH internals in labour HURT. it was so going against the forces of nature to have someone's hand shoved UP while everything was wanting to come DOWN. especially mid contraction...OUCH lol! but like all things you can get through it...or tell them to get lost and get out LOL!

HTH

[Lolli]

In my experince, internals are very painful and extremely uncomfortable. Far worse than any pap test I ever had- the only thing that competes in terms of discomfort was an internal u/s.

I had quite a few of them in pre labour with ds, and quite a few more in labour, due to complications. I've asked my mw for as few as is neccassary this time round, hopefully none at all. I felt they were almost used against me in my last labour- i could tell them the pain was getting worse, contractions were closer, things were heating up- but they wouldn't believe me until the internal confirmed it (an internal was used to decide whether I could call dh or not, ffs). It undermined my confidence in my own body and mind.

Just my two cents hun From your perspective, I can see why you were ticked off at the response you got from your mates- i would have been too.

[bon]

I don't think the issue is internals during labour, it's internals done during pregnancy. If you ask for one and want one before you have gone into labour, that's a bit different to a doctor telling you you need to have one because it is routine or just something that they have always done. But either way, they are mostly unnecessary. In labour it's different - they can be very handy to give an indicator of how things are progressing, and if you want pain relief they will often do one just to make sure you are not too far along to have it. But even then, you don't have to have one at all if you don't want to. I prefer as few as possible. I think I had two last birth, but the midwife was very good and they really didn't hurt.

Ali - a standard internal exam (as I have experienced it anyway) is just a doctor or midwife inserting a couple of fingers into your vagina and feeling the cervix to see whether it has dilated, and if so by how much. I guess a speculum could be used, but the only time I have ever had a speculum in there is for a pap smear.

[Sagres]

Yes, sorry my example was a bit misleading because it was about internals during labour. But by the same token I can imagine a situation were I would find the information gained from an internal before labour useful in decision making e.g. if I was very overdue and considering induction I would find the information about whether my body had spontaneously started the process or not (and the implications this has on the chances of a successful induction) useful in my decision making process.

[AliB]

Ali - a standard internal exam (as I have experienced it anyway) is just a doctor or midwife inserting a couple of fingers into your vagina and feeling the cervix to see whether it has dilated, and if so by how much. I guess a speculum could be used, but the only time I have ever had a speculum in there is for a pap smear.

Thanks, I didn't realise they used fingers. I now understand why it would be ouchy - I HATE the feeling of having my cervix touched Oh well all stuff I need to get used to I suppose ;P

[Inanna]

Not necessarily Ali! I had 4 babies without an obs fingers on my cervix!!! It can be done and it is done every day!!!!