internal exam of uterine scar - Page 2

[mp30]

I'll have to clarify with him again if this is something that he would do or if other OBs in his practice are known to do - maybe he was giving me a heads up. Heck i'm saying no to it! I have been known to misunderstand or misinterpret stuff lately, but this was pretty clear. It was mentioned in the same paragraph as continuous monitoring and a uterine catheter to monitor contractions because i'm vbac. I will be refusing all this stuff. It was very surprising because this same doc does a lot of vbacs and seems pretty crunchy. I even heard he is supportive of homebirths for non-vbacs. Something doesn't add up. It could be others in his practice and they also just recently joined practices with another bigger group of OBs to cut down on insurance cost and to have coverage for births. It's kind of a sad state of affairs here in CT for OBs. A lot are leaving because they can't afford the insurance and they don't like what has been happening to the practice. But that's a whole other issue.

[leavemealone]

If I had an epidural that hadn't completely worn off yet, how would I know if the dr did this exam while I was distracted with my new baby and not metioned it to me? Would it possibly be mentioned in the hospital records? I ask because I did look down at the dr at one point (maybe 10 minutes) after my baby was born and he was feeling around on my abdomen with what seemed to be the other hand in my vagina (I'm not sure if it was his entire hand or not). At the time, I assumed he was seeing if the placenta had detached yet, but now I'm wondering. Since I was still partially numb, he could have done it and I just not have known about it. I were not still numb, he probably couldn't have done it without me knowing, but this is sort of bothering me now.

[wombatclay]

It should be in your complete hospital record.

[PookieMom]

I'm wondering now if my doc plans on this. I'm writing it down to ask him tomorrow at my appt. The last thing i want to be saying after my vbac is, "where's your hand?!?....hubby where's his hand?!?....is it in there?!?....why's it in there?!?.......Doctor, get your hands where i can see 'em!!!":

[megjo]

I know this is an older thread, but I have to comment. I just watched my vbac birth of my daughter and was amazed at how much I had forgotten! For one thing, my midwife commented after she did the internal exam (after baby was born and placenta was out), that she had done an internal exam of the incision and that it was intact. I did not realize that this was NOT standard. Kind of irks me off now. : I didn't realize she was doing it because at the time, I thought she was evaluating my cervix since I had a superficial tear. It's sad what they think is the right thing to do sometimes.

[jrojala]

Ouch, no way. Sick and barbaric (sp?). I did not think any doc's still did this!
Why would you NEED to ever do that? So you got baby out, placenta's lookin good... What would it even matter if there is a scar seperation? it will heal....
icky

[PookieMom]

sorry replying so late, but i did ask my ob about this. He said it's something they routinely did in the 80's and really don't do anymore because the finger's prodding around in there can actually cause the separation.

As for asking the doc to "show me their hands". Well, my doc wasn't there for the delivery, it was his associate (equally good) and yes, i did at one point after ds birth ask her (kind of louldly) where her hands were. She was just checking for tears but she was very nice to explain to me everything she was doing after that.

[selainek]

Hello,

I am planning a VBAC in Oct and also have a doctor who considers a manual interuterine exam "routine" after delivery. On my next visit I'm going to print some articles and try discussing my feelings about the procedure with her. However, no matter what she says during my OB visits I WILL be REFUSING the exam at the time of delivery. Here are the articles I've found so far:

http://www.asjog.org/Journal/Issue%2...views-VBAC.pdf
PDF - requires adobe acrobat *very last paragraph of article*

http://www.vbac.com/chapter38.html#53
section 5.3

http://www.aimsusa.org/CareInNormalBirth.htm
section 6.2 #15

http://www.childbirthconnection.org/...oad=gecpc3ch38
PDF *website requires registration -- free* section 5.3

I hope these help, good luck!

-Susan

[mamalove07]

I have a look of absolute horror on my face at the thought of anyone's hand in my uterus ...

[babz]

I VBAC'ed last week (yay!) and my ob checked my scar. I had an epidural and 4 bags of penicillin during labor due to my GBS results not being in. I don't think she would have checked me w/o anaesthesia or meds. I also bled very little at delivery.

[TanyaS]

I find it very interesting that many OBs say that they cannot find the previous uterine scar when doing a RCS (they prefer to cut through the original scar). This makes me think that they are not going to be able to find anything with their hands that they can't even see with their eyes. It also reminds us just how well the body heals itself. The outside scar heals much differently than the internal scar.

[wombatclay]

congrats on the vbac babz! Did you OB say why she checked?

[julie128]

My OB did this, and it did not hurt. Make sure he "scrubs" first, though, to reduce the risk of infection. It probably is a good idea, especially if you think you might have another child.

[wombatclay]

It probably is a good idea, especially if you think you might have another child

I'm wondering why you would want this done? None of the studies I could find showed ANY benefit to the practice and most showed it could (and does) cause problems. Did your OB give a specific reason for an internal check? Were you bleeding too much or was there retained placenta?

[grumpyshoegirl]

Originally Posted by wombatclay

And on a totally non-medical, non-academic, level...the thought of having some OB do an internal "spot check" of my uterus is just so unbelievably icky that...well...ugh.

Oh, totally agreed! It's like a manual D&C or something. Just.....ew.

[babz]

Originally Posted by wombatclay

congrats on the vbac babz! Did you OB say why she checked?

Thanks! I'm still totally high from the experience. No, she didn't tell me why, only that my scar felt good.

Interestingly, I had a big discussion w/her when I was about 28 weeks pregnant about my birth plan but did not address this. She was very respectful of my birth plan, so I imagine if I had asked her NOT to check, she would have respected that. She is very flexible.

[mighty-mama]

: good to know... thanks

[rmzbm]

Originally Posted by TanyaS

I find it very interesting that many OBs say that they cannot find the previous uterine scar when doing a RCS (they prefer to cut through the original scar). This makes me think that they are not going to be able to find anything with their hands that they can't even see with their eyes. It also reminds us just how well the body heals itself. The outside scar heals much differently than the internal scar.

With my last section the OB mentioned he couldn't find the incision. There was, according to him, a LOT of scar tissue...but scar tissue is scar tissue...if he can't see the CUT, I'm not really losing much sleep over rupture risks.