Pelvimetry: Thoughts/Experiences?

[phathui5]

Last night, I had to do a (written) pelvimetry assignment about different types of pelvises for my midwifery school coursework.

All I remember of pelvimetry myself is the hospital-based midwife I initially saw with my second baby performing a pelvic exam and not explaining to me what she was planning to do before she did it. It was pretty uncomfortable and (in my opinion) unnecessary considering that I had already successfully birthed an almost eight pound baby.

Have you found pelvimetry to be valuable in your midwifery practice? How has it helped? What do you do to make it more pleasant?

[MidwifeErika]

I think the times it can be the most useful are when women have doubts about their pelvis. It can be helpful to take a slow exam to explain to a woman exactly how her pelvis is shaped and reassure her. Or sometimes women have been told things they don't understand about their pelvis from previous providers and it can be helpful to do an exam so you can better explain to her what she has been told. I think it can be made MUCH more comfortable by simply a woman being aware of everything you are doing and what you are looking for. So much of the pain can simply be from surprise when you don't know what someone is doing to you.

[holly6737]

I think pelvimetry is unnecessary in pregnancy. Ultimately, everyone is going to get a trial of labor. You're not going to recommend a c-section prior to labor just because a woman might be platypelloid, you know? A trial of labor is the only real determination if a woman has an "adequate pelvis" or not. 

When I do think it's useful is during birth. If a woman has arrest of dilation or descent, I think it can be useful to do pelvimetry to see if this baby is going to really be able to get through this pelvis or if you need to just call it. That's when I think pelvimetry can be a valuable tool to have in your "toolbox".

[mwherbs]

For the longest time I really resisted seeing any usefulness to pelvimitry. Alot of my feeling stemmed from doctors where I lived using exams accompanied with comments like "oh you are small" or t"his is going to be a really tight fit"... They really set women up to fail...
But over the years I have run across midwives who use the info as just one more tool, so they know how to guide a woman into positions to move a baby down better if there is any progress problems.

[completebeginnings]

I don't believe in it prior to labor unless as Erika posted a woman has some real concerns that can easily be explained and reassured but I do use it occasionally during labor when there is a stall of some sort. Most recently a primip had such a narrow pubic arch I never thought that baby would come through. She would have been sectioned for sure in the hospital. But due to careful examination we were able to help her open by pushing open on her ischial spines (I know sounds terrible and it was not comfortable or what we wanted for anyone involved) but after hours of pushing with no progress a almost 9 lb baby was born a few minutes later. And due to the exam we were easily able to explain to the mom what we were doing and why and get full consent hoping to reduce the chances of physical and emotional trauma. I am not sure I would have been willing to do something so invasive if I hadn't have done a in depth exam to help assess what the problem really was ( baby too big, inadequate contraction strength, nuchal cord, inadequate outlet etc.)