do i have to get a pelvic exam? - Mothering Forums

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#1 of 14 Old 11-04-2005, 01:03 AM - Thread Starter
 
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Hi, so with my 1st pregnancy i was in another country and there they did not do internal exams during pregnancy under normal circumstances. Here I am seeing a MW, but I have had so many more procedures. I hate it. Can I really tell her no, I dont want a pelvic?
And BTW, does anyone refuse to hear the heartbeat? Why?
I hate all these exams!
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#2 of 14 Old 11-04-2005, 01:22 AM
 
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No, you can refuse anything! I had none during either of my pregnancy's, one a hospital birth with a family practioner and one a homebirth with a lay midwife. I had 1-2 during my first birth and 1 during my second. Neither my Dr. or midwife suggested doing them during pregnancy so not all Dr.'s and midwifes think they are needed and I hold with that feeling. I know there is research out there on this subject or at least some facts.

I did listen to the heartbeat with a doppled both pregnancies but I am considering refusing the doppler this time. I think I'll make my midwife practice using her fetoscope. I am going to e-mail her some info about dopplers.

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#3 of 14 Old 11-04-2005, 01:33 AM
 
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You can refuse anything I only had anyone down there 3 times total through the whole thing- first time in labor so she could decide to stay or not and twice after to look at a funky tear.

I did not use doppler before, but I did allow it in labor. We used a fetascope beforehand to listen to the heartbeat.

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#4 of 14 Old 11-04-2005, 01:33 AM
 
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Many direct entry midwives do not do exams during pregnancy because of the risk of miscarriage along with the unreliability of results. My understanding is that paps are often wonky when you're pg.

If you don't want/don't feel the need for an exam, tell your midwife. If she has a solid argument as to why you should have one, then weigh what she says and research it. For example, someone who is in a committed relationship with no history of abnormal pelvic exams might feel different from someone who is not. Personally, I feel good about the fact that the midwives I know do pelvic exams after birth, and I feel even better about the fact that they are very cool with women's specific needs/desires.
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#5 of 14 Old 11-04-2005, 03:14 AM
 
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So what exactly are they checking for during the internal exams throughout pregnancy? I've been wondering about this. I know towards the end they check to see if you're dilated/effaced or whatever, and I think I'd go crazy not knowing. The exams don't really bother me though. Although I checked my own cervix every day while TTC, so I don't see why I couldn't feel for myself, whatever it is they're feeling for. Unless the cervix gets way high or something.

As for the heartbeat thing--I WANT to hear the heartbeat everytime! With all the miscarriages, that sound is so reassuring. What's the difference between a fetoscope and a doppler? And what are the risks associated with each?
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#6 of 14 Old 11-04-2005, 03:20 AM
 
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My MW does not do them as a matter of routine. My first two were with OB and both times I had a pelvic. I asked my MW about it and she said that she does not do them without a reason or request and especially since I had already bore two babes vaginally, she was not concerned about my pelvic size.

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#7 of 14 Old 11-04-2005, 04:49 AM
 
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I refused to have pelvic exam as well and she respected my decision. If you are not comfortable to have one let her know. ANIKO
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#8 of 14 Old 11-04-2005, 05:32 AM
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I'm 39 weeks and my OBGYN has yet to give me a vaginal exam.
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#9 of 14 Old 11-04-2005, 12:19 PM
 
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Vaginal exams have no benefit for predicting when labor will start. People go around dilated to a four or five for weeks, or go from not dilated a smidge to holding their baby a few hours later.

It's just not really warranted to shove a hand up there, IMO. First there's the discomfort .Ouch! Late PG is uncomfy enough already! Then there's the risk of introducing infection. That can cause serious problems. It's not worth risking it *to me* just for information that has ZERO bearing on anything.
And then it's also very undignified. Why should I lie flat on my back and let my "caregiver" do that to me when it provides no useful information?

I find my late PG mood is BETTER when I don't know. Why? I'll explain.

If a pelvic exam is done, and I am not dilated or effaced, the temptation is to feel discouraged, because "nothing is happening" despite the fact that rationally I KNOW my current level of dilation has no bearing on when labor might start. If I am dilated/effaced, and I start having some of my usual prodromal contractions, I am more likely to think "This is IT! I'm already dilated so much... this must be doing something!" and then disappointed when it all stops again, just like it did the last time. Duh. And then again disappointed when the next week show I'm no more dilated, or barely, than the last week.

If I don't know, I have a much easier time just relaxing and focusing on the reality that my body WILL go into labor when the time is right, and trying to stay comfortable, etc.

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#10 of 14 Old 11-04-2005, 12:39 PM
 
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Quote:
Originally Posted by happeeevraftr
The exams don't really bother me though. Although I checked my own cervix every day while TTC, so I don't see why I couldn't feel for myself, whatever it is they're feeling for. Unless the cervix gets way high or something.

As for the heartbeat thing--I WANT to hear the heartbeat everytime! With all the miscarriages, that sound is so reassuring. What's the difference between a fetoscope and a doppler? And what are the risks associated with each?
The problem with the exams (as mentioned by a pp) is that they can introduce infection. ALSO they can start labor early or even break your water.

Doppler uses ultrasound- fetoscope is just a stethoscope (basically) There are many questions about how safe doppler is and many women choose to err on the side of safetly and avoid them.

-Angela
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#11 of 14 Old 11-04-2005, 01:08 PM
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Quote:
Originally Posted by KittyKat
If a pelvic exam is done, and I am not dilated or effaced, the temptation is to feel discouraged, because "nothing is happening" despite the fact that rationally I KNOW my current level of dilation has no bearing on when labor might start. If I am dilated/effaced, and I start having some of my usual prodromal contractions, I am more likely to think "This is IT! I'm already dilated so much... this must be doing something!" and then disappointed when it all stops again, just like it did the last time. Duh. And then again disappointed when the next week show I'm no more dilated, or barely, than the last week.
Yeah, I like that!

Last night, DH and I were trying to decide whether to get some gloves so he can check my dilation before we go to the hospital (he used to be an OB). We finally came to the conclusion that it really wouldn't tell us as much as my own feelings and reactions to the labor would tell us. And focusing on those things keeps the focus where it should be, not on some objectively measurable, "scientific" sign. Doctors can get so preoccupied with the measurements, they lose track of the mama.

As for the dangers of a doppler, I am willing to risk them during active labor for two reasons: 1) because the baby isn't moving enough to tell us s/he's okay; and 2) measurement of the baby's heartbeat is instructive (to a certain degree, taken together with other things) and there is something that can be done if that particular measurement indicates trouble.

Doppler in pregnancy is more of a luxury, I think. Baby kicks so often, there is no doubt her/his heart is beating. I'd love to learn how to use a fetoscope, though, and to promote its continued use! That's neat.

warmly,
Kam, mamamama! to Meg and one more due in March
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#12 of 14 Old 11-04-2005, 01:42 PM
 
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imo, pelvic exams during pregnancy don't have much purpose. as mentioned above, dialation and effacement during an exam are really no indication of how soon labor will start, and paps are somewhat unreliable during pregnancy. And there is a risk of infection as noted before. Some practioners will "routinely" sweep your membranes during an exam!!!

I think that there are emotional issues that come into play with pelvic exams as well, at least for me I know it's true. I'm pretty uncomfortable with them. My mw only does them during pregnancy if the client requests it and keeps them to a minimun during labor and birth.

You always have the right to say NO. If you feel like the pressure from your care provider would be too much for you to say no to, take your partner, trusted friend, anybody who will help you advocate for yourself. You don't have to have an exam, just because it's "routine" doesn't mean it's "required."

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#13 of 14 Old 11-05-2005, 12:43 AM
 
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I didn't have any pelvic exams during my pregnancy or labor. I had a homebirth with a cnm and also had parallel care with my family practice doc. IMO it goes smoother with declining procedures if you come off as someone whose decisions are informed. I also think it's a lot easier to decline procedures if you have a home birth. I have also had a hospital birth and did have 1 cervix check during labor that time (but this is still ultimately your decision).

I personally wouldn't want to decline having them listen to the heartbeat at prenatal visits, but it's your body so you don't have to let them do anything. My midwife also used a fetoscope. The doppler is a form of ultrasound, so I can see why someone might have concerns about that.
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#14 of 14 Old 11-07-2005, 06:41 PM
 
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I had one exam during my last pregnancy, but that was bc I had never had one before in my life, and she wanted to do a pap, check to make sure the baby shute was big enough, etc.

I've heard they also check to see if your tail bone is fused?

I had 2 checks during labor, one to see how far I was when the mf got there (6cm) and one to make sure I was ready to push (I didn't feel like pushing, but was 10cm). Since I just had a pap a few months ago I'm not expecting to have to have and exam during this pregnancy, she'd have to give me a pretty compelling reason. I'm perfectly comfortable with them, just not thrilled about the chance of getting infections.

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