Anyone else not get "checked"? - Page 2

[pampered_mom]

With ds (my "elective" cesarean just shy of 40 weeks) I was checked several times. With dd (my HBAC) I was only checked once. I had experienced fairly regular contractions all night that then petered out come morning. I already had a prenatal scheduled and requested that my midwife check me. In the end it was very reassuring because I knew something was happening - I ended up feeling a bit more relaxed about the process. After that I never felt it was necessary.

[mamatolevi]

Originally Posted by rainashine

So how common is this with OBs? I was pretty uninformed when I had my dd and it wasn't really presented as something to "choose". Has anyone had any trouble refusing checks in an ob practice? Now with future births I'm hoping to have a MW but I'll be a VBAC so I'm sure will have to have OB back up.

extremely! My first OB (his partner actually) just shoved his hand in there w/o asking at my GBS test. I was pretty pissed about it. But even after complaining was told that's what is done and was not given a choice about more. ahh. the days of my ignorance. How I DON'T long for them.

My last OB was pretty respectful. he starts doing checks at 40w, but does not push it all. He makes it very clear we can say no. We did continue checks b/c we were looking at possibly inducing (long story) and needed to know for bishop's score but when it came to labor the only check I had was when I was asking for the paracervical block and when I was apparently starting to push about 10 mins later. (I didn't realize I was pushy - my doula noticed!)

I don't plan on allowing checks this time. We'll see how I feel when I hit 42 weeks though.

[pjs]

I wasn't checked with #2 or #3 though I wish I had with #3. I had a precipitous labor (1.5 hrs) and my midwife missed the birth. Perhaps if I had considered it an option at 41 w 6 d after 2 doses of castor oil, she might have already been here. I totally dismissed the idea of checks (thinking there would never be a pro), but even though things were fine without my midwife, I wished it had been presented as an option because then she most likely would have been here for the birth (and perhaps I would have had an inkling that baby was coming fast and furious if she'd checked and I'd been 7 as opposed to being checked and being a 1)...

[SequoiasMom]

Originally Posted by pjs

I wasn't checked with #2 or #3 though I wish I had with #3. I had a precipitous labor (1.5 hrs) and my midwife missed the birth. Perhaps if I had considered it an option at 41 w 6 d after 2 doses of castor oil, she might have already been here. I totally dismissed the idea of checks (thinking there would never be a pro), but even though things were fine without my midwife, I wished it had been presented as an option because then she most likely would have been here for the birth (and perhaps I would have had an inkling that baby was coming fast and furious if she'd checked and I'd been 7 as opposed to being checked and being a 1)...

Hey, there's a pro!
My idea of pro would be that I am 39 weeks, will be 39w4d at next appt. and if I do decide to get checked, I'll know more about what's up with my body. True, it could mean any number of things, but just having more information would make me feel better. That's my pro.

I am going for a VBAC, so the thought of going over is terrifying to me, as I am not able to be induced at all. Just to know there was *some* progress would set my mind at ease and more than likely contribute to lowering my stress level. Another pro for me. I suppose I was just speaking personally.

[sewaneecook]

Originally Posted by laohaire

What are the pros? (Can't think of any...)

I'm 90 minutes away from the birth center, so I have been getting checked fairly regularly (2x so far and I'll be checked again tomorrow at my 40w appt). If I'm at 2 cm I know I'll have more time to get to the birth center than if I'm at 4 cm. My first birth was fairly short, so this has been a bit of a concern of mine. With DS I was only checked once to see if I was at least 4 cm so that I could get in the water (before then it can slow progress) during the birth. If it weren't for the distance I'll have to travel, I would not be getting checked at all.

[MOMYS]

Now with my last pregnancy, I had a false alarm a week before baby was born. I actually asked to be checked because I felt things fizzling out, but I've also had precipitated labour before and I didn't want the midwife to leave if things were progressing.

When I went into actual labour I thought things were going to go slowly. When the midwife arrived about a hour after my water broke, I felt like I was already in transition, except a couple of things were different to all of my previous labours. I actually asked the midwife to check me and I was in fact 7 cm. It was good for me to have known this.

I had no checks during the pregnancies.

[Turquesa]

So what are the "pros" for the OB? I'm not wondering so much about our own cynical speculations (e.g. looking for an induction excuse), but what is their stated rationale for routine checking?

[amydiane]

I plan on declining the early ones for sure....so far no one's offered, but I have an appointment on Wednesday, so we'll see. If I get to 40 weeks, I might get curious.

[SandraS]

Originally Posted by sewaneecook

I'm 90 minutes away from the birth center, so I have been getting checked fairly regularly (2x so far and I'll be checked again tomorrow at my 40w appt). If I'm at 2 cm I know I'll have more time to get to the birth center than if I'm at 4 cm. My first birth was fairly short, so this has been a bit of a concern of mine. With DS I was only checked once to see if I was at least 4 cm so that I could get in the water (before then it can slow progress) during the birth. If it weren't for the distance I'll have to travel, I would not be getting checked at all.

Good luck. I was checked with #2 and went from 4 to 10 in under 10 minutes.

I really don't think it matters one iota what you're at and when you'll go.

[SandraS]

Originally Posted by Turquesa

So what are the "pros" for the OB? I'm not wondering so much about our own cynical speculations (e.g. looking for an induction excuse), but what is their stated rationale for routine checking?

Habit. They're used to doing it. There's no real medical reason for it.

[mamatolevi]

Originally Posted by SandraS

"No" is a very powerful word. And a doctor won't be angry if you use it.

A good dr won't be angry. You'd be amazed and how many dr's get upset over it.

[mamatolevi]

Originally Posted by Turquesa

So what are the "pros" for the OB? I'm not wondering so much about our own cynical speculations (e.g. looking for an induction excuse), but what is their stated rationale for routine checking?

It gives them a chance to strip your membranes when you're pushing or past 40w (w/o your consent, I might add) b/c ZOMG! you can't just do nothing!

[AlexisT]

I wasn't checked at 36 weeks. I was checked at 38, but they were deciding what to do--I had to deliver, and I didn't have time for an all-weekend Cervidil fest.

This wasn't in the US but my understanding is that NHS midwives are very keen on checking and on membrane stripping--I swear that everyone I know got their membranes swept at 40 or 41 weeks.

[Turquesa]

I also found another unstated reason OBs do them: Mulah.

I guess I was just wondering what the stated reasons are. Does ACOG had a protocol for them, a medical rationale for doing them routinely, or something along those lines?

There are multiple other ways to determine a baby's positioning and station. And as the OP stated about cervical effacement....so what? It's kind of like how losing your mucous plug means that labor is imminent and going to happen "sometime." Of course it is. You're pregnant.

[AlexisT]

A lot of insurers have switched to global fee for pregnancy (sometimes pregnancy and delivery) for precisely this reason--I guess some docs got a leetle greedy, especially ones billing low-paying insurers.

I don't think it's about the money, as such, because in some other countries docs (or midwives) really go in for VEs, or ultrasound, or whatever the trend is in their country. It's cultural. They've been taught to check, so they do.

[pinksprklybarefoot]

I wonder if it has become one of those things that OBs do because "that's just how we have always done it," even though the medical rationale isn't there... kind of like the no eating/drinking during labor thing.

I'm in the "What is the point?" camp and don't get checked until I am in labor.

[MegBoz]

Originally Posted by Turquesa

...means that labor is imminent and going to happen "sometime." Of course it is. You're pregnant.

Hilarious!

[Peppamint]

I'm one of those moms who is dialated to 3cm by 36-37 weeks... so getting checked prior to labor is usually discouraging.

With my last baby, I waited until I was 5 days past my edd to get checked, and it was with the intent of sweeping my membranes to see if we could get the prodromal labor to kick into high gear (my BP was acting up). It worked and I don't regret it... but I'm glad I wasn't having regular checks prior to that point, it was discouraging enough having all that prodromal labor.

[meganmarie]

I also found another unstated reason OBs do them: Mulah.

Turquesa, thanks for posting that link. I would describe it as eye-opening except that I don't think my eyes could be any further open when it comes to medically-managed childbirth. An extra $250 insurance reimbursement per vaginal exam is certainly a reason to routinely include them in your practice even if the information provided by them is worthless.

[amandaleigh37]

I just gave birth Sunday at home... and was never checked once. Not during pregnancy or labor.