To my way of thinking, prenatal VE is primarily if not entirely a ritual with various underlying meanings and purposes. I agree with Pirogi that it's a paternalistic thing, one of numerous acts and words used by OBs (and sometimes hb mws too) designed more than anything else to serve the creation of a power structure in the mother-doctor relationship. Well, not just ' doctor control over patients', and the corresponding participation by patients to essentially 'submit' to the doc's power--but also feeding both parties' sense of 'power over birth'.
As some have pointed out, VE has no true value as a measure, or predictor; even within minutes of birth, VE can be misleading as a source of info (thinking now of the mama whose baby was posterior, cervix was high and very posterior, no more than 3-4 cms--hard to tell because hard to reach--and having contrax every 4min but only 45 seconds long--who had a sudden, VERY intense shift in labor and was pushing her baby out 15 min later). The informational/predictive value of VE is even LESS reliable prior to labor's onset. It has NO predictive value, at any time! But it has come to be so important, one way or another in the course of care, and a woman's experience of, and relationship with, her care provider (and the provider's relationship w/her of course).
We have been taught, over the course of one short generation, to accept and even 'believe in' the power of prenatal VE (and I'm so glad to be older than that...never had ONE VE during pregnancy, never had it offered even, never missed it!). We were taught by OBs in the last 20 or so years...whether directly by our own OB, or indirectly by our friends/relatives who went before us in babyhaving...not just to 'allow' prenatal VE, but to WANT them, to VALUE them, to feel that something is 'missing' if they don't occur!
As a feminist, as a 'rhetorical critic' (an analyzer of words, images and actions under the assumption that they all have symbolic significance to people along with any 'material', literal significance), as a mom and 'Trust Birth' mw, I've had some 30 yrs to consider all matters 'pregnancy and birth'. And I will tell you that the great majority of VE is done as a ritual with almost NO real value as an assessment tool (occasionally it can be--at least for those of us with insufficient knowledge of 'non-VE methods' of determining some issues w/labor). Actually, a great deal of what happens in our care has far more symbolic significance than of actual value. Not to say that there should never be anything 'ritual in nature' in our lives or prenatal care...that would be impossible, for one thing--ritual and symbol are enormously important to us, are an intimate part of how we communicate and form our selves and relationships, our lives and societies, religions, all of it. It's just the things we don't KNOW are ritually based, the things we believe have 'real', material value, that have so much power over us.
But, with or without 'actual assessment value', VE can sure be of great value in the establishment of power relations between doc/mw and 'patient', and in the securing of our sense of control over birth! So, anyway--I won't say that a woman should or shouldn't have VEs in pregnancy, and I won't tell anyone how to feel about their prelabor VEs, should they choose some...I just hope to prompt further thought about all this, so that women can make truly informed (informed and aware on all levels) and FREE decisions about it.
So--maybe, knowing (well, agreeing to some extent anyway?) that VE is so primarily a symbol, a ritual with 'hidden agendas' and not so obvious impact on us, a woman might even choose to allow them so that her doc/mw won't feel threatened by her, will have some notion of her 'adequate compliance with protocol' and not get buttons pushed
that don't warrant pushing. By the same token, a woman who really wants, say, a normal birth with no/few 'interventions', might begin during pregnancy by refusing VE as a way to show that she is already taking charge of things.
People have different ways of establishing their power in relationships, and getting what they want, however--I'm not saying that 'refusing VE/other testing' is THE way to demonstrate your will to take charge of things. Still--when you know what's going on beneath the surface, are aware of the symbolic force of particular words/actions, you give yourself more power to choose, and more understanding of why one might make this choice or that one!
To wind it up...VE is a ritual, and has little to no material value. Use it accordingly or don't, all for your own good, and nothing else!