Internal exams question

[9jawife]

I am planning a natural birth with Midwives at the hospital. The Midwives I see want to start doing internal exams at 36 weeks like the doctors do. I learned in my birthing classes, though, that exams carry a risk of infection, AND they don't even predict when your birthing time will start! Is that true? I personally don't mind knowing if/how much I am dilated and effaced, but if it doesn't actually give us an approximate idea of when birth will begin....what's the point?

 

[irish_cob]

Good question, and in the uk you don't have any exams until you're in labour. Or unless you go overdue and you agree to have a sweep. If you don't want any exams just say no.

 

[sue_88]

There is no point to internal examinations and of no benefit to the mother

 

[nullaby]

If you don't wish to know, you can decline them.

 

[Berri]

Seems early and pointless, I'd decline. My dr did an internal check when I was 39+5 to see what was going on and whether I'd need an appointment the next week. She said it didn't seem like anything was happening - DS was born less than 48hrs later!

 

[sezzolou]

I just had a natural home birth. I wrote in my birth plan that I didnt want any internal examinations at all. Midwife really wanted to do one when she arrived so I gave in, told 4cm which made me anxious...the main reason I didnt want one in the first place. I gave birth less than 2 hrs later though. I wish is stuck to my guns and said no as it made me doubt my progress!

 

[Sam Pearson]

...what's the point?

Exactly. Why would you allow that for no medical reason? Your baby will come when s/he is ready. I"d tell them to keep their hands out of my vagina. Even in labour I don't allow any internals.

 

[MindUtopia]

You're right. There's no point. It just gives them something to do. It's why they don't even do them here (unless you get to 41 weeks and request a stretch and sweep). Personally, I would decline. I only had one cervical exam and that was when I was in labour and already fully dilated. That was horrible enough and I plan to decline even those next time around. You don't have to do anything you don't want to, even in labour.

 

[babyface15]

where are you located? i'm in Canada and put "no or minimal exams" in my birth plan. For each exam pre labor I had to request it (I was overdue and had two sweeps) & in labor they simply asked if I minded being checked, I had the option to say no!

 

[9jawife]

Turns out I was worried for nothing-they do not force the issue with Midwife clients. But now that it's been a few weeks, I think I might actually allow them to do it--stressing NO stripping of membranes. Just curious as to how my body is progressing.

 

[BunnyN]

They can give an indication of if your body is ready for labour but it's still not a sure thing. You can apear ready and still take weeks or you can seem no where near ready and go into labour the next day. I decided to refuse internal exams because it seemed like it would just add to the pressure and I didn't really want to be poked more than needed and I didnt trust them not to give me a quick sweep while they were there, which I didnt want. After I went overdue I did check my own cervix a few times. It was so high I couldnt reach it until a couple of days before labour started so it did change not long before labour for me.

 

[mcsmyth1]

They aren't very indicative of when labour will happen at all.

I had one at 34 weeks but was having contractions so it made sense to check if I was dilating. I go on call for a home birth next thursday and it is in my birth plan to have no internal exams, I want to let my body work things out itself, and not have being told how far gone I am affecting my concentration.

 

[Viola Payne]

Sorry, I don't mean to highjack the thread, but if you don't have any internals during labour how do you get a sense of how far you are?

 

[Olivette]

Sorry, I don't mean to highjack the thread, but if you don't have any internals during labour how do you get a sense of how far you are?

From the research I've done and what I've seen others say, the internal exams just give you a snap shot view of how things are at that exact moment. Things can change in an instant and it's no way to tell how well things are progressing. For me I know it will stress me out if I'm told i'm only 2 cms, then only 3 cms several hours later.

I have full faith and trust in my body and believe that when the time comes, I will know when the right time to push is.

 

[babyface15]

I'd like to add that in labor I had an internal when I was checked in and the doctor said I was about 7 cm. A few hours later a nurse wanted to do another and I obliged. She said at that point I was about 7 cm and the previous doctor had just been too generous with his earlier exam. I found that to be so discouraging. So that's something to consider as well if you want to agree to internal exams. Plus there is a risk of your membranes rupturing, which could put you 'on the clock' to deliver before they insist on artificial induction due to risk of infection. Artificial induction carries a number of its own risks and can make labor more intense.

 

[babyface15]

the opposite is true as well, if you feel you've been working hard and not making much progress an internal exam that shows you've gone from 4 cm to 9 cm can be very motivating! just listen to your instincts and you should do wonderfully

 

[madasa]

Since their approach and your wishes are so far apart even in pregnancy - is it worth shopping around for new midwives, so that you are not battling for what you want and need in labour?

It is far better to find a provider who is in line with your wishes if possible, than one who isn't and try to make them change their policy on the day!