Anyone declined internals?

[Celesse]

I'm thinking of declining internal examinations during labour unless there is a problem. Its not that I have a problem with internal's I just think that if the midwives don't know for sure how many cm dilated I am then I'm less likely to be a victim of "failure to wait".

Last labour was fairly slow and this time will be a HBAC and I don't want to give them any excuse to send me in. Plus I know they don't like to speed up labour in VBAC birth and I'm worried if things were slow then they would try and suggest a C-Section.

Anyone have any experience in declining internals? How did the midwife respond? Was there any pressure to "just have a look and see how we are doing"?

 

[Mervs Mum]

Me and just about every woman I work with!

My own MW was totally fine with it and said she could she what was going on without one. She used the same external signs I use as a doula. Observing behaviour, cold legs, purple line, back 'breaking' etc.

I have however had a MW who was clearly VERY uncomfortable not being able to do a VE. She ended up calling the supervisor of mws and it was a challenge protecting the space at times but we managed. I've had every variation of everything in between the two.

I think it's pot luck as to who turns up on the day but to have discussed it in advance as well as it being in the birth plan/prefernces is (according to the mws) helpful.

 

[Kess]

My MW is fine with not doing internals, in fact she prefers not to! She says she can generally tell how things are going without anyway, and knowing how far a woman is dilated isn't a reliable guide to how long things have to go anyway. She did say she might suggest one if I want to get into the pool early, as if I get in too early it might slow things down, but it's totally up to me. I hate internals, so will be declining any that aren't completely necessary.

 

[Mervs Mum]

You might enjoy this post.....

https://sarahvine.wordpress.com/201...-assessing-dilation-without-an-internal-exam/

 

[Bournefree]

I really hope that you don't get the situtation where you are having to defend the reasons why you don't want to have an invasive internal examination in labour, as you have the utter right to refuse this.

Any MW worth their salt should be able to know when you are in either 1st or 2nd stage labour without needed to do this routinely.

Your wishes should be respected - It would be totally illegal, let alone immoral for a MW or Dr to insist on internal examinations or to perform one without your expressed consent. Make it clear from the outset your refusal and make sure your support can keep answering for you, so you don't have to defend it in labour, and you are protected.

I had one internal at my own request in early labour at about 3-4 cm.. I felt I needed to know if I was in labour or not (silly hey, it was obvious to everyone else). It acted as a boost for me, and I didn't feel I needed wanted anymore than that (and infact the MW didn't want or offer to do anymore)

I think it is a great idea, and I also think what you want is the most important thing and they have to listen to you.
XXX

Kess - if you want to get in the pool "early" (I know some policies would say they like you at 5 odd cm before hand), it is upto you. Labour might slow, but what is wrong with that? You can decide to get out again, or stay in a relax. It shuldn't be a problem - but if you are in hospital they have this "policy" so it makes more efficiant use of the pools (i.e so they can turn it around faster). It's your birth, and if you have a pool to use and want to use it - use it, no matter what stage you are at!
XxX
XxxX

 

[DaisyDoodles]

My midwives have said they will only do internals if I ask them to and even then, they'd prefer not to... they said there's absolutely no need for anything intrusive thankfully!

 

[Kess]

Kess - if you want to get in the pool "early" (I know some policies would say they like you at 5 odd cm before hand), it is upto you. Labour might slow, but what is wrong with that? You can decide to get out again, or stay in a relax. It shuldn't be a problem - but if you are in hospital they have this "policy" so it makes more efficiant use of the pools (i.e so they can turn it around faster). It's your birth, and if you have a pool to use and want to use it - use it, no matter what stage you are at!
XxX
XxxX

I'll be at home, with an IMW, so no policies at play. It'll be totally my choice if I decide to get in and accept the chance that labour might slow or prefer to stay out for a bit longer, all my MW is saying is that IF I want that information, she'll do an internal. It's up to me, that's just one of the few instances that her birthing mothers sometimes prefer she does an internal (she often does none at all, and will only do one if the woman asks - she may gently suggest one if she feels there is some information to be gained from doing one that the mother may want, but she'd never push). Thanks for sticking up for me though!

 

[Bournefree]

hahaha! No worries, I forgot you were home birthing!
I would love to have an IdMW, that must be so reassuring. They are so confident in their skills and see more women all the way through there pregnancies and birth, so really get to know you and baby better. You lucky duck!
XxX

 

[indigo_fairy]

I didn't refuse any last time, but boy do I wish I did, every time is was a negative reaction as I hadn't progressed to their protocol... And I guess everytime I found out I hadn't progressed it just put more and more fear into me which is a vicious circle! Especially when they said I'd got to 7cm, then 6hrs later said I was at 6cm and I was swelling, that really panicked me, but I now know swelling can be normal just because of baby pressing on the cervix, but at the time they treated it like I was about to swell up and die or something!!

So this time, needless to say I will certainly be having the minimum of VE's, I would be happy to have one when the MW arrives (as it will hopefully be well into my labour if all goes to plan) and then again if I'm going hours and hours and feel I need to know. I'm definitely putting on my birth plan, minimum VE's and expressed consent first. I'll have DH and doula to stick up for me if I have any pressure, how frustrating that we should even be preparing for these kind of potential problems in the first place?

 

[lynnikins]

i had 2 internals with ds2 one to check before i was induced then again caus i wanted to know how things were going and it surprised the MW that i was so far dilated 6cm, next thing that went through there was his head lol i knew when i was fully dilated and he was on his way out lol the MW's were telling me not to push so they had time to put on their gloves

 

[Mum2b_Claire]

I had 2 intenala with Ruby - one on arrival at the birth centre (as they were not sure how far along I was, they were very keen to send me home and they did, as I was only 3cm) then one when my contractions basically stopped at and the MW broke my waters to try and step them up a bit. (9cm).

I don't know if I'll have any this time or not, it depends if there is a reason to have them or not, I definitely won't agree to them at 'routine' intervals.

 

[chuck]

I had 2 VE's but I agreed to both.

As I was HBAC'ing the MW's wanted to have enough info for me to be safe, I was more than happy for MW to examine me shortly after she arrived - mind you she was in no hurry what so ever, it was probably nearly 45 mins after she arrived, and another after a few hours when she was certain I was through transition (I had been sick and felt shivery) and had been for a while but I was having no urge to push and losing quite a bit of blood -so I allowed her to check what was going on.

I would have declined any other though the 2 she did were worth while to me and I think thats what you have to bear in mind, is having the MW's opinion on dilation/effacement and babies position (anterior/posterior) at that particular time of any use to YOU?

If its of no use to you then decline.

 

[NaturalMomma]

My Midwife never offered, she left it up to me if I wanted them or not. She said she didn't feel the need unless she thought there was a problem. I only had 1 internal and that was because it was taking baby forever to come and we thought his position was off a bit. So she checked and he was.

 

[lesbianlove]

thats great that you can refuse as i didnt even know u could!! i was also wondering can you refuse a check after your childs born like for stitches and stuff as iv had no stitches with either of my boys and found the ie more painful than the delivery hoping to have a homebirth with this one x

 

[Mervs Mum]

You can refuse anything you like!! If they suggest stitches and you dont feel it's necessary then you can refuse.

 

[lesbianlove]

well nobody ever tells u that i wished they had with ds1 and ds2 i had refused in hospital but it was a basic we need to do this so your getting it done and went ahead and i actualy felt sorer after it than after delivering il deffo be refusing all examinations

 

[Kess]

thats great that you can refuse as i didnt even know u could!! i was also wondering can you refuse a check after your childs born like for stitches and stuff as iv had no stitches with either of my boys and found the ie more painful than the delivery hoping to have a homebirth with this one x

You can refuse anything you like!! If they suggest stitches and you dont feel it's necessary then you can refuse.

I really do think it's horrendous that people aren't told they have a choice! How can anyone give informed consent when they don't know one of their options is "no"? I think from too young an age we are conditioned to accept anything the medical profession say and do, and it's not right. It makes me steaming mad! This baby, and any future children, will be raised to know they have full ownership over their bodies, but that's just part of the solution. Medical professionals need to watch their language, it's all "must", "have to", "can't".

 

[HayleyJA]

Thanks for this thread Celesse... I'm also thinking I might want to decline VE's this time around so this has been interesting reading.

I was speaking to my sister about it; she's about to qualify as a MW. It sounds really obvious, but every VE they do must be documented as 'VE with patient consent' although in reality I don't think any of mine were positioned to me as 'Are you in agreement?' They were more 'Lets just see how you're doing...'

It should be quite straightforward to decline any/all examinations and MWs shouldn't bat an eyelid.

 

[Mervs Mum]

Unfortunately they tend to word things in a way that gives you the impression you can't decline. As Kess said it's a cultural thing with the medical profession. 'I'm just going to pop a few stitches in there for you, ok?' 'let's have a check and see what's happening, ok?' 'I just need to listen into your baby for a while, ok?' 'We are just going to help speed things up a little with this drip, ok? .... And the list goes on. And you're right Kess, that's not informed choice. It's subtle, sometimes polite, inferred direction.

Unfortunately though Hayley they often DO bat an eyelid When women decline because they are not used to women taking control of their births and bodies. They are used to be the ones driving things not the women. Too many modern mws have lost (or never even learned) traditional midwifery observational skills. They don't trust the process enough not to be able to just sit on their hands and let it unfold unhindered as much as possible. They often seem to need to feel needed. Sad.

 

[HayleyJA]

It is a real shame... I wonder how many ladies on this forum realise they can decline? All too often I see threads across the pregnancy sections from worried ladies wondering if a MW 'puts her whole hand up there' or whether internals hurt, or asking when the MW will start routine checks for dilation, as if these elements are all part and parcel of the process.

I guess, like you say, it is the 'norm' as most see it and unfortunately gives those in the medical profession the upper hand.

Sorry, going slightly off on a tangent here but it's quite a thought provoking subject....