Internal Examinations

[NattieLou]

In this country progress is determined by cervical dilation which is assessed every four hours in labour (6 hours for inductions)...if you are unfortunate to have a prolonged labour/ induction then you can imagine how many examinations you will need

This is hospital-based medical protocol, not evidence based-medicine based on a woman's need. It is instituted largely for the benefit of the care-givers rather than that of the mother and baby. Unless there are any indications of foetal distress or other complications, baby will come when baby is ready. The examination itself and the associated stress can in itself lead to a slow down in the progress of labour for many women. In a normal labour, there is no necessity to regularly determine the degree of cervical dilation at pre-set intervals, and it can have the unwanted effect of precipitating a cascade of unnecessary interventions.

It's a personal choice. Educate yourself, discuss your concerns/preferences with caregivers and make the choice that is right for you. There's no right or wrong, just what's right or wrong for you.

 

[NattieLou]

I wanted to completely agree with Snoopy. Your body, your baby, your birth. Here's a great article about the role of internal exams, particularly for first-time Mums:
https://www.midwiferytoday.com/articles/pushing.asp

Thats a really good article! Everyone needs to read it, I feel so much better about the birth now!

I'm so glad it was reassuring. I find the more I learn and understand about the anatomy and physiology of birth, the more at ease I feel about the prospect.

 

[Celesse]

You can refuse any medical procedure you want to, it's your body, eg people refuse blood transfusions for medical reasons.
Whether it's in your (and baby's) best interest to do so is a different matter. Though with internals a good midwife should be able to tell whats going on from other signs.

Only in second stage will a 'good' midwife be able to tell if a women is fully dilated and therefore a examination is not needed.

Agreed she may not be able to tell how many cm dilated, but she will but be able to have a good idea from other signs (which are less invasive) if labour is progressing and all is well. An experienced midwife will have seen many births and will have a good idea from observing a woman's behaviour how far along she is, and more importantly if things are progressing safely.

 

[Celesse]

In a normal labour, there is no necessity to regularly determine the degree of cervical dilation at pre-set intervals, and it can have the unwanted effect of precipitating a cascade of unnecessary interventions.

Nicely put.

 

[alibaba24]

im sure you can refuse a sweep if you want to i cant see them being able to force you but im pretty sure when your in labour theyr going to have to check whats going on down there i hate the thought of them too but iv had a few now and learnt i just have to lie back and think of scotland

xx

 

[ProudMum]

I felt the way you do at the beginning of my pregnancy and my midwife said you have the right to refuse anything you don't want and to specify you only want minimal pelvic exams.

However........ I went overdue myself, had to be induced and ended up having a forceps delivery. I must have had over 10 different people doing various things with my downstairs and I promise you I DIDN'T CARE!! It's their job, they've seen it all before and you'll be so desperate to get the baby out safely that you honestly won't mind.

People told me this before I went into labour and I didn't believe them, but having been there myself now I know it's true.

Good luck with everything and try not to worry. Oh, another thing you could do is ask for gas & air to help relax you before any internals - my midwife offered it to me (great stuff!)

This exact same thing happened to me with my son..
Sadly tho, I have gone back to being frightened again but I know that when its time for those internals to be done I will let the drs do their job.
I was 41 weeks before I let anyone put their fingers up there with my first- My OB/GYNcouldnt understand it but I guess its just one of them things.
I even asked the OB not to look atme down below and to cover me with a blanket.
The night I was admitted to hospital it took 4 hours or more to convince me to let random MW's examine me. I was shocking.

 

[mrs_rj]

I'm sure every single woman out there would want to avoid one if possible, but i believe that the health of the baby (and you!) comes first! Internals aren't done for the fun of it - i have had to have 4 so far in this pregnancy, each time to check if i was in early labour.

They aren't nice, but if you are nervous just say and they will explain to you what they are doing and will be as quick / gentle as possible. They really will have seen loads of womens bits before - it's there job, so just lay back and think of your baby! xxx

 

[2bananas]

In all honesty people,

you should be more worried about the size of the thing coming out instead of the few fingers going in to asses dilation!

Internals aren't pleasant, I had around 8 with my first labour due to slow progress but I'd rather know what was going on than midwives having to guess.

 

[suzib76]

i can understand refusing a sweep if you would prefer to go into labour spontaneously, what i dont understand is why you would not want to have internal examination when in labour, as although you do not have to have them, thye obviously do carry some benefits
if its just about the midwife 'seeing' thats not a good enough reason to refuse in my opinion

 

[trashit]

you have to have them in labour to know how dilated you are, and anyway your gonna have the midwifes down there when your in labour, you cant escape it. Ive had one at 25 weeks to see if i was in early labour. They dont hurt at all. Its impossible to relax i tensed up straigjt away!

 

[trashit]

but they reli dont hurt hon

 

[lisaboo79]

i have managed to get till now without one lol

but i have a sweep on wednesday so i am seeing not alot of choice there!!

 

[Jan34]

No one likes internals but my view is that they are an evil necessity. As for sweeps, I'll go for one. rather a sweep in the midwife's room at the surgery than some of the artificial induction methods, i.e. having prostaglandin gel applied to your cervix on the antenatal ward, or having your membranes broken with a hook through your cervix.

 

[redpoppy]

I think you should read up on your options and assess what repercussions there are for the birth.

I don't think a sweep is necessary and maybe you can ask your care providers how long you can wait, what your other options are and whether you can delay having one and for how long.

I would like to go into labour naturally and would like to avoid sweeps but not as much as I'd like to avoid an induction.

Also, the birthing centre I'm due to go in to (excellent midwife lead unit) has a window of taking people between 37 and 42 weeks according to scan dates. After that I have to choose between tow crappy hospitals. SO towards the end of 41 weeks I imagine I'll be wanting sweeps and all sorts!

You have to remember that you have the right to say no to things and that you should ALWAYS ask why something is being done, what your alternative options are, whether there's a danger to you or your baby if you DON'T get something done and whether it's okay to delay whatever it is they want you to get done.

Best of luck!

 

[AuNatural]

Internal examinations are certainly not a necessity. Not having them carried out does not effect the health of you or your baby. That is not the reason for having them.
They can be intrusive and totally unnecessary, unless you yourself want to know how dilated your cervix is. They have many disadvantages. It is a personal decision for every individual woman, but choosing to not have them done, certainly does not mean you are posing a risk to the health of your baby!

Rachel