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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.
I had two during labour with DD1, none during the pregnancy. The first one as by my midwife when we first arrived at the hospital to check my dilation and boy did it hurt! I didn't mind having one though as I was interested to see how far along I was (3cm, 2 hrs after SROM). The second internal was when I was fully dilated and I didn't feel it as I'd had an epidural.
With DD2, I had one at 38 weeks as my OB offered a S&S. I could have easily declined and he wasn't the least bit fussed or pushy but I was over yet another very painful pregnancy at that point so I cheerfully accepted :lol: It didn't feel much different to a pap smear and was over with so quickly. During her labour I had two internals. One by my midwife when we arrived at the hossi (approx 1hr after SROM) and the second when the OB arrived. The first was a bit uncomfy but bearable. I was 2-3cm and not contracting much, if at all. I ended up having a 37 minute labour and my OB announced when he arrived that it would be quick and wanted to check me out. I dilated from 6-10cm within 5 minutes. That internal was very painful but any wonder when DD was literally about to fly out! Hearing my OB say '6cm dilated, no make that 7. This baby is almost here!' (or something to that effect) was very uplifting!
I swear everyone had their hands up there during my labour and that was before it all turned pear shape. To be honest I couldn't have given a hoot. They were for a reason and it really was the least of my problems.
I had maybe three or four during my labour with DD, none with either of the boys. MWs with the boys didn't need to do an exam - they could tell I was progressing. And it was lovely.
So far in three labors/births ive had one ve and it was at my insistence in my first labor at 8cm. I think I was actually entering transition as I suddenly decided I wasn't in labor at all and needed reassuring I was and it was real. I dont remember it being painful or anything as it was on my terms and I was prepared I guess.
I have "no ve's unless requested by me" in my birth plan in big red letters.
With DD1 I felt that the vaginal exams played a major part in my eventual 'failure to progress'. I felt pressured to progress faster and disappointed every time they told me I was 'only x cms'. I ended up with ARM, epidural, augmentation, and eventual c/s.
With DD2 I wasn't having that again. I put in my birth plan that I didn't consent to any vaginal exams. I wanted a VBAC and did not want to be put on a time limit. I ended up having one exam, at my request, when I was fully dilated. That was because I didn't believe things were happening so fast and that I could push already because of what happened in my first birth. It was my choice and I felt in control and that made all the difference.
First pregnancy I had two S&Ss, then was induced, so one for the gel, then went into labour 10 hours later, had two more through the 9 or so hours of labour. Was quite ready to refuse them, it was my plan, but then I kind of wanted them, so went for it.
Second I had three S&Ss, all at my request. Then, in labour, was offered one and really didn't feel like it, but succumbed to the curiosity. It turned out to be perfect timing, as I was in that beautiful lull between transition and second stage. Three minutes earlier or later would have totally sucked and I probably would have refused.
With Liebling, I had them and it didn't bother me. The examinations were not for my benefit, nor Liebling's benefit, but they showed the midwives that I was either not in labour or progressing as per the ticksheet. I had not been vaginally violated by medical personnel at that point.
With Stormageddon, I will be having none. Because no medical person is going to touch me when I'm pregnant or in labour unless there is a genuine medical need. And there is no genuine medical need for vaginal exams, from what I can see - just for the other person's curiosity to be sated.
I also didn't find an option that suited my feelings, but I chose I'm comfortable with them and will accept or refuse them freely.
I don't find them painful at all, so that affects how I feel. I have a midwife who will ask if I want one, and leave it up to me. I like to know what's going on, so I will have one sometimes at a prenatal exam around 38 weeks +/-, (also to have a stretch and sweep, if I'm at that point) and in labour, I like to know that I'm making some progress, so I had one when the midwife arrived last time (6-7cm) and one to make sure I was OK to push, at my request. I was pushing involuntarily, but didn't quite feel safe to go with it yet. The midwife said "if your body wants to, then go for it" but after she checked me, she said I was at 9, so I should try to pant through another one or two contractions, and then I could push full strength. I had her check again before I pushed, just to be sure.
My midwives don't push internal exams, nor do they seem to want to do them just to satisfy their own curiosity, or to make sure I'm staying "on schedule". If they did, I'm sure I'd feel differently!
I had none with DD (transverse presentation for last four months of pregnancy leading to scheduled csection).
With DS I had built up a fear of having them. First one was at 40+5 at my OB appt and it really wasn't that bad. I also had a stretch and sweep, which I requested in hopes of kick starting labour and avoiding a csection 6 days later (I was trying for a VBAC).
Next one was at 41 weeks during hospital appt for CTG monitoring. Had another stretch and sweep. Again not too bad.
During labour later that night and the following day I had three. I was 3cm, 7cm and fully dilated. I'd had an epidural for the latter two and the first one was ok. Overall I found the VEs useful in letting me know I was progressing with my labour and keeping me hopeful of achieving my longed-for VBAC (which I did get). Perhaps if I had not progressed as well/fast then I would have found them disheartening, or if they were painful. But for me they were more of a positive than a negative.
I went with what I was told for the first 3 births, but I was much more educated (finally) & confident with #4, so I put my orders in on booking into the hospital. I think I ended up with 1, maybe 2 VE's. But I had a posterior baby & back pain that I thought was pushing pain. Turns out it was too early & there was a little swelling to my cervix. Hearing that got me back on track & I regained control. So I don't regret allowing that one.
I selected I am uncomfortable with them but have them as the dr/mw suggests.
Personally, they are excruciating for me. I literally scream each time. DD1, I had 1 VE & was 8cm, that was when I first arrived at the hospital. DD2, I would say more than 10 for sure. I honestly had no idea I *could* refuse them!
I selected I am uncomfortable with them but have them as the dr/mw suggests.
Personally, they are excruciating for me. I literally scream each time. DD1, I had 1 VE & was 8cm, that was when I first arrived at the hospital. DD2, I would say more than 10 for sure. I honestly had no idea I *could* refuse them!
I think I am desensitised to them after going through IVF. Having Drs/Specialists/Sonographers up my hoo-har on a regular basis meant after a while it was a bit routine.
During birth with DS I had two, DD none. They are rather uncomfortable though aren't they? :O
This too!:
I think I was scared of them due to the unknown factor. Also how FAR up the hoo-har the Dr has to go - bit further than what I had experienced with IVF.