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I stumbled across an older BB article on Internal Examinations and since it's been years, I was curious to see what people's thoughts on exams now were.
How do you feel about vaginal / internal exams during pregnancy and birth? Did you have them or refuse them? How many did you have if you consented?
Im not a fan and have refused any internals during pregnancy. In labour I had 2, one was to check we had enough time for DH to tranfer me the next town in our car and not an ambulance and the other was at my own request when my midwife informed me I couldnt be fully dilated so DO NOT push......I mean, how could I possibly know ;)
I had SO many with DD - 10+ with my induction with her that I could remember and there may have been a few more. They were horrible and totally unnecessary in my mind. They did nothing to help me, nothing to help the midwives and Dr's other than one after 35 hours of labour that told them I was 9cm dilated with an anterior lip and it was time for a c/s. I also vomited during one of them it was so painful to have during contractions and I swore if I ever laboured again I wouldn't have so many, that I would refuse until I wanted one not the drs/midwives for curiosity sake which is what it felt like to me. Pity I never went into labour with DS but when I spoke to the midwives before he was born they noted that I wasn't happy with VE's and would only have them if absolutely necessary.
Oh my goodness, thats awful Tanstar :( Do you mind if I add your comments to the article?
I said i was uncomfortable with them and happily refuse, only cause that fit me most. I wouldn't say i was uncomfortable, i am comfortable with them. but will still refuse unless there was an indication. eg.. another thing happening that would warrant one (that does not include 'just to see what is happening). You can tell from a women's behaviour etc in labour as to 'what is happening'.
for Spocks birth, I had a few because I was getting so much pressure and uncontrollable urges to push but she wasn't moving. so I felt I needed to check to make sure my cervix wasn't swelling (I did most of them myself rather than get my midwife to do it).
I find them pretty unnecessary generally, especially during pregnancy. There's a time and a place but generally they're just another unnecessary intervention. I was never offered any during either of my pregnancies which I'm grateful for, because I really don't think the state of a woman's cervix before she's actually in labour is very important. During DD1's labour, I was asked if they could check me upon transferring to hospital. I was pretty scared and also didn't have the willpower at that stage to say no, but I also wanted to know things were happening. I was 7cm.
For DD2 I requested it. I was feeling a lot of pressure and pushing urges, but the pain in my back was overriding those feelings and I couldn't bear down properly. First I checked and felt my waters bulging, then asked my midwife to check. I was 9cm (although she didn't tell me at the time).
I ticked "I am uncomfortable with them and try and keep them to a minimum/refuse some" but in fact I am quite comfortable with them if they are medically necessary. I have always had a trusted, named midwife so if she suggested one I would agree. I wouldn't want them done repeatedly in labour but this was not how my midwives operated so I didn't have to refuse, although I would have been comfortable refusing iyswim.
There wasn't really an option that fit me. I would say in theory I would keep them to a minimum, but I've never been is a position where I've been asked for many (I think 2 first time and 1 or 2 second time.....well those are the ones in addition to the induction actions which involved a VE ITMS) so that is a hypothetical position. I don't looooove them but I like to know what is going on because information and knowledge is an important part of decision making. First time I would have benefitted from more VEs and knowing the state of play earlier as I would have made some different - more appropriate - decisions. Second time they weren't necessary but not an issue either, we all knew how things were tracking from other signs. I didn't have one after 5cms and there was no mistaking what was going on after that point!
I had in my birth plan that I didn't want internal exams unless I requested one. I also stipulated that they could only tell me I was "progressing nicely" and not give me a number.
It turns out it was a mute point after DD decided to come fast and was birthed on the couch at home with DP on the phone to 000 and the Ambo's arriving 3 minutes after her birth.
Couldn't find an option to really fit me. I would have as many as my GP suggested if it was Pap Smear related.
Had none at all during pregnancy and maybe 1 during labour for each labour to check dialiation. Actually I tell a lie, I had a stretch and sweep for my third, it was the most uncomfortable feeling ever, I was desperate to try anything to go into labour naturally. It did nothing. I am fortunate that my OB's didn't think them necessary during pregnancy.
I need to know a valid (in my mind) reason for having one. My most recent was to check on my Mirena, so that and Pap smear is really the only valid reason for me.
I would like an option in between the first two - I don't mind them, but I wouldn't have them as often as the doctor suggests, if they were suggesting it as often as some people have said they have. For pap smears, etc, I have no problem with them. In pregnancy, I think they are mostly unnecessary, and thankfully I had an obs who agreed, and I had none. During labour I had maybe 6 internals to check dilation, but I was happy to have them because I did have a very long, slow labour (30 hours) and it helped me to make decisions about getting the epidural and when I had epidural top-ups and how big they were. However, if the doctor/mw had been suggesting them every hour, I would have been refusing 2 out of 3 of them.
I had them but didn't have many. 4 in total though only 1 was during labour. The only one I had in my prenatal appointments was at 40 weeks then when I went in to be induced with gels, which didn't end up happening, the morning my waters were broken and then a few hours later. The only reason the midwife wanted to do that last one was because I'd refused syntocin when my waters were broken and progress would shut the doctor up.
I dont feel any option reflects my feelings accurately. I have no problem with internals but I am also comfortable refusing if I feel it unneccesary. I had one internal during each labour when I arrived at hospital (4cm first baby, 7cm second). I found them helpful at the time as I needed convincing with both that I was indeed in labour. Neither led to further intervention.
I added in an option if that helps those who feel there isn't an option for them.
Sure thing Kel!
So far this pregnancy, only had one after massive bleed at 11 weeks, just to check cervix was still high and closed.
In the past, personally, I don't mind them, in fact find it interesting. Saying that they were paps/coloposcopies. I went to a cervical cancer specialist (I was high grade CIN3) and she could tell without asking me, that I wasn't a smoker just by looking down there?! Don't know how, but she mentioned something to do with the colour of the cells. But she could clearly see my 'affected' area of cervix by the white cells, which was the CIN grading.
I'm not sure how I feel about it now thinking about labour, so maybe I'll answer answer again in 12 or so weeks!
Personally I don't mind them when given a good reason. But then I had complex pregnancies, and quick labours.
I've lost count of how many I had with 4 pregnancies, induction due to pre eclampsia (1st baby), induction due to waters breaking and no contractions for more than 14hrs plus high BP (2nd), prem birth (3rd), threatened preterm labour multiple times, induction due baby heart rate deceleration multiple times (more than 8 times in a couple if hours) (4th)
I can understand why other ladies don't like them though.
My midwife doesn't do them routinely. I didn't want any because I had done a heap of research on how useful they are (not very, in a normal physiological birth) and the risks of doing them. I ended up asking for one after about 38 hours of labour - I felt like I hadn't progressed for several hours and I had a lingering feeling that my baby was stuck. I talked it over with DH who asked how I would feel if the exam showed there was still a long way to go and whether there was something else we could do to reassure me. Then I asked my midwife who reassured me first that the baby would be born without it and that she could tell from my behaviour that baby was close but that if I wanted one, she could do it. She said she wanted to do one only so would be thorough. She was very gentle but it was extremely uncomfortable. It gave us good information about the position of the baby (head deflexed) and my midwife was able to suggest positions to help shift the baby so we could move things along. I don't regret asking for the VE and am grateful that I had support people who supported the wishes I expressed before labour and a midwife who provides evidence based care.