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Old Mar 1st, 2011, 13:16 PM   1
kirstr1984
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internals


in the nhs pregnancy book, it says that internals are not compulsary but how would you know how far dilated you are if you dont have one?



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Old Mar 1st, 2011, 13:19 PM   2
Mya209
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There are ways of telling externally, I don't have the link, maybe someone else can post it?



 
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Old Mar 1st, 2011, 13:28 PM   3
chuck
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Why would it matter if you know how many cm you are according to one persons judgement of your cervix?

When you're ready you'll know...having internals and numbers written in your notes puts you on a timeline adn if you dont meet deadlines you get interventions!

I'm not having internals this time unless I want one...I doubt it though LOL!

The purple line is one way
http://www.google.co.uk/search?clien...JMe7hAf_8amPDA



 
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Old Mar 1st, 2011, 14:38 PM   4
KandyKinz
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There's lots of things that can give clues as to how far along a woman is in labour

- Where the heart rate is best ausculated... As baby descends lower and lower the best position to hear the heartrate also moves inward and down.

-There's the distance between the top of the fundas and the xiphoid process

-There's the purple line that goes up the natal cleft (above the butt) and once it hits the top the woman's fully dilated

-There's leg temperature.... In early labour the feet get cold and that coldness gradually moves up the calf as dilation progresses.


Other signs include how the woman is feeling and behaving as well as what the contractions are like....

Early Labour
-Contractions are irregular
-Women become easily distracted with conversation
-They are often have this excited vibe coming from them
-They tend to be alert and energetic

Active Labour 4-5cm
-Contractions become regular and consistent
-Doesn't want to talk during contractions
-Seems "normal" between contractions

5-7cm
-Burping
-Farting
-No longer wants to eat
-Face/Cheeks gets red
-Tends to still be quite coherent between contractions but requires alot more concentration during contractions.
-Bloody show is likely to start around this point in small amounts
-Walking turns into a wobble

Transition (7-10cm)
-Women tend to get tired
-There's a noticable increase in contraction length and intensity.
-Contractions get noticably closer together
-They frequently decide they can't do this anymore, they need drugs, they want to die....
-Agitation and snapping at people is more likely to occur now....
-Eye rolling
-Vomiting
-Sweating
-Feeling either way too hot or way too cold or both
-Modesty no longer matters
-Feels like she needs to the bathroom for a #2
-Amount of bloody show increases
-Starts getting "grunty" at the peak of the contractions

Cervical Lip Left
-Sudden spacing of the contractions and the woman suddenly feels they are manageable again.
-Woman is more likely to communicate with you between contractions
-Contraction pain is felt down by the pubic bone and may feel like a burning sensation
-Starts getting "grunty" throughout the entire contraction

Fully dilated
-Feels pressure between contractions
-Can't help but push during contractions
-Contraction pain above the pubic bone no longer there, pressure pain takes over.
-Pushing results in the perineum bulging and increased show

And there's more but I just can't think anymore.....


And ofcourse every woman and birth is different but the above seems to be very common trends in natural unmedicated labours.... But messing with nature results in not being able to trust in nature..... So when medications become involved relying on the above signs becomes much less reliable which increases the need and value of vaginal exams.



 
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Old Mar 1st, 2011, 14:48 PM   5
PeanutBean
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It's possibly all posted above anyway but this link is useful I think:
http://sarahvine.wordpress.com/2010/...internal-exam/

I'm not going to have any internals unless it appears there is a real problem.



 
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Old Mar 1st, 2011, 14:50 PM   6
linsayp
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I would recommend having them - I had one at 2.50am and was 2cm then one at 7.30am and I was 10cm. They told me I was still in early labour at that point (even though I'd been fighting the urge to push for 3 hours)

So IMO they're a good thing to have as otherwise my baby would've been born on my sofa. The external signs aren't always obvious, even to a ward full of bitchy midwives.



 
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Old Mar 1st, 2011, 14:55 PM   7
KandyKinz
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Quote:
Originally Posted by linsayp View Post
I would recommend having them - I had one at 2.50am and was 2cm then one at 7.30am and I was 10cm. They told me I was still in early labour at that point (even though I'd been fighting the urge to push for 3 hours)

So IMO they're a good thing to have as otherwise my baby would've been born on my sofa. The external signs aren't always obvious, even to a ward full of bitchy midwives.
I may be completely crazy for thinking this but fighting the urge to push for three hours tends not to be a typical sign of early labour Perhaps the issue here is not with the external signs not being obvious but the ward full of bitchy midwives who still need to learn a thing or two about birth



 
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Old Mar 1st, 2011, 16:24 PM   8
onedaybaby
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I have on my birth plan that I don't want internals but when the midwife came for my 'home birth visit' at home last week she asked me to reconsider as they like to check you when they first arrive to see if they need to stay or if they can go and come back later.
I've read so much about natural birth and labour that I'm sure I'd be able to tell if I was in properly active labour and beyond 3cm or if it was still early, even though this is my first, surely they can tell too?
I don't want to feel pressured into these things like I'm making a bad choice for my baby.
I feel that too by putting in my birth plan that I don't want the baby to have vitamin K. I couldn't remember why I decided against it and can't find where I read about it now either but it was something she urged me to reconsider too. But what she said doesn't sound right anyway. She said that babies are born with no vit K to help clotting so if they have a birth injury they could die. But I read that all babies are born with lower levels than adults, and as all babies have low levels maybe that's just the way it is meant to be?
Kandykinz, we should talk again about this stuff as would like to discuss birth plan stuff!
We're having a home birth and I'm using hypnobirthing-type techniques.



 
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Old Mar 1st, 2011, 16:30 PM   9
Mya209
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What's the negative to Vit K then? Why say no to it?



 
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Old Mar 1st, 2011, 16:31 PM   10
Bumpontherun
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I had a really long hesitant labour last time. I went to hospital after 56 hours of contractions and I was pretty pleased to be told I was nearly 6cm. I didn't experience a proper transition, think my uterus was just too tired to muster the effort and I never had the urge to push so knowing I was 10cm from the internal was quite useful IMO! I don't really see what the big deal is with internals, they don't hurt and give you a progress report on what's going on. I'm hoping for a natural birth this time and am going to try hypnobirthing but I'm quite happy for midwives to examine me as and when they see fit.



 
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