Cervix checking « Back to Group Discussions

[maydaymom10]

I'm just curious if anyone else is restraining from having their cervix checked during appointments? My midwife has offered at the last 2 appointments (36 & 37 weeks), but I've refused. I just don't think I want to know right now. But, everyone keeps asking me how dilated/effaced I am and I'm now beginning if I shouldn't find out. I'm a part of some other more mainstream DDCs and so many of the women are posting how they are 2cm/40% at 34 weeks and such, and I just don't get how that information wouldn't drive me crazy. More because I'd be focused on the numbers that might not change for weeks than on focusing on what I feel going on in my body.

Anyway, just curious if anyone else is waiting to get check to either closer to her due date or even until labor starts. I might change my mind next week, but for now I'm pretty set on just waiting. 

[veganyogamomma]

I wont be checked until I'm in labor. It doesn't have any bearing on how much longer I will be pregnant, and Id rather not get caught up in the emotion of it one way or another. These last few weeks are hard enough as it is! I've had people ask and I just say I choose not to be checked. I'm doing my best to avoid all obnoxious questioning from now until this baby arrives!

[buko]

so many of the women are posting how they are 2cm/40% at 34 weeks and such, and I just don't get how that information wouldn't drive me crazy

I was JUST saying this to DH.  Even here on MDC, there are a few women who will report they are 1-2 cm and X% effaced and Y station, and I "get it," I guess... but it's just not relatable to me.  It does nothing for me-- it's almost worse than nothing for ME, personally, as you said-- it's like how we chose to forego listening for the HB on doppler and wait for the fetoscope @ 20 weeks, vs. being able to hear it on doppler at 11 weeks or so.  (I also had no u/s, for a variety of reasons, but part of why I would have gotten no more than ~1 "electively," if I had any, was related to the above reasoning.)

My MWs don't even offer checks in pregnancy, and they're CNMs...  Just very "if it ain't broke, don't fix it."  They also prefer not to do any in labor, which is awesome, and I get the sense that even if you include maternal request checks, they might do ANY checks, AT ALL on maybe 1/4 of women (in labor), and only 1-2 checks on most of those women.

I am not interested in any checks during labor unless there's something really concerning going on, so... awesome.

I thank G-d every day that my MWs are SO on the same page as I am.  It's truly incredible.  Because my mom is an MD and a research fiend, I have had some excellent docs, but my MWs are easily right up there with my best doctor ever in terms of practicing from an evidence-based perspective, let alone "bedside manner" and accessibility.     

[LightForest]

Count me in! I'm just not interested in knowing how far along I am. I think it would just make me get my hopes up (that labor will commence soon) for no real reason. I suppose I'll get checked during labor, if I'm really needing to push and there's some question as to whether my body's ready (dilation-wise).

But really, I WILL have this baby in-arms within 5 weeks. That's the only thing I can know (more or less) for sure!

[wildmansmom]

Originally Posted by veganyogamomma 

I wont be checked until I'm in labor. It doesn't have any bearing on how much longer I will be pregnant, and Id rather not get caught up in the emotion of it one way or another. These last few weeks are hard enough as it is! I've had people ask and I just say I choose not to be checked. I'm doing my best to avoid all obnoxious questioning from now until this baby arrives!

I'll be refusing until I'm in labor for the same reason!  I was told by the OB last week that I can't refuse and they will make me get checked when I come to the hospital in labor even though it still doesn't tell you when the baby is coming.  I dilated 2cm to 10 cm in 3 hours with my son. and I remember it being more painful to have a cervical check at 37-38 weeks than it was to be in labor.
 

[cabbitdancer]

I'm also not interested in cervical checks, for basically the same reasons already posited on here. I thought they might sneak one in when they did my GBS test, but there wasn't even a peep out of them, so I'm starting to think this doctor doesn't set so much store on them...

[buko]

I'm kinda blanking, but is there any real GOOD information that can be gleaned from a prenatal cervical check on a woman during a normal, low-risk pregnancy, especially if one hasn't had a lot of prodromal labor, funky symptoms, etc.?

[firespiritmelody]

As a mama that has never delivered before her dd and with dd3 was 3 cm dialated before her dd and strechy to 5cm at a few days after and STILL didn't deliver until 41w5d, I will be holding out as long as possible and avoiding checks before my dd. There is a bit of concern that my mw, doula and my doula's 2 "main" back ups will be out of town from about a week after my dd for 5 days but my doula (who is a close friend) would postpone leaving if labor was eminent, so I will probably consent to a check around my dd or within a day or two after to see if conditions are "favorable" so that as a team, we can consider that info in our plans.

[jodieanneanton]

I must admit that I did check my own cervix a couple weeks ago....    I was feeling cervical twinges of pain and was curious and that really got the better of me.  Before that, I was going to have none and now that I have done that... I have recommitted to no more checks.

Really, there is nothing that can be gathered from cervical exams aside from "This lady is dialating," "The cervix is softening," "Her body is moving toward labor...eventually."  I walked around with DD1 at 2 cm dialated for at least 3 weeks.  With DD2, I was 3 cm for just as long.  Some practitioners believe that checking the cervix (Especially if it is anterior or posterior) is a good indicator of when labor will likely happen.  This is not a reliable sign of onset of labor, though.  They also think that you can tell if baby is headdown.  You can, but palpating the belly can also determine this. In fact, frequent cervical checks (Even before labor) have some unpleasant side effects and dangers that I really want to avoid.  The least of those are the fact that I would get all wrapped up into feeling like a ticking time bomb! Another thing that can happen is (This may be familiar to you, mayday, bc I got the info from a thread on our birthtrust group) a prenatal cervical check can cause inflammation of the cervix which can cause a weak spot in the amniotic sac causing the bag to break prematurely 24-48 hours after the check.

My plan is to not have any cervical checks prenatally.  During labor, I don't think it is really necessary... but I will play that by ear... For now, I plan on declining all checks unless I feel I "need" one.  (I don't really see that happening, but never say never, I guess.)

[buko]

That's all what I was thinking, Jodie.  I feel like when I hear someone say she is 2 cm dilated, X% effaced, etc., she's basically saying, "I'm in my last 4-6 weeks of pregnancy."  Which is... self-evident?

[jodieanneanton]

Originally Posted by buko 

That's all what I was thinking, Jodie.  I feel like when I hear someone say she is 2 cm dilated, X% effaced, etc., she's basically saying, "I'm in my last 4-6 weeks of pregnancy."  Which is... self-evident?

 yeah!

[micah_mae_]

Well for me it will be helpful because I know my body will dilate at least to 5-6 cm before labor even starts. So if I get checked and I'm 5 cm I know to get my mom down here and start getting ready because it'll be a few days, or less. If I'm already 6 cm I know it'll be a couple days or less. Kwim?

[buko]

Sure, micahmae-- I can understand it might be helpful in some circumstances.  Absolutely, it can at least give a clue in cases like yours.

I think when I've known someone's dilation, though, it's like 98% of the time "I am 1-2 cm dilated, 25-75% effaced, etc." from maybe 34-38 weeks or so...  Which, okay, that's cool, but I feel like maybe (in the "mainstream" especially, for lack of a better word) women are being told this means something...  Or that being "completely high and closed" means something.  Or like has been said...  IDK, in most cases, I think it's another piece of (non-)information for information's sake that if anything, leads to poorer or the same outcomes, but which takes more philosophical control from the woman-baby dyad and puts it in the hands of doctors, machines, "objective" measurements, math...  Sort of a mechanization effect, and the more "technical" information it seems you "need" to know, the more women are supposed to depend on doctors, hospitals, etc.  (I am going to insert again here that my mother is an allopathic MD and I am all for "modern medicine" in many cases, but I still think this is a valid and important point.)  

What I am reminded of is an off-topic post by a 50-60 y.o. woman on a business-related board I used to post on.  She was saying that @ ~34 weeks, her daughter was told her baby was measuring huge on the u/s and she should consider induction at 38-39, and then at 36 weeks, baby is too small, has suspected IUGR (and she should consider induction, etc.), and LOL and what the heck?  So I VERY gently kinda said, well, these things aren't necessarily super-accurate, and maybe she should think about getting a second opinion b/c it looks like the doctor may be placing a bit too much emphasis on an iffy "measuring technique," etc.  And she was like, "Oh, no-- don't get me wrong!  I am THRILLED my daughter has access to all this fabulous technology and critical information, because obviously it means she is getting the very best possible medical care.  I just thought it was 'funny.'"

So...  I mean, I think some of this becomes a part of the big Machine That Goes Ping!  You're Not Qualified, Dear.  And a false sense/illusion of control.  YKWIM?  I know my thoughts are kinda disjointed b/c I'm doing like three other things as I write this, but...  It also makes me think of a story my MW was just telling...  And she is a CNM, mind you...  About how she attended one birth where things were going beautifully, so she was mainly just checking the HB every 30 (and later every 15) minutes, and then a quick catch, no repairs needed, etc.  And the mother of the birthing woman apparently complained later that she (the midwife) "didn't do anything" (but, apparently "play on her computer"-- she was actually taking notes about the birth on her laptop).  Because OBVIOUSLY birth can't be something that, in many/most cases, women can understand and "do" themselves, or with a little, relatively low-tech help.  No, we ALL NEED printouts and numbers and Machines That Go Ping! or we won't know what's going on.  Even though, you know...  dilation is only very occasionally important information (especially prior to labor, but also often during labor), u/s "measurements" for weight and fluid and such are notoriously inaccurate, even hours passing on the clock aren't directly correlated to much, and continuous fetal monitoring raises C/S rates without improving outcomes, etc., etc...  No, we're supposed to be grateful for the Very Best Possible Medical Care that only numbers and experts can provide.

Okay, incoherent rant over, LOL...   

[storygirlcindy]

Ironically enough, I'm fine with checks now but think I will decline most of them in labor. I had a few early cervical checks between 28-32 weeks, because I started having regular contractions (usually 3-5 minutes apart 24/7) then. At that point, they wanted to keep an eye on things and make sure that my cervix wasn't effacing or dilating, because at that point it would have been a risk factor for preterm birth. I didn't have my first "normal" check until my 36 week appointment Friday, with my GBS test. I don't set too much stock in what it is at any given time, but for me, because most of the "this is how you know you're in labor" signs no longer apply (since my contractions are regular, timeable, often painful/don't allow me to move or talk sometimes, make me nauseated, etc.), I feel like it's helpful to know how things are or are not progressing. I.e. - if I were to get checked next week and suddenly have gone from a 1 to a 5, I'd be a little more "on alert" than if I had been at a 1 both weeks in a row. Obviously it's an incredibly imprecise measurement and doesn't tell you much about when the onset of real labor will begin, but in my case, I'm sorta grasping at any piece of information that I can use right now since everyone currently agrees that I probably won't recognize early labor! I've also been pretty careful to observe anything that's happened in the wake of an exam and (ironically enough) they've never made a difference in my contractions etc., despite the fact that I contract so much. If it seemed like they were speeding things up, I'd decline.

As far as labor goes, once I know I'm in active labor, I don't see a need for frequent checks unless I'm feeling super pushy and need to make sure that's ok. At that point, having frequent checks (esp if it's not the same person every time, since everyone's readings can be different!) just seems like it would be a) fairly pointless and b) potentially really demoralizing.

Anyway, just my two cents there. I'm also a high-risk pregnancy anyway, so have had more monitoring through the whole pregnancy than a typical pregnant lady. I also have a genetic illness (hence the high risk status) and have spent a lot of my life in doctor's offices and hospitals, so I'm pretty comfortable with medical procedures, but also do my own research and am not afraid to speak my mind when I don't agree with what a doctor is doing.

[sunshinelove]

It sounded coherent to me, Buko! . I think its ridiculous how when shown inconsistencies in a particular system, if they are deeply attached to the system they will do what they need to in order to preserve the untainted image of that system. So, like in your example, the woman wouldnt look at how the machinery and the doctor who interpreted it as being unreliable and even potentially dangerous because this would soil her image at how "wonderful" the medical system is! She just laughed it off, not wanting to face the obvious, that maybe these machines and the doctors using them do more harm than good.

[buko]

Originally Posted by sunshinelove 

It sounded coherent to me, Buko! . I think its ridiculous how when shown inconsistencies in a particular system, if they are deeply attached to the system they will do what they need to in order to preserve the untainted image of that system. So, like in your example, the woman wouldnt look at how the machinery and the doctor who interpreted it as being unreliable and even potentially dangerous because this would soil her image at how "wonderful" the medical system is! She just laughed it off, not wanting to face the obvious, that maybe these machines and the doctors using them do more harm than good.

 I wish I could come up with a better analogy, but just imagine if even clearly non-diabetics had to take our blood sugars at every meal, and little deviations "necessitated" additional interventions, etc., etc.  Or if we all had 4 pap smears a year...  after all, more information is better!

Storygirl, it makes total and complete sense to me that it is good info to have in certain situations.  In fact, as pro-low-intervention as I am, I think basically every single pregnancy and birth intervention is useful at least occasionally.  Sometimes EXTREMELY rarely (like maybe NPO or episiotomy or CFM) and sometimes a little more commonly (a 10-15% C/S rate is probably a good thing).  It's just the 100% of the time mentality that maddens me.  

It's funny, because I, too, am actually very comfortable with medical procedures.  Not because I've had to undergo more than average (in fact, probably less), but with mom being a doctor and all-- most of them are NBD to me, psychologically.  And hospitals to me are mostly "where mom worked."  And heck, I got the flu shot, and will be vaccinating pretty close to on-schedule, and etc., etc.  But to throw out another couple of examples...  I remember when DH was finally put on a halfway effective asthma regimen (he was always terrible about taking care of his health and wasn't even diagnosed with asthma-- even though his is pretty bad-- until his late 20s, when MY MOM made him go to the ER during an attack).  Well, his blood pressure was checked and it was high, so they put him on a diuretic.  Then he got gout (from the diuretic).  So they wanted to put him on something for the gout that had its own side effects... and I was like, wait, hold up.  Talked to Dr. Mom, and sure enough, what he REALLY needed to do was to get on different asthma meds because they were raising his BP.  Not on a drug for a side effect of another drug for a side effect of another drug for a side effect of the original asthma drug!  And I remember, too, when I went to see an allergist, and he was HIGHLY credentialed (allergist to the White House) and had a great bedside manner (it seemed), but he sent me away with literally 4 scripts for a minor problem PLUS!  I had a rash on my arm.  So he gave me orders for a Lyme disease blood test *even though* the rash would have to be *very* atypical for Lyme AND it was a Friday and I TOLD him I had an appointment with my dermatologist on Monday.  (It was eczema, BTW, triggered by my allergy test, LOL.)

I immediately got on the phone to Dr. Mom, who has her boards in allergy/immunology, and she was like, uh, yeah, you only need 1 of those drugs, maybe 2 if the first one isn't cutting it, and just wait and see your dermatologist.  And I told her she had spoiled me, because I had assumed all/most docs were like her, heavily into evidence-based medicine and minimal intervention, and she laughed and told me she was sorry she had given me that impression, because, no.  Unfortunately.

Anyway.

I think because of my mom (and other loved ones in the medical field), I get indignant when people make disparaging remarks about docs being in it for the money, or callous, or malicious.  I think those people are very much in the minority.  BUT.  "When you're a hammer, everything looks like a nail."   

[micah_mae_]

I agree with all of that. :) I do decline checks during labor though as I don't feel that's important unless I feel it necessary.

[scruffy too]

My MW has never offered to do one, nor will she offer until I'm in labor, and even then she said if I really want one, I should ask for one.  My doctor has made no mention of these checks either.  Which is good because I don't want them.  Maybe I'll change my mind when I'm in labor, but right now I don't see the point.

[SamiPolizzi]

I don't even know if my midwife does cervical checks before labor. I'm guessing not, and if she does, I plan to decline. I don't think I want to be checked in labor either and I have a feeling my midwife will be fine with that too. I would, however, LOVE to check my cervix myself... but I can't reach it. :(

[sunshinelove]

Buko--i didnt mean to say all or even most doctors are malicious (if thats what you were alluding to in your last paragraph). I was just pointing out how these machines are relied so heavily upon that they seem to do more harm than good. The fact that doctors rely on them make whatever good they are trying to do come across as bad. I know theres a lot of great doctors out there but the way the medical system is set up today makes their greatness diminished, if that makes sense.