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OK, now I know that this is not an exact science and I'm not asking about how midwives/other health professionals actually measure because from what I've read they do that with the tips of their fingers.
My question is - if you naturally tense up a bit from having an internal, can it skew the measurement? Or is your cervix something that's not affected by how relaxed or tense you are. Obviously it's better to relax but ...
Just curious really.
Hey Fionas
you cant affect the dilation of your cervix by 'tensing' up during an examination...but you can affect the dilation of your cervix by being tense and fearful in labor
xx yogababy
Maybe if you are worried about it, ask not to be examined there are other ways to tell how far you are progressing in labour
I agree, the emotional signposts in labour are a good indicator of progress. It's quite do-able to go through labour without VEs. I know one of our Bellybelly Midwives, Alan Rooney, often goes many months without ever feeling it necessary to do a VE. Some hospitals like to do 4 hourly VEs according to policy, but you can refuse if this is not what you want.
Once while I was supporting a woman at a birth centre, my client asked the midwife if she should have a VE. I loved the midwife's response, she said, "How far dilated do YOU think you are? Shut your eyes and imagine your cervix." I thought, going by her emotional signposts, that she was about 5 cm. She shut her eyes for a moment, then opened them and said, "5 cm." The midwife said, "You know, your instinct has been pretty spot on all along - I don't think we need to do a VE."
By contrast, in the hospital section of the same hospital, I supported another client who was making steady progress through her first labour. The midwives were great, but there was a woman OB who kept pressuring my client to have a VE - nothing was wrong, there was no indication for a VE other than the fact that she had been on hospital grounds for longer than 4 hours and the Ob wanted to know "where we were at". My client refused, citing her birth plan, I backed her up, the midwives agreed not to do a VE - and then the Ob came into her birthing room and just kept at her and at her until she finally quit pacing and threw herself on the bed saying, "Oh all right then get it over with" just to shut her up.
I think tension and anxiety about having a VE can affect the measurment. I heard a story of a woman at home with a midwife who measured her as being so many cm's, and after getting to hospital, she was rather roughly examined by an Ob who said she was 2 cm less than what the midwife had measured at home. Due to tension, she'd actually closed up some.
There may be situations in which you actually want a VE, but you can cross that bridge if you ever get to it, and safely decline any unwanted routine VEs. If you can figure out which environments and activities and personnel during birth will cause you to relax and go with the flow of your birth, and which are more likely to cause you to be tense or on edge, these are things you can put in your birth plan.
The Pink Kit discusses how you might check your cervix yourself - they say, you're not actually trying to measure, you're simply observing for changes - this can help you feel more in touch with you body and boost your confidence.
I'm not sure how completely accurate VEs are and I agree with you that it's not an exact science, and factors such as tension in the woman, how gently or roughly the exam is done, and difference in perception on the part of different caregivers can all alter results. There are other ways to observe progress, or the lack of, during labour, that are pretty compelling. You put the pieces of the puzzle together and you can get a pretty good idea.