VEs in Late Pregnancy- Their Emotional Value?

[MegBoz]

It seems it’s common to have vaginal exams at the weekly appointments post 36W of pregnancy. I had co-workers I didn’t even know well and friends-of-friends ask if I was dilated!

When they asked, of course they all got a lecture about how it doesn’t really mean anything – you can be firm, high & closed & have the baby that night, likewise you could be 3cm and walk around that way for 2 more weeks. Besides I was GBS+ & the VEs just increase the risk of infection.

The strange thing was, they all replied, “Oh yeah, I know that. But I still wanted to know if anything was happening down there.” I’ve heard this repeatedly.

So it is as though there is a disconnect between

• The intellectual realization that this data means nothing (without labor, of course)
• & The emotional desire to view it as “progress” & a good thing (a sign that birth is coming soon)

As we know, of course birth is “imminent” – you’re pregnant!

Ya know, I think I realized I too might have been tempted to be disappointed if I was still hard & closed at 41W. Again, the intellectual realization might not be adequate to stop the emotional disappointment. (Likewise, if I were 3cm, I’d probably get even MORE anxious for things to start.)

So what was your choice- did you have VEs in late PG? & why do you think people consent to them even if they know the are worthless? Are we all just so desperate for insight into WHEN because the NOT KNOWING is too tough to handle? (My DS went to 41W4D and I did find the issue of not knowing when to be really difficult.)

[WifeofAnt]

I'm not sure if I'm going to allow them but I heard of a woman who walked around for three weeks at 6 cm!!!

[vanislandmama]

Funny things about humans, we let emotional thought trump rational thought. My DH and I were just talking about this last night. It's kind of like all the old wives tales we have about whether we are carrying a boy or a girl. So many times over it has been proven that there is no correlation between heart rate and sex. Same goes with the shape of a womans belly. Round and out: boy, high and wide: girl. The only thing it depends on is the the shape of the womans body pre birth and the way the uterus and baby are lying.
Deciding to get checked is an emotional choice woman make with the hopes that the doctor will say something exciting. Unfortunately, it usually only leads to more anxiety and disappointment. We got so close to end and want to hear that we are almost there. We know that it doesn't mean anything, but for some reason we still do it. I learned this the hard way with my first. My MW told me a week before my due date that I was 2 cm and effaced and baby was way engaged and that she thought I'd have my baby within a week. Well, that sure did make the next 3 weeks feel like an eternity. I was 10 days past my due date.

[MegBoz]

Originally Posted by WifeofAnt

I'm not sure if I'm going to allow them but I heard of a woman who walked around for three weeks at 6 cm!!!

Oh yeah, that reminds me, one mama I know got induced simply because she had been 4 cm for weeks! No other reason! She said her OB said she'd never heard of a woman walking around at 4cm for so long. WTH?! That's a reason to induce?!
I remember thinking "OK, so that's reason # 8 million to decline the VEs - so we don't have to have that discussion!"

[Ola_]

Originally Posted by MegBoz

The strange thing was, they all replied, “Oh yeah, I know that. But I still wanted to know if anything was happening down there.” I’ve heard this repeatedly.

Hmm, do you think they really knew that, or maybe just didn't want to seem ignorant?

I pity the person who asks me about what's happening in my vagina - they're gonna get an earful!

[nia82]

I think most women don't know they can refuse the exams! I sure didn't know with DS... I was with an obgyn and it just was normal... Now I know better and won't allow them at all with this pregnancy. It's horribly painful, potentially dangerous (infections or unwanted membrane sweeping!) and just no reliable information...

@ Megboz: wow that is creepy... I'm starting to think obgyns do the exams to push inductions....

[VillageMom6]

Originally Posted by vanislandmama

We know that it doesn't mean anything, but for some reason we still do it.

So true, so true, so true!

I've spent the last eight months explaining to my family and friends how checks mean nothing... it's just to satisfy curiosity... usually it leads to disappointment... this time I'm refusing all checks until I feel the urge to push.

Well, guess what? I just turned 36 weeks and I caved. Completely caved. One week ago I was all "No checks!". Yesterday? "Could you check me, please?"

Gah, it's going to be a long month!

(I was 1 cm. dialated, by the way. When do you think I'll go into labor??)

[Magali]

I just got them last pregnancy because my Dr. said "Now I will check your cervix." Of course she didn't mention that it was a really useless piece of information. And honestly I didn't really know what any of it meant...even if there was a point.

[harli]

I really think that most people don't realize they mean nothing at all. Heck I don't think most OBGYN's realize they mean nothing, at least not the ones I've dealt with.

I actually just had a 'discussion' with my MIL about this today. My sister was due yesterday and MIL was asking how far along she has progressed. I told her that my sis hasn't had any VE. MIL seemed shocked and was asking 'well how are they going to know around when she will deliver?'. I told her the VE's don't tell you that anyway and that you can reverse dilate or even be like me who was 3-4 cm's dilated for months on end. She proceeded to strongly INSIST that a good doctor can tell around when you will deliver by looking at the thinning of the cervix and how much you are dilated. She does that all the time, where I will explain something and she will INSIST that I'm wrong and she is right. I just politely smile and nod and wait for my eye to start twitching in frustration.

MIL is also HIGHLY against midwives telling me how I will kill my baby (not preg. yet) if I go to one. Guess she's in for a surprise huh?

[bella99]

You know, I really didn't mind them. And even though I knew they didn't predict anything, they helped me feel like the end was near, even if it was 1-4 weeks away. I knew my doctor wouldn't sweep my membranes (he doesn't believe in it) and wouldn't push an induction (doesn't induce prior to 42 weeks), and after going through fertility treatments, I guess I was used to people being all up in there

At my 36 week appointment, I was 1 cm, 80% effaced, and baby was at 0 station.

At my 37 week appointment, I was 2 cm, 100% effaced, and baby was still at 0 station.

At my 38 week appointment (38w3d), I was a little over 2 cm, 100% effaced, and baby was at +1 station (and boy was that uncomfortable with a head between my legs).

My daughter was born at 39 weeks exactly. In retrospect, my appointments did show a progression towards my body prepping itself, week by week.

I think the thing is, even with factual information in front of us, by the end of your pregnancy, most women are looking for a sign, any sign, that labor is close, that the time to meet your baby is near.

[Turquesa]

Originally Posted by nia82

@ Megboz: wow that is creepy... I'm starting to think obgyns do the exams to push inductions....

Oh, that's not the only rea$on, unfortunately.

With that factor, unwanted membrane sweeping, and fishing for induction excuses, they can then push VEs by playing on the emotional aspect that MegBoz has described. "But don't you want to know...?"

[Turquesa]

Originally Posted by bella99

I think the thing is, even with factual information in front of us, by the end of your pregnancy, most women are looking for a sign, any sign, that labor is close, that the time to meet your baby is near.

Oh, don't worry. There are plenty of signs--abs swollen out to kingdom-come, extreme fatigue, peeing every 5 minutes, losing your mucous plug, pushy relatives wondering "when," pushy OBs pushing induction . . . these indicators are no more mathematically accurate at predicting labor than VEs and constant ultrasounds. I do agree that the psychology is complex, and women and their doctors are willing to convince themselves to believe in the pseudoscience of frequent VEs. There's nothing like believing that you can control the uncontrollable and predict the unpredictable.

[jennica]

With Ds, I didn't know it meant nothing. Had I known that at the time I would not have done them as they were really uncomfortable. My midwives acted as though they meant something, and I trusted their judgment on it. After all, they were midwives practicing in what I thought was a natural birth friendly hospital. At my last prenatal, the midwife then stripped my membranes without my knowledge or consent. That is when I realized it was something I should have been refusing in later pregnancy, but it was too late by that point. This time I have had no exams at all, and my homebirth midwives haven't offered any. I don't plan to have any in labor either.

[dannic]

Originally Posted by vanislandmama

deciding to get checked is an emotional choice woman make with the hopes that the doctor will say something exciting. Unfortunately, it usually only leads to more anxiety and disappointment. We got so close to end and want to hear that we are almost there. We know that it doesn't mean anything, but for some reason we still do it. I learned this the hard way with my first. My mw told me a week before my due date that i was 2 cm and effaced and baby was way engaged and that she thought i'd have my baby within a week. Well, that sure did make the next 3 weeks feel like an eternity. I was 10 days past my due date.

yup.

[MegBoz]

Originally Posted by Ola_

Hmm, do you think they really knew that, or maybe just didn't want to seem ignorant?

Hm, good point. I suppose that's possible, but at least with one woman, I can picture her face & the tone of her voice when she replied, "Oh I know [it means nothing] I just wanted to hear that something was going on down there!" It did seem like she was sincere that she knew. So it sounds like the classic case of disconnect between the intellectual realization of fact & emotional desire to view it as "progress."

Originally Posted by nia82

@ Megboz: wow that is creepy... I'm starting to think obgyns do the exams to push inductions....

Oh, absolutely! I read about the "Sneak-Attack Induction" before. Basically, go for the weekly check up, have the VE, told you are dilated -- then told, "Oh, you're in labor! Head on down to L&D right now! Congrats! You're going to meet your baby today."

Then when you arrive at L&D, and -surprise, you're not progressing! So they "speed things up a lil' bit" with pit, AROM, etc.

Basically... they induced you when you really thought you were in labor & then once you arrived they needed to just "speed up." Scary thought.

[broodymama]

With DS1 I was 4 cm dilated for 8 weeks (preterm labor), then 6 cm at 39 weeks when he was finally evicted. (AROM induction before a hurricane evacuation.)

With my others I had no VEs during pregnancy or labor and it was much more peaceful.

[SwanMom]

I had 1 VE during this pregnancy (when I was in labor: I was 5 cm dilated). The baby came out fine without more! Not even when it was time to push.

My midwife did say that having a VE late in pregnancy increased your chances of birthing before 41 weeks. Anyone know about that? I still declined.

Also, does anyone else think it's weird how being pregnant gives everyone license to ask about the state of your cervix? I had all sorts of acquaintances ask me how dilated I was...I didn't mind, but it was still odd/funny.

[MegBoz]

Originally Posted by SwanMom

My midwife did say that having a VE late in pregnancy increased your chances of birthing before 41 weeks. Anyone know about that? I still declined.

Never heard that. Now there is some research that sweeping membranes can make you birth faster (i.e. decrease the risk of going beyond 41W) but some research shows it makes no diff. But, of course VE & membrane sweep aren't synonymous.

Of course, maybe it's a correlation vs. causation issue - the HCPs doing lots of VEs are clearly not practicing evidence-based medicine. So maybe they're the same HCPs who push induction on due-date. So that would lead to that "correlation" that mamas having regular VEs in late PG don't go beyond 41W.

Originally Posted by SwanMom

Also, does anyone else think it's weird how being pregnant gives everyone license to ask about the state of your cervix? I had all sorts of acquaintances ask me how dilated I was...I didn't mind, but it was still odd/funny.

I do think it's weird! I wonder if it's an American thing to be so bold to ask about that. For example, we're apparently the only ones who want to know a baby's weight. I was on a con call at work with a guy from the UK & his team based in The Netherlands (people from India, Israel, Sweden, etc.) & he announced the birth of his 2nd child & said, "oh, and for the Americans who like to know, the baby's weight was..." it hadn't occurred to me that this was not a universal tradition. When you think about it, it is weird.

Anyway, overall, being PG seems to make people think your body is not your own & the universe has license to butt in - touching your belly (I never had strangers do it, but I've heard others have.)

[Addie]

I delivered with a hospital-based midwife practice, and their policy was no VEs unless the mom requested one. I didn't have one until my 40 week appointment, and even then it was more of a "well, sure, why not" type thing than a "we need to know what your cervix is doing." I asked the midwife about the policy once, and she reiterated that the information gleaned by doing VEs beginning at 36 weeks doesn't really do anyone any good, but they offer them because some moms just want to know, and some moms come in and say that their friend/mom/sister is demanding to know.

At my 40 week appointment, the midwife could barely even find my cervix because it was still so high up (and, I'm tall ). This confirmed my suspicions that nothing was going on because I'd had nothing even resembling a contraction yet. She checked again at my 41 week appointment, after days of increasingly persistent contractions, and lo and behold I was 6 cms! Baby was born the next morning.

[nia82]

OT: People ask about baby size and how long your labor was back home too (Germany). Nobody ever asked me if I was dilated or effaced though.