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36 week appointment/cervical check

post #1 of 20
Thread Starter 
So i had my 36 week appointment on Friday. Everything is looking good. I'm 1.5 cm dialated and 40 effaced. I know that means virtually nothing in regards to when I'll go into labor.

Dang, the cervical check hurt. For those that have had them is the pain normal? I also spotted quite a bit afterward. Has anyone refused cervical checks prior to labor or can tell me how necessary they are?
post #2 of 20
I always find cervical checks uncomfortable, so when I saw the doc on Friday for my 37 week appt, she asked and I refused. (The GBS test was invasive enough, thanks.)
As you say, it doesn't really mean anything, so I can't see any point.
post #3 of 20

Yes, you can absolutely refuse them.  Just say that you'd prefer to wait until you feel closer to labor or delivery.  

post #4 of 20
My midwife only does them if she has a reason. This is my second pregnancy with her and I have only had 2 checks in total. One during labor when I asked her to check since I was nervous and though I felt the urge to push. I ended up being 10cm dialated.
My second check was after a bought of contractions and loss of a large bit of my plug around 31 weeks. She wanted to see if anything was really going on. Turned out my cervix was low, soft and partially effaced.

I would deny checks unless you really have a valid reason, even during labor.
post #5 of 20
Thread Starter 
Thanks everyone. That is what my gut was saying.
post #6 of 20

Here in the UK we don't get cervical checks until we're in labour, and I think even then it's optional. It's interesting how things vary between countries.

post #7 of 20
Agree, no reason to do a cervix check at routine prenatal visits unless there's concern about preterm labor. It's so uncomfy, and (I think) unneccessarily sets folks up to start thinking quantitatively about labor and birth.
post #8 of 20

I had them with my first two kids, I declined with my younger two.  There's no evidence based reason to do them.  I think one exception might be if there was a need to induce, to be able to gauge how successful an induction might be-i.e. are conditions favorable?  That being said, if there was a need to induce, then whether or not conditions were favorable might not matter-but I think inductions when the body is clearly not ready-little to no effacement, no signs of dilation-are a reason why so many inductions lead to c-sections.

 

I also think cervical checks can do more harm than good in terms of introducing outside bacteria up into the vagina (of course so do sex, but I still feel that's different.  And then the unnecessary trauma to the cervix before labor-which is why so many women have spotting after a cervical check.  I think one reason OBs (I only say OBs because generally MWs don't) like to do cervical checks is really just to have something that they're doing at appointments this late in pregnancy, to kind of justify and have a point to weekly monitoring-although I do believe checking baby's heartrate and mom's BP and such are good non invasive means of monitoring late pregnancy and screen for any potential issues.

 

At my appt last week, my OB mentioned we'd do one tomorrow to check baby's position.  I plan on declining.  If she's still concerned about baby's position, then she can check with an U/S. My cervix is always very high and very posterior, even well into labor, and I have no desire to deal with the discomfort I know will come from a check-especially this early. 

post #9 of 20
I told my OB that there was nothing "real" happening, so it'd be a waste of time. He was totally okay with it. I really don't see a reason at all. Even if it shows I'm dilating... So?
post #10 of 20
Thread Starter 
I have Kaiser which uses a reduced prenatal schedule for low risk pregnancies. I'm only going every two weeks through my due date which at first i thought was strange but I'm actually happy i dont have to go weekly. After 40 weeks I'm not sure how often they'll see me.
I think I'll decline the cervical check at my 38 week appointment and discuss it with the doctor for my 40 week.
Thanks again for all your responses and input. I don't really have anyone to ask in real life.
post #11 of 20
Quote:
Originally Posted by thefreckledmama View Post

I had them with my first two kids, I declined with my younger two.  There's no evidence based reason to do them.  I think one exception might be if there was a need to induce, to be able to gauge how successful an induction might be-i.e. are conditions favorable?  That being said, if there was a need to induce, then whether or not conditions were favorable might not matter-but I think inductions when the body is clearly not ready-little to no effacement, no signs of dilation-are a reason why so many inductions lead to c-sections.

I also think cervical checks can do more harm than good in terms of introducing outside bacteria up into the vagina (of course so do sex, but I still feel that's different.  And then the unnecessary trauma to the cervix before labor-which is why so many women have spotting after a cervical check.  I think one reason OBs (I only say OBs because generally MWs don't) like to do cervical checks is really just to have something that they're doing at appointments this late in pregnancy, to kind of justify and have a point to weekly monitoring-although I do believe checking baby's heartrate and mom's BP and such are good non invasive means of monitoring late pregnancy and screen for any potential issues.

At my appt last week, my OB mentioned we'd do one tomorrow to check baby's position.  I plan on declining.  If she's still concerned about baby's position, then she can check with an U/S. My cervix is always very high and very posterior, even well into labor, and I have no desire to deal with the discomfort I know will come from a check-especially this early. 

I think it's strange to do a check for the babies position. My midwife will take about a minute to feel all over my abdomen to find the babies position. I lie still and she pushes and feels around until she is confident she knows where the baby is. She can even tell how deep the baby is as well depending how much of the head/neck she can feel. You could as about that method.
post #12 of 20
Quote:
Originally Posted by thefreckledmama View Post

 

At my appt last week, my OB mentioned we'd do one tomorrow to check baby's position.  I plan on declining.  If she's still concerned about baby's position, then she can check with an U/S. My cervix is always very high and very posterior, even well into labor, and I have no desire to deal with the discomfort I know will come from a check-especially this early. 

How would a cervical check tell her anything about fetal positioning? Palpation, sure. U/S, that too, though it seems overkill. But a cervical check? 

 

I will be declining all cervical checks unless we're talking induction - in which case I want to know my Bishop score. During birth, we'll see what happens, but unless I personally want that information, or there's a medical reason for it, I plan to minimize vaginal exams.

post #13 of 20
Thread Starter 
For me that's how they learnef she was head down. If I'm remembering correctly, I think she just pushed crazy hard from my belly and around my cervix to get the position. Similar to when they check your uterus/ovaries at a regular obgyn exam but way more painful...
post #14 of 20

I'm guessing she can feel the baby's head against the cervix, as opposed to a squishier butt?  She has palpitated my stomach in an attempt to tell baby's position at the past two appts, but the placenta is up front, so I think that's making it more difficult.  At my last appt she said she "thought" she felt the baby's head down low-but I have clearly been able to feel the head when I try to feel baby's position in previous pregnancies, and I don't feel a head in my pelvis when I check this time. It's interesting to me, because I saw HB midwives for part of my last pregnancy, and they were always able to very easily tell baby's position by feeling on my stomach, even with the placenta up front with my son as well-but my OB who has had more "training", has a really hard time with it, and wasn't nearly as adept as the MWs were.  

 

I agree with you, Chispita.  I would probably only do cervical checks in order to know my Bishop score if induction were necessary.

post #15 of 20

i just had mine checked at 35wk and it didnt hurt but only because mine was not dilated and very high. he did say he felt babys head , witch i dont think i believe him because my last appt my son was transverse-breech and it didnt feel liek he has flipped and the kicks are still in the same spot plus what i think is his head still feels hard and round.

 mine hurt with my other pregnancy because i was dilated and and very low. this is my forth and im worried it might go by slow since my first two i was 3cm by 36wk lol and now 35 nothing

post #16 of 20

Chiming in to agree with other posters....the only time a cervical check was ever useful information for me was IN labor when i was feeling pushy but thought it was too soon (I had only been in labor for 1.5 hours, but surprise, I was 10 cm)

 

I had cervical checks with DD1 and it eventually led to a membrane sweep.  I also think if your care provider tends to be sneakier (i.e., clamping the cord and not telling you, or other things like that), cervical checks leave you open to having a membrane sweep without your consent under the guise of, "oh, it's just a rough check".  I know it's anecdotal, but it happened to me and I ended up in a 20 hour exhausting labor with DD1.  I now throw that on the pile of reasons why cervical checks prenatally are not useful (unless induction is on the table).

post #17 of 20

I had no idea cervical checks hurt.  I'm glad I read through this thread.  I guess I just thought they were similar to a regular, non-pregnant pelvic exam.  I remember watching one of those reality shows filmed in a labor and delivery ward once and there was this young woman who was vehemently refusing a cervical check to see if she was fully dilated despite all of the midwives insistence (they were nurse midwives working with a medical model of care - very pitocin-happy midwives).  Now I feel bad, because I totally bought in to the message that the show was trying to push, which was that this silly girl was refusing something perfectly reasonable despite the medical need for it.  So, thanks for clearing that up for me before I give birth.  I've had the good fortune of not having any cervical checks (my mom couldn't believe this).  And I don't think my midwife will recommend them unless there is some legitimate reason.

post #18 of 20
Thread Starter 
I didn't know they hurt either and I'm annoyed the doctor didn't warn me.
post #19 of 20

With my first pregnancy, my midwife offered to check my cervix and even do a membrane sweep at my last appointment, which was at 38+6 weeks. I wasn't in any rush, so I declined. And then went into labor the next day anyway, and had him in the wee hours of the morning on 39+1. thumb.gif

 

For pregnancy #2, my midwife ended up doing a cervical check at 36 weeks to try and help her find the baby's position. She just could not figure it out for certain even with quite the lengthy palpitations, so she tried doing both. In the end, she still wasn't sure if he was head down or not, and considering I was going for a homebirth, we needed to know. I ended up getting an ultrasound a couple of days later (and he was, indeed, head down). I can't remember if it hurt or not... but I don't think it was comfortable, that's for sure.

Other than that, I've only had the checks in labor and didn't find them to be painful. Then again, I was already in pain, so maybe that's why! There weren't many — maybe three with DS #1? And definitely only one with DS #2, since she only made it twenty minutes before he came out. orngtongue.gif I'm planning to decline any checks prior to labor this time, too, unless necessary in some way.

post #20 of 20
I had my first cervical check at 41w with my son just to make sure something was going on down there as the midwife put it. I was ok with it at that point. It was incredibly painful as my son's head was very low and basically in front of my cervix. I remember being sore for days afterwards. She did explain why it was so painful and apologized and she discovered I was 3cm but I went on for another almost 2 weeks of pregnancy. So yeh it didn't give an indication of much really.
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