Please remind me why Internals can be bad!

[thebigfam]

I have my 37 week appointment today I and I am getting anxious to know what is going on in there.  But I know deep down I don't want internals and that they don't really show anything.  Please remind me! 

Big Momma

[Pirogi]

How much you are now dilated, effaced, and the baby's station has NOTHING to do with when you will start labor or how long it will be.  Your baby will be born when it is ready.

:)

[MsFortune]

They can theoretically introduce bacteria into your vagina.  But if your OB/MW uses gloves, this should not be an issue. 

[myk]

they hurt.

that and they may introduce bacteria/yeast into the vagina that would otherwise reside outside the body. it could irritate your cervix and cause spotting, which would usually be harmless but you don't need the stress.

[rosiewik]

To parrot what other posters have said..

In theory even if your care provider wears gloves it can force bacteria that is normally present in your lower lady parts into your theoretically open cervix. That is where the mayhem begins. 

AND...

I've had so many friends walk around for weeks at varying degrees of dilation and effacement. 

I too have really wanted to get exams, so I keep reminding myself of these things.

And telling myself this "My baby knows when AND how to be born." 

And then I have sex, take a walk, eat spicy food, drink raspberry leaf tea, have pineapple for desert, play with my nipples and wait..wait..wait. 

[thebigfam]

The nurse asked me if I wanted one.  I simply said no and she said "that's what I thought." the doctor didn't mention anything about an internal.  I gave her my birth plan that she read and everything was good!  Whew!  Lets remember this again next week... If I am still preggo.

Big Momma

Oh yeah doesn't sex introduce the same bacteria that an internal does? 

[MPsSweetie]

I'm weird, I like to know where my body is...  But I had an internal yesterday and cramped ALL night long.  So that wasn't fun!

[myk]

i'm fighting off the curiosity, personally.. with all the BH i've been having and other stuff, i've been seriously wondering how things are doing down there! i got checked a week ago and was offered this week because of some other problems i was having.. i said no, but it was hard to resist :)

[SumnerRain]

I accepted mine at 38 weeks because of 8 hours of regular, painful ctx.  I was not dilating or thinning at all, so I have decided no more until maybe I get to 41 weeks... just because it was SO discouraging.

[rosiewik]

Originally Posted by thebigfam 

The nurse asked me if I wanted one.  I simply said no and she said "that's what I thought." the doctor didn't mention anything about an internal.  I gave her my birth plan that she read and everything was good!  Whew!  Lets remember this again next week... If I am still preggo.

Big Momma

Oh yeah doesn't sex introduce the same bacteria that an internal does? 

Yes, I think sex would pose the same/greater risk as a vaginal exam, BUT it is decidedly more worthwhile in my opinion. 

And I heard something anecdotal about semen having some slightly antiseptic quality, but Lord knows I'm not doctor and I haven't done the research..

Oh, and my internal exam I got when I actually thought I could be in labor...

It caused me to spot brown or lose my mucus plug. I can't tell which. Which is just one more thing for me to google/wonder about. 
 

[stik]

The only outcome I ever wanted from an internal exam at the end of my pregnancies was for someone to say "This baby is crowning RIGHT NOW!"

If that had actually been happening, I wouldn't have needed an exam to give me the information. 

When curiousity overcame me, I checked my own cervix.  I never tried to check for dilation, because I just don't feel capable of being that precise, but I could take a reasonable guess at station and effacement, and having an idea about those things made me feel like I was making meaningful progress towards having a baby sometime in the next few weeks. 

[allisonrose]

With my last pregnancy, I declined an internal the day (or maybe two) before my water broke. I was very glad I did even though the on call midwife spoke longingly of knowing my dialation (no internals due to my GBS+ status) because if I had had one, I would have wondered if the midwife stripped my membranes without bothering to ask or if just the internal alone was enough to disturb things.

[JoyfulJessie]

I think one difference about the bacteria introduced through sex is that you are in your own home and your body is already accustomed to your partner and yourself, but hospitals are actually "dirtier" than your own home. It's a good point that your own bacteria from lower down could get forced into your cervix - but I don't think that really matters until your waters break. Don't have sex if your waters break, other than that, you should be fine.

Plus, hubby's sperm has prostaglandins that can help soften the cervix, so as rosiewik mentioned above, the benefit may outweigh the risk.

[Pirogi]

Most practitioners don't use sterile gloves for a cervical check, so the gloves really only serve to protect you from the germs the practitioner may be harboring under their fingernails (which is not trivial).  As PP mentioned, it is the unfamiliar germs from the environment and from where the gloves have been stored that pose a more serious risk.  Yes, there is likely bacteria in your lower lady parts that would make its way up to the cervix, and this may in a small percentage cause problems, but the repeated exposure to this bacteria from a sexual and other activity throughout the pregnancy probably gives a protective effect.

[AFWife]

Originally Posted by allisonrose 

With my last pregnancy, I declined an internal the day (or maybe two) before my water broke. I was very glad I did even though the on call midwife spoke longingly of knowing my dialation (no internals due to my GBS+ status) because if I had had one, I would have wondered if the midwife stripped my membranes without bothering to ask or if just the internal alone was enough to disturb things.

I think that my "rough" internal with DS caused labor at 38 weeks...she said I was only 1/2cm dilated and she'd see me next week...que water breaking that night. I've heard that messing with your cervix like that (sticking your fingers into it) can encourage it to dilate..

[nosce]

DDDC-

An excellent article on why to refuse them during labor-

http://www.midwiferytoday.com/articles/pushing.asp

And as far as prenatal cervical exams go, here's my story-

With my daughter, who was born with an OB in a hospital, my doctor did the first one at 36 weeks, "just to see". She discovered me to be 100% effaced and 6 cm dilated and literally told me to call my parents and inlaws, claiming we'd have a baby in our arms before the weekend. Two weeks later, I was still pregnant but very grouchy from attending phonecalls of the anxious IS THE BABY HERE YET?! variety. She checked me again at 38 weeks, found me 8 cm dilated and was absolutely certain I'd go into labor if I so much as sneezed.
A week later, my water broke on its own and I had a baby. Meanwhile I'd suffered three weeks of people calling every two minutes sure I was in the hospital, 3 weeks of making plans that sounded like, "I'd love to go out for dinner...as long as I'm not in the throes of labor, that is."
Honestly, while it was awesome to know that my body had slowly done the hard work of labor for me over many weeks, I wish I'd never found out that I was "so close to labor", because I really wasn't. My last month of pregnancy would have been a lot less stressful if everyone had been expecting a baby at 40 or 41 weeks instead of 36.

I'm declining all cervical checks this time, because of that experience. I told my midwife I want an entirely hands-off birth process- I'd like her to stand by and assist if medically necessary but otherwise let us do it. If we need to know how far dilated I am, she said she was happy for me to check myself and then report to her how far apart my fingers were.