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#1 of 38 Old 02-03-2009, 07:38 PM - Thread Starter
 
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I'm trying to figure out why anyone would want one if they were not having any preterm labor issues?

I'll be 35 weeks on Friday and I have never had a cervical check. I have no desire to know how effaced I am or what station or any of that. What's the purpose? At this point if I go into labor they won't stop it anyway and women can be finger tip dilated (or more) for weeks before they deliver.

So can someone give me one good reason to have an internal cervical check?

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#2 of 38 Old 02-03-2009, 07:42 PM
 
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Because doctors seem to think it actually means something, despite evidence to the contrary. Imo, there isn't actually a good reason, just curiousity & a desire to make it seem like they're doing something.

mom to all boys B: 08/01ribboncesarean.gif,  C: 07/05 uc.jpg, N: 03/09 uc.jpg, M: 01/12 uc.jpg and far too many lost onesintactlact.gifsaynovax.gif

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#3 of 38 Old 02-03-2009, 08:03 PM
 
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If you had to be induced and needed to know your bishop score. Other than that I just don't know.

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#4 of 38 Old 02-03-2009, 08:25 PM
 
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If you had to be induced and needed to know your bishop score. Other than that I just don't know.
I agree that it's beneficial in this case. Also if you're unsure of baby's position the dr/mw can tell if there's a head down there or not. I don't really think there's a benefit to giving routine internal exams to full-term women though. Nothing wrong with refusing.
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#5 of 38 Old 02-03-2009, 08:25 PM - Thread Starter
 
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If you had to be induced and needed to know your bishop score. Other than that I just don't know.
If you HAD to be induced would they even care what your bishop's score was?

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#6 of 38 Old 02-03-2009, 08:25 PM
 
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Well, I agreed to one (it was after 36w though) because my last labor was horrific and nearly 22 hours long. So it was a huge comfort to me to know that my body is working and being proactive this time. Already I've dilated the same as what it took over 8 hours of painful labor (and nonstop vomiting) to get to. That has just been an enormous comfort to me and is helping me feel much more confident about this birthing experience and what it will be like.

I understand some mamas being anti-cervical checks and that's fine. But for others, like me, checks can be helpful because they are reassuring.

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#7 of 38 Old 02-03-2009, 08:27 PM
 
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If you HAD to be induced would they even care what your bishop's score was?
It might help them decide what route to take with induction (whether the cervix needed to be ripened, whether AROM might be enough, etc)
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#8 of 38 Old 02-03-2009, 08:28 PM
 
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I have what is called "Incompetent Cervix" - basically you start dilating/effacing early on and often with NO symptoms. I lost a baby at 19 weeks because of this. Had my cervix been getting checked we may have been able to catch it before it was too late.
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#9 of 38 Old 02-03-2009, 08:30 PM - Thread Starter
 
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I have what is called "Incompetent Cervix" - basically you start dilating/effacing early on and often with NO symptoms. I lost a baby at 19 weeks because of this. Had my cervix been getting checked we may have been able to catch it before it was too late.
That is different, that is pre-term labor issues. I'm talking about those of us at 34+ weeks with no pre-term labor issues. I agree, if you have pre-term labor issues or you are worried about them due to a previous pregnancy than cervical checks would be beneficial.

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#10 of 38 Old 02-03-2009, 08:33 PM
 
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Because doctors seem to think it actually means something, despite evidence to the contrary. Imo, there isn't actually a good reason, just curiousity & a desire to make it seem like they're doing something.
Because I think some women think it actually means something. I luuurve seeing women go "I'm 2 cm dilated and 60% effaced--Doc says I'm going into labor soon!" (and they spend another 4 weeks walking around like that --which of course women do not like to hear) and another will go "Not effaced, not dilated, baby high and floating free. I'll be going overdue, likely." (and their kid is born--naturally--by breakfast the next morning ).
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#11 of 38 Old 02-03-2009, 08:33 PM
 
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Well, I agreed to one (it was after 36w though) because my last labor was horrific and nearly 22 hours long. So it was a huge comfort to me to know that my body is working and being proactive this time. Already I've dilated the same as what it took over 8 hours of painful labor (and nonstop vomiting) to get to. That has just been an enormous comfort to me and is helping me feel much more confident about this birthing experience and what it will be like.

I understand some mamas being anti-cervical checks and that's fine. But for others, like me, checks can be helpful because they are reassuring.
But they are only reassuring if they give you the answer they want to hear and what happens afterwards fits in with that. If you are found to be 2cm dilated and 50% effaced, that might feel like great news, will it still feel like great news though if 2 weeks later you haven't birthed and another check has you at the same point? Similarly how would you feel if you got checked and there was nothing happening? Probably you'd feel quite discouraged, but then plenty of women will have babies within hours of such a check, because it's a check that has little if any predictive value.

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#12 of 38 Old 02-03-2009, 08:58 PM
 
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I'm more medically oriented than many on these boards, yet I agree that a cervical check in this circumstance is pointless. At best it could give you some vague information about possible timing of things. At worst, it could speed up when you go into labor by irritating cervix, etc. At some earlier stages of twin pregnancy it can definitely make sense, if there's indications of shortened cervix on u/s or increased BH contractions, etc.-- because at earlier stages there are interventions you might want to forestall preterm labor. (And, sadly, incompetent cervix has no symptoms really to act as a warning sign) But at 35 weeks, there's nothing they're going to do to hold off labor at this point anyway, especially at 35 weeks with twins.
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#13 of 38 Old 02-03-2009, 09:53 PM
 
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just on to share my experience: with dd2 my OB did it routinely starting at 36w and i didn't know to refuse it. i went into labor that night and had a horrible, drawn out labor experience (i wasn't fully 37w yet so they wouldn't help me with labor but i wasn't 35w either, so they wouldn't stop it....i spent 5 days in the hospital in labor limbo hell) i definitely think the unnecessary check had something to do with it. :

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#14 of 38 Old 02-03-2009, 10:47 PM
 
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My ob told me the only reason she started doing them routinely was because the overwhelming majority of her patients wanted them. She considers them pretty pointless if you aren't considering an induction for some reason.
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#15 of 38 Old 02-03-2009, 11:00 PM
 
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That is different, that is pre-term labor issues
What I was trying to get across is that IC is symptomless, so you aren't having PTL symptoms until it's too late. A cervical check would clue you in early enough that there is a problem.
So anyway, I'm a huge fan of them during the 2nd trimester when IC presents itself. Beyond that, I'd agree with you.
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#16 of 38 Old 02-04-2009, 12:21 AM
 
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Because I think some women think it actually means something. I luuurve seeing women go "I'm 2 cm dilated and 60% effaced--Doc says I'm going into labor soon!" (and they spend another 4 weeks walking around like that --which of course women do not like to hear) and another will go "Not effaced, not dilated, baby high and floating free. I'll be going overdue, likely." (and their kid is born--naturally--by breakfast the next morning ).
But why do so many women think it means something? It's because dr's & a lot of pregnancy books imply or out right tell them it means something. Heck, lots of doctors seem to think it actually means something. I can't tell you how many times I've heard women say they wound up with a cesarean because at some arbitrary date they weren't dilated or effaced at all so the doctor told them they weren't going to go into labour.

mom to all boys B: 08/01ribboncesarean.gif,  C: 07/05 uc.jpg, N: 03/09 uc.jpg, M: 01/12 uc.jpg and far too many lost onesintactlact.gifsaynovax.gif

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#17 of 38 Old 02-04-2009, 12:38 AM
 
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My midwife checked me several times in the weeks preceding my due date, and I was one of those who walked around at 4 cm dilated, 90% effaced, baby well descended (I could feel his head myself, no problem). So then the question became, "why aren't you going into labor?". I would rather not have known, because it ended up being too much pressure and concern for something that was just me, just my body's slower, gentler way of going into labor. This time one of the first questions I asked was if they did cervical checks, and was relieved to find out that they did only if *I* wanted it.

BTW, even after 3 weeks of 4cm dilated and 90% effaced, I ended up having to home-induce with castor oil(in order to avoid a scheduled hospital induction) at around 40 weeks. I don't know how long my body would have gone without me prodding it, but my cervical signs certainly didn't at all mean that labor was imminent. They just meant my induction could be successful.

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#18 of 38 Old 02-04-2009, 12:54 AM
 
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Originally Posted by DeannaK View Post
If you HAD to be induced would they even care what your bishop's score was?
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It might help them decide what route to take with induction (whether the cervix needed to be ripened, whether AROM might be enough, etc)
Exactly. When I was faced with induction my ob said AROM would do it (based on my bishop score). He was right, had a 2.5 hour easy labor. (I was way past my edd at that point too, it wasn't routine ve).

They have their benefits but I think it has way too many draw backs.

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#19 of 38 Old 02-04-2009, 01:00 AM
 
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I can't have a doctor do a pap smear without heavy sedation and muscle relaxants. Seriously! I've never been abused, but I just can't tolerate another person touching me in that area (unless it's me or my partner).

So, I am hoping for an issue free pregnancy. It's way too much stress for me to have anyone touch me down there, and I'd like to avoid drugs during my pregnancy.

Because I have these issues, I'm totally biased in the sense that I can't understand at all why anyone would agree to cervical checks. Just the thought of it makes me cringe. Assuming, of course, no health issues or problems.

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#20 of 38 Old 02-04-2009, 01:03 AM
 
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I think it's so you can have a response when people ask you if you are dilated! If you're not brave enough to tell them to f$%k off, that is.

I am not surprised by the pp, that women want to know. Many of my friends have told me that they're going to have their babies early because they were dilated and effaced whatever at 36 weeks. Then it's not too surprising when they've decided to induce when the baby hasn't arrived by 38 weeks.

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#21 of 38 Old 02-04-2009, 01:35 AM
 
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Originally Posted by nigellas View Post
What I was trying to get across is that IC is symptomless, so you aren't having PTL symptoms until it's too late. A cervical check would clue you in early enough that there is a problem.
So anyway, I'm a huge fan of them during the 2nd trimester when IC presents itself. Beyond that, I'd agree with you.
Unfortunately I think IC is rare enough, that even though the consequences can be awful for the small number of women that do have it, that the risks of giving every woman a vaginal exam at frequent enough intervals probably outweighs the benefits on a population basis, unfortunately the retrospect that a particular test or treatment would have saved your baby doesn't mean it should have been done. Most regular OBs seem to check at the first visit and then not until the 3rd trimester. It's possible that with appointments at 4 week intervals in the 2nd trimester that IC would develop fast enough that one check would be fine, then it be too late before you get to the next appointment. My scatty pregnancy brain means the name of the drug has gone right out of my mind, but I know our first prenatal visit did cover somethings that might have been a flag for IC.

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#22 of 38 Old 02-04-2009, 04:02 AM
 
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I've had a few due to ptl issues, the last one being yesterday, as I was having constant - every 5 minutes - contrax at 34 weeks. now that i've gotten past 36 weeks, i don't believe i'll be having any more.

i mean, i like as much information as i can get, but i can see how i would obsess over it and probably end up hindering my own labor process by doing so. at this point, it doesn't matter - a few more days and i'll be considered term so i'm good with just letting things progress as they will.

it'll probably drive my mom crazy, she goes nuts over stats and actually asked my mw "so if she's a cm dilated and 90% effaced, with a 7.5lb baby (estimate from palpation), when do you think she'll go into labor?" the woman has done this 3 times - she should know the answer to that! i think she's just looking for something to tell the ladies at work.

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#23 of 38 Old 02-04-2009, 11:55 AM
 
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What I was trying to get across is that IC is symptomless, so you aren't having PTL symptoms until it's too late. A cervical check would clue you in early enough that there is a problem.
So anyway, I'm a huge fan of them during the 2nd trimester when IC presents itself. Beyond that, I'd agree with you.
I don't know of *any* OB that actually does dilation checks before 35+ weeks on a normal low-risk pregnant woman, but also, a manual cervical exam won't necessarily catch IC, especially not early enough to do anything about it. You need to have weekly transvaginal u/s to really monitor it accurately. In your case, I'd *certainly* go the weekly u/s route and would likely get a preventative stitch placed at the appropriate time as well.

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#24 of 38 Old 02-04-2009, 12:03 PM
 
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Oh, and to respond to the OP... I don't do dilation checks at the end of pregnancy. If there was some medical need to do one, then ok. But I prefer to keep my pants on at all visits. My OB is fine with not doing a check. When I said I didn't want one as the nurse was handing me the paper covering at my 35 week appt last time, she just said "Ok!" and put it back - no big deal. The OB came in and did the normal prenatal appt and didn't even mention me refusing the exam. Not a big deal at all.

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#25 of 38 Old 02-04-2009, 12:40 PM
 
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Sorry to hijak your thread, but I'm curious...

Does anyone know whether your Bishop score (at 39 weeks) can indicate whether natural induction methods might be more effective? Or is it all just a crapshoot?

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#26 of 38 Old 02-04-2009, 02:54 PM
 
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I declined all checks after the one I got at 35 wks with the GBS test. My doctor likes to do them, but agrees that they don't tell you anything relevant at this point.

I will probably get one at my next appt for my 40 wk checkup, just because I am curious.

But they are uncomfortable and do have a small risk of infection/possible AROM if you are dialated. So why do it?

Incidentally, my family (mom and sisters,etc) are about to have a heart attach over my risky behavior! They think you can tell my overal health my the cervix! Crazy...
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#27 of 38 Old 02-04-2009, 03:51 PM
 
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Sorry to hijak your thread, but I'm curious...

Does anyone know whether your Bishop score (at 39 weeks) can indicate whether natural induction methods might be more effective? Or is it all just a crapshoot?
Yes any induction technique is more likely to work with a high bishop's score including natural ones like castor oil or the cohoshes. As for other less serious methods like having sex, eating certain foods, or walking those seem like more of a crapshoot as to whether or not they'll actually send you into labor.
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#28 of 38 Old 02-04-2009, 04:32 PM
 
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So what is the best way to tell your MW to stay out of your hoo-ha?

I'm about in my 3rd tri the 12th is my last monthly appointment and then I start the bi-weekly dates. Which I am not thrilled about, I'm thinking about asking her to do every 3 weeks, middle ground.

Anyways, when she saies "I'm going to check your cervix" can I just say 'no'? They looked at it via U/S at 19 wks. I just am not comfortable with peoples business in my business. I wish I could check myself but I don't really bend like that anymore There is no way DH would check. Hes squimish.

Plus this pregnancy is sooooo classic. Baby hasn't had a single hair misplaced on his head. except 'being big' so says the 5'2'' MW to the 5'8'' pregnant woman and her 6'4'' husband

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#29 of 38 Old 02-04-2009, 07:59 PM
 
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So what is the best way to tell your MW to stay out of your hoo-ha?
At my OB's office, the nurse handed me the paper sheet, and I just said "I don't want to do any dilation checks or anything." It wasn't a big deal.

I don't recall if my midwife asked if I wanted one or not? I know it's certainly not a big deal to her if I don't get one. Either she never offered, or if she did offer, I just said no. I really can't remember though.

It's really not that hard to say "I don't wish to have any cervical exams." Probably best not to say "Stay out of my hoo-ha!"

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#30 of 38 Old 02-04-2009, 08:21 PM
 
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I don't think most peopel question it. that or they think it's a telltale sign of if labour will be soon (which is isn't!!) now knowing what I know I don't plan to have ANY cervical checks unless there is some sort of actual reason for one. if I want one, I'll ask my husband to help me (It's not that complicated - you just need some common sense and really clean hands lol)

I get so upset when I hear OBs or midwives telling patients things like: "wow you're 2.5 cms dilated and 50% effaced! you probably wont even make it to your due date!". do they realize the power of those words to a woman who is SICK of being pregnant!? it's CRUEL! and rarely actually predicts anything.

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