Vaginal exam?

[lotusblossom9]

So my midwife today said that next week I could request a vaginal exam, to check for dilation, if I wanted. She said it's my choice. What are the pros and cons of having a vaginal exam at this point (on Thursday I'll be 38 weeks)?

And here's some good news...the baby is measuring 36cm. I measured small last week so they wanted to send me in for an u/s if this week he was still measuring outside of the 2cm range. He grew 1.5 cm so he's in the range and all caught up! Phew!

[Snugglebugsmom]

I had my first vaginal exam last thursday, at 37 weeks. The midwife said she could tell I was 2cm dilated "all the way up".
For me personally, I like knowing these things. I also don't ever have any bleeding from an exam, so I don't see a disadvantage to them.
If there are any other cons, I'm not aware of them.

[njbeachgirl]

Pros-you know what your cervix is doing at that moment, can get things going if your body is ready

Cons-introduces germs up there, (not many because she will be wearing a sterile glove but i've heard it can increase the risk of infection?) can be discouraging if you are not dilating or effacing at all, can cause irritation/spotting/annoying ctx.

With my DD I had one at 40 weeks and was very discouraged because I was not dilating or effacing at all. Turns out DD was born 2 days later :

This time I have not had one yet but I am considering it at my appt. tomorrow just because I am curious.

The bottom line is.... don't read too much into it, because you could be totally closed and go into labor that night, or you could walk around dilated for weeks

[kalamos23]

Ditto the dilated for weeks part *points to self* I'm either 100% effaced or dang close and 5+cm and have been 4cm+ for the last 3 weeks. Still no baby!

[finnegansmom]

I'm on the fence about these. I had one today because I have never had an internal or anything with these midwives and have had tons of menstrual cramps the last 4 or 5 days. But nothing else. Turns out "not even a fingertip". I knew that, really. Which is fine, I'm only 38 weeks. I don't expect to have this baby before 40 weeks... Also, I was 2cm dilated with my son for 5+ weeks before he came, with a little help of AROM.
I don't think it's a big determinant, but if you are interested, why not?

[veganf]

I don't see the point.
You could be not dilated at all, which might discourage you, but then you could go into labor the same day and dilate quickly.
Or you could be 4cm dilated and get your hopes up then walk around that way for 4 weeks.

I personally decline vag exams without good reason (for me that has been twice in 4 pregnancies, to confirm a vertex position).

[ekblad9]

My babies tend to be breech so sometimes they check internally if they can't tell from the outside. When I've had OB's they always want to check. When I've had homebirths they rarely want to check. This time I'm doing an ABC so it's my choice. I'm totally a curious person and want to know even though I KNOW I will walk around dilated to 4 or more for weeks. Still - I do like to know where the head is.

Pros - if you're a curious person it gives you one less thing to wonder about.

Cons - for me it's when you're not dilated at all. Even though I know that doesn't mean a darn thing it can still be frustrating, yk?

[quarteralien]

I've often thought about writing an essay on dilation checks, the premise being that humans are obsessed with rating things on a scale of 1 to 10. And that's usually how it goes. It's not "You're dilated 10 cm." it's more "You're a 10!" I personally don't see a point in them. However much you're dilated means NOTHING as far as when labor will get going, I find them very uncomfortable, and I really don't want someone else in my space. But that's totally my perspective. I honestly don't understand the curiosity, as it really isn't a good indicator of progress, but to each her own.

[pazerific]

Originally Posted by njbeachgirl

i've heard it can increase the risk of infection?

i think the increased risk of infection is because bacteria that can be hanging around externally near the vaginal opening can be pushed up inside where it can grow and flourish.

personally, i fall into the "not unless there's something to learn from it" camp. and i don't consider dialation or effacement to be reasons for a check for the same reasons as nearly everyone else has listed already. another reason i don't like them is b/c they make me cramp. when i was in labor with dd, the only times ctx were actually painful (not just something that i had to work with) were when i was getting checked, and when i was on pitocin.

[delicious]

Originally Posted by veganf

I don't see the point.
You could be not dilated at all, which might discourage you, but then you could go into labor the same day and dilate quickly.
Or you could be 4cm dilated and get your hopes up then walk around that way for 4 weeks.

I personally decline vag exams without good reason (for me that has been twice in 4 pregnancies, to confirm a vertex position).

ITA with this.

[devilish_fetish]

Originally Posted by ekblad9

My babies tend to be breech so sometimes they check internally if they can't tell from the outside. When I've had OB's they always want to check. When I've had homebirths they rarely want to check. This time I'm doing an ABC so it's my choice. I'm totally a curious person and want to know even though I KNOW I will walk around dilated to 4 or more for weeks. Still - I do like to know where the head is.

Pros - if you're a curious person it gives you one less thing to wonder about.

Cons - for me it's when you're not dilated at all. Even though I know that doesn't mean a darn thing it can still be frustrating, yk?

What's an ABC?

[pazerific]

alternative birthing center.

[nubianamy]

I'm another one who declines vag exams without reason. I probably won't have one until I'm in labor. It doesn't really tell me anything useful, and there are some risks associated with it.

[Kidzaplenty]

:

[Lorette]

I would never get one.
Cons:
>>Uncomfortable or hurt
>>Can introduce germs and cause infection
>>They don't tell you anything constructive (you could be closed and start labor that day, or 4cm and not go into labor for 4 weeks).
>>They can discourage you and cause you stress if you aren't dilating and you want to be.
>>A lot of times a care provider will strip your membranes while doing the exam and not even ask you whether it is ok. Then your body can be pushed into labor when you aren't ready yet and you could have a long and complicated labor because it wasn't really time yet.

Pros:
I can't think of any.

[catnap70]

As I said in a different thread last week, I have a no fingers in the buki policy. No need.

[aprilsfools]

I don't think there is any pro if she is just checking for dilation or effacement- those updates don't really tell you anything.

Cons:

-Raises your chances for infection/ germs.
-Causes discomfort for no reason.
-Some care providers will use this information to force inductions and make you think your body is not capable of going on its own. On the other side, they can take this information and get your hopes up that your baby will be coming soon.
-Membrane sweep- either by consent or not might cause you to go into labor before you are ready, or it will just cause a lot of painful contractions that do nothing.


My MW checked me at 36 weeks to confirm the baby was head down (we were unsure from belly check and HB). It was very quick, but still caused me to have constant BH for the following two days. Although worth it in the end for my own piece of mind (I was terrified she was breech), it was not fun.

[kris4chloe]

I was just thinking about this yesterday and decided that if my midwife wants to do an exam I am going to decline. No matter the results that baby comes when the baby comes, and it does not help my mental status one way or another knowing I am xx amount of centimeters dialated or nothing at all. I dont need to get my hopes up, nor do I need to get disappointed.

I will just continue to wait patiently, plus I am a big baby and really, really dislike getting checked. My last ob was not the most gentle and I am sure that doesn't help.

[Sunshine4004]

My OB will not do an internal exam unless there is a medical reason or I should demand one. I will not be planning an internal exam until I am at the hospital in labor.

[firespiritmelody]

I like to follow my progress. I love my MW and know that she would not do anything (like a membranes sweep) with out my consent. She is always extremely gental. Honestly if you're seeing a care provider that you are worried would do something like that with out your consent, you should really be seeing someone else.

I am one that slowly dialates a bit for a few weeks before labor starts. I wouldn't know that with out checks as I'm not coordinated enough to check myself.

I dont see how the increased risk of infection "from germs around the vagina being pushed in" is any greater with a VE then it is with sex - honestly, wouldn't that be worse? I do understand that there could be germs from the mw or ob, but mine washes her hands and then uses a sterial glove, so i believe the risk to be minimal.

With my iron being so low recently I have had several checks to determin position and to track my progress etc in case things started to pick up. Every woman needs to make this decision for herself but I really dont believe there is a right or wrong answer to it. If I had a male doctor whom I was uncomfortable with, I probably wouldn't want to be checked either. But I think it's really situational.