Are internal exams necessary during pregnancy (especially early on)?

[LillianB]

I will be going in for my 1st prenatal visit next week, when I'll be 11 weeks. I called the office today to find out what to expect and they told they would be doing blood work, urinalysis, vital stats, a pelvic exam and a pap. I already know that I'd like to refuse the pap, but I'm wondering about the necessity of a pelvic exam. With my last pregnancy I saw a midwife and didn't have any. If it's important I'll do it, but I'm unclear as to what the benefit is....?

[andaluza]

I was due for my pap anyway at my 8w appointment and had it done. I didn't even spot even though I usually do and was worried I would. They also test for chlamydia and gonorrhea as a matter of course, because these stds can affect the fetus. You should be able to refuse any tests and exams that you want to, however.

[OrangeMoon]

No, it is not necessary. Just another reason not to use an ob! (cough cough) lol.

[dogmom327]

Nope. The only internal exams I've had were at my request in the final stages of labor (I seem to lose my confidence during transition). 

[sjdragonfly]

Any testing for chlamydia and gonorrhoea can also be done with a urine test, so you really don't need the pelvic exam. And, if you've already been tested for those things at a previous pap, you don't need to do it again.

[greenmamato2]

I had my yearly exam back in October, so I'm not due for another one, and I know I don't have any STD's because hubby and I are exclusive with each other, and have had standard testing at our yearly check ups anyway as a part of the typical screen they do. 

I am going to refuse my pelvic exam and pap at my first appointment on Monday (6 weeks) and will let them know I don't want one until I'm around 20 weeks, earliest. 

I have had a lot of miscarriages, and one was right after my pelvic exam at 12 weeks, so I really want to be overly cautious.  I didn't have any problem with pelvics with my two daughters, but given my miscarriage history and the fact that you just can't always know what causes it in one woman/pregnancy or another, I just want to be cautious for my own peace of mind.

[MamaInTheDesert]

I asked my midwife at my last appointment why pelvic exams might be necessary during pregnancy. She answered that they really weren't necessary until labor. I then asked WHY did my OB give me a pelvic exam at every single visit during my last pregnancy? First she questioned "Really? Even early on?" When I answered her in the affirmative, she said: "Because he's a pervert." We kind of laughed about it, and she said that she honestly couldn't think of a single reason why he would be sticking his hands in me at every appointment.

[slmommy]

Quote:

Originally Posted by MamaInTheDesert 

I asked my midwife at my last appointment why pelvic exams might be necessary during pregnancy. She answered that they really weren't necessary until labor. I then asked WHY did my OB give me a pelvic exam at every single visit during my last pregnancy? First she questioned "Really? Even early on?" When I answered her in the affirmative, she said: "Because he's a pervert." We kind of laughed about it, and she said that she honestly couldn't think of a single reason why he would be sticking his hands in me at every appointment.

It's kinda my personal theory (based on nothing other than my outlook/experiences so don't flame me too much) that some drs. like to get patient really used to cooperation/taking orders/letting whatever be done to them.

I live in a really high c/sec rate country, pretty much no natural birth, etc... went to do a 12 week NT ultrasound and they wanted to do transvaginal... everything I read read about NT in US is abdominal... I fought with the tech and he insisted that I was wrong. (I am normal weight so that wasn't an issue) He finally agreed to abdominal, but said he would not sign his name to the NT part... well I guess he got a good enough pic anyway because in the end he did... 

I think it is just a tactic here for women to get used to take off your pants and do what you are told, get used to that early and then you will be ready for the birth.

Edited by slmommy - 3/17/12 at 12:50pm

[phathui5]

I'm an apprentice at a birth center. We don't do pelvic exams in early pregnancy. We are willing to do them near the end if a mom asks for one, but she usually has to be the one who brings it up.

[Mama2mc]

I had my first baby with an OB, and she did not do a pelvic exam till labor. I was due for pap while pregnant, but she said she prefered to do it after pregnancy; that was fine by me, because I was afraid of any kind of spotting. My second was with midwives, and again I had no pelvic exams till labor, and a yearly some months postpartum. I think pelvic exams during pregnancy, especially so early on, are unnecessary and intrusive...

[greenmamato2]

Have to say - its really good to hear so many stories of pregnancy centers/ midwives / etc who don't do pelvics until much much later. :)

[Plummeting]

I got my Pap literally the day before I conceived last time, so I didn't need one once I was pregnant. I went through that entire pregnancy without any internal exams at all. The labor was precipitous, so there was no time for checks during labor, and I don't know if I would've had any anyway. I'm not planning on having any this time unless something is wrong.

[Baby_Cakes]

I didnt have any internal exams at all my last pg, until i was in active labor and wanted to know how far i was, bc i wanted to get into the birth pool.  Not necessary at all to have internals early on!

[obdoc]

There is no need to do "curiosity checks".  I will not do one before 39 weeks unless there is a REASON to check--they hurt and I think may be a cause of preterm birth---I mean---when you have sex the penis is not actually TRYING to get into the cervix and see what is going on---not natural.

Most moms want to be checked at 39 weeks (most want earlier but I explain that there is no need and the exam is not meeting any baby needs).

[faithsstuff]

I am so glad this question was asked!  I had a pelvic exam at every visit during my last pregnancy.  Besides being painful, it's so demeaning to be talking to your doc in that stupid paper gown.  Going with midwives this time.

[aHikaru]

i never had an internal exam during my pregnancy,,, just one time towards the end, I was 1cm dilated and DD came the next morning :)

[dangerbunnygirl]

I had a pap with my first appointment since it had been a really long time since I had one, so I was fine with that. I haven't had any other internal exams though and I had an appointment yesterday, I am 39 weeks today :)

[GoofyInOK]

I'm glad to read this.  I went to the only hospital in my town that has midwives when I first found out I was pregnant, and the midwife who saw me pretty much demanded that I have a pap smear.  I refused and told her that I didn't want to do anything internal, that I had been spotting a little, and I didn't want to exacerbate that.  She became angry and said that something must be wrong with me for me to refuse treatment, that I must have had some sort of abuse (which I needed to tell her about even though I just met her), and that they couldn't do an ultrasound on me without it being internal, so there was nothing she could do for me.  It was absolutely awful.  :(  Needless to say, I didn't continue my care there...  In fact, I walked out sobbing.  I found a great homebirth midwife who hasn't even asked to do anything internal yet, and I'm 24 weeks.  I guess I am telling you all this to let you know that there are bullies out there about internal checks, and if you encounter one, RUN!  If you truly don't feel comfortable with internal checks, you don't have to have them.  Good luck, ladies!

[monkeyscience]

I'm also not clear on the point of internal exams during pregnancy. I do know that some providers like to do a pap smear at the beginning, though I'm unclear as to why - if they find cancerous/precancerous changes, I don't think they can treat it without terminating the pregnancy or putting it in serious jeopardy. My midwife says she doesn't do internal exams unless asked, that she prefers to do a pap after the baby comes. I *did* have an internal exam at my first visit, but it was at my request because I was afraid I might have some sort of infection, based on my symptoms. Since then, nothing.

[FaithHopeLove29]

I don't know if it's standard care where I am or not, I was due for a Pap for my first appointment as a follow-up after an abnormal+treatment in the spring. I agree with Monkey - I don't know why they do the pap, as my doc explained she wouldn't do anything else (biopsy or treatment) if it came back abnormal, so it seems kind of pointless. But it eased my mind to have a normal pap so I was glad I had it. Since then, no other internal exams, and I don't expect any until I get close to my EDD (I'm 29 weeks).