Anyone else not get "checked"? - Page 2 - Mothering Forums
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#31 of 53 Old 07-06-2009, 08:52 PM
 
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Originally Posted by SandraS View Post

"No" is a very powerful word. And a doctor won't be angry if you use it.
A good dr won't be angry. You'd be amazed and how many dr's get upset over it.

Stinkerton 12/10/01 9lbs8oz, induced to c/s; Little Man 5/20/03 7lbs11oz, r c/s, fear of another labor; Jillybean 11/18/07 10lbs8oz 37cm head, induced VBA2C; and the Wee Beastie, 9lbs8oz, 35cm head, rpt VBA2C
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#32 of 53 Old 07-06-2009, 08:56 PM
 
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So what are the "pros" for the OB? I'm not wondering so much about our own cynical speculations (e.g. looking for an induction excuse), but what is their stated rationale for routine checking?
It gives them a chance to strip your membranes when you're pushing or past 40w (w/o your consent, I might add) b/c ZOMG! you can't just do nothing!

Stinkerton 12/10/01 9lbs8oz, induced to c/s; Little Man 5/20/03 7lbs11oz, r c/s, fear of another labor; Jillybean 11/18/07 10lbs8oz 37cm head, induced VBA2C; and the Wee Beastie, 9lbs8oz, 35cm head, rpt VBA2C
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#33 of 53 Old 07-06-2009, 10:27 PM
 
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I wasn't checked at 36 weeks. I was checked at 38, but they were deciding what to do--I had to deliver, and I didn't have time for an all-weekend Cervidil fest.

This wasn't in the US but my understanding is that NHS midwives are very keen on checking and on membrane stripping--I swear that everyone I know got their membranes swept at 40 or 41 weeks.

DD 01/2007, DS 09/2011

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#34 of 53 Old 07-06-2009, 10:44 PM
 
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I also found another unstated reason OBs do them: Mulah.

I guess I was just wondering what the stated reasons are. Does ACOG had a protocol for them, a medical rationale for doing them routinely, or something along those lines?

There are multiple other ways to determine a baby's positioning and station. And as the OP stated about cervical effacement....so what? It's kind of like how losing your mucous plug means that labor is imminent and going to happen "sometime." Of course it is. You're pregnant.

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#35 of 53 Old 07-07-2009, 12:34 AM
 
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A lot of insurers have switched to global fee for pregnancy (sometimes pregnancy and delivery) for precisely this reason--I guess some docs got a leetle greedy, especially ones billing low-paying insurers.

I don't think it's about the money, as such, because in some other countries docs (or midwives) really go in for VEs, or ultrasound, or whatever the trend is in their country. It's cultural. They've been taught to check, so they do.

DD 01/2007, DS 09/2011

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#36 of 53 Old 07-07-2009, 11:08 AM
 
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I wonder if it has become one of those things that OBs do because "that's just how we have always done it," even though the medical rationale isn't there... kind of like the no eating/drinking during labor thing.

I'm in the "What is the point?" camp and don't get checked until I am in labor.

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#37 of 53 Old 07-07-2009, 11:23 AM
 
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...means that labor is imminent and going to happen "sometime." Of course it is. You're pregnant.

Hilarious!
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#38 of 53 Old 07-07-2009, 12:04 PM
 
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I'm one of those moms who is dialated to 3cm by 36-37 weeks... so getting checked prior to labor is usually discouraging.

With my last baby, I waited until I was 5 days past my edd to get checked, and it was with the intent of sweeping my membranes to see if we could get the prodromal labor to kick into high gear (my BP was acting up). It worked and I don't regret it... but I'm glad I wasn't having regular checks prior to that point, it was discouraging enough having all that prodromal labor.
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#39 of 53 Old 07-07-2009, 12:23 PM
 
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I also found another unstated reason OBs do them: Mulah.
Turquesa, thanks for posting that link. I would describe it as eye-opening except that I don't think my eyes could be any further open when it comes to medically-managed childbirth. An extra $250 insurance reimbursement per vaginal exam is certainly a reason to routinely include them in your practice even if the information provided by them is worthless.
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#40 of 53 Old 07-07-2009, 04:27 PM
 
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I just gave birth Sunday at home... and was never checked once. Not during pregnancy or labor.

Amanda , mama to my two boys: N (10/06) and : A (7/09)
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#41 of 53 Old 07-07-2009, 04:27 PM
 
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no. not only is it pointless but also uncomfortable.

Boys: 12/94, 1/99, 11/03, 6/11. Girls: 11/06, 10/09, 12/12 2ndtri.gif

 
       

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#42 of 53 Old 07-07-2009, 05:49 PM
 
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I've always been checked from 36/37 weeks on with my doctor. I think with #3 I declined a couple of them. I plan on not getting checked at all this time. I probably will when I get to the birth center, but I don't want checks after that unless I feel the need for it. I won't have any "just because", yk?

Leigh

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#43 of 53 Old 07-07-2009, 06:18 PM
 
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My MW will do them for a suspected problem (I just had one at 24w for pre-pre-term labor) or if you request it.

But generally she doesn't do them at all. Actually, she says she does "visual cervical checks" during labor - that after a thousand births, she can tell by looking at your face how dilated you are, and be pretty darn close to right. I love my MW.

Writer, wife to a great DH, AP mama to one sweet boy 6/07 and expecting a girl in October!
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#44 of 53 Old 07-07-2009, 07:35 PM
 
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Also, if you'd really like that "information", you can check yourself

I was checked with sort of "standard" frequency during my first pg & birth.

Maybe 1x during my 2nd pg and then I checked myself frequently during my 2nd labor. And I really ought not to have been - I was GBS+, not treating, and my water was broken. But it was one of those "you do what you gotta do" things - for some reason I needed that "objective" measurement of where that labor was at to be able to get through. MW didn't check me except when I asked her to because I was pretty sure I had an anterior lip but wanted a second opinion - and then a half hour or so later I asked her to reduce the lip, which she did.

I checked myself out of curiosity when I was having contractions around 20 weeks - cervix was posterior and I couldn't reach it so I figured things were probably okay in there. I checked myself recently when I found some thick "pluggy" mucous on my undies - cervix is now forward, mushy, and fingertip dilated, which is fine with me at 34 weeks. I may allow an internal around 37 weeks IF MW is still having a hard time figuring out baby's position - for some reason this one is hard to palpate, and we're pretty sure it's head-down but it would be nice to be sure since we'd change some things if there is a breech baby in there!

Here as mama to W (2/04), R (5/06), D (7/09), and J (12/9/12!), co-parenting with my DH

I WOH part-time, am a doula & childbirth educator, home/unschool, and hope we are nearing the center of chaos


 
  

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#45 of 53 Old 07-08-2009, 09:52 AM
 
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I think it's relatively common for US OBs to do vaginal exams at 36+ week appointments, but they're by no means necessary.

I only had one vaginal exam in my first pregnancy, in labor, at my request.

Expat mama to my 7-year-old Halloween boy and my cheeky preschooler, who came before the midwife in January 2010... Gestating a new bean, debuting spring 2014!
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#46 of 53 Old 07-08-2009, 11:28 AM
 
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With my first we did checks starting at GBS test and then every week after that. Sometimes more than once a week. But I had pre-e and they were checking to see if could be induced. There were some days I was checked at the beginning of the day and the end of the day. Those were the days I was hospitalized for observation. I was checked often because of my epidural.

With my second I wasn't checked until 41w1d to see if I was ready for induction. Baby wasn't moving. I was checked often because of my epidural
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#47 of 53 Old 07-08-2009, 03:00 PM
 
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I just got back from my 37 week appointment, and the OB said they'd start checking my cervix next week. I asked what for, and she gave a vague answer like, "Just checking on things." I could have pressed it, but we hadn't gone over my birth plan yet and I wanted to keep the confrontations down if possible. I still plan on declining next week, unless someone can give me a really good reason for it, which I doubt.

Amy, wife to Paul 5/20/01, SAHM to Daniel 5/23/07, Claire 7/15/09, and Elaine 9/4/12

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#48 of 53 Old 07-08-2009, 03:06 PM
 
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Why do I read, over and over again, that making your wishes known is considered "confrontational"?

I watched a TIVO'd version of The Doctors yesterday, and one of them said, several times, YOU ARE IN CHARGE WHEN YOU ARE IN THE DOCTOR'S OFFICE. He reiterated this. Over and over again.

Making your wishes known (no exams, no tests, whatever) isn't confrontational. It's making a decision with your doctor about your wishes. If your doctor doesn't partner with you, you absolutely MUST find a new one. You are paying THEM for a service, not the other way around. They are not superior to you. They are not on a pedestal. They cannot force you to do anything. They do not always know what is best for you. I don't care about that piece of paper on the wall - my accountant has one too, but he makes mistakes.

Saying "no" is not confrontational. Period.

SANDRA, 41 year old VERY laid-back mama to VERY free range kids Brett (16), Justus (11), Autumn (4), and Ayla (1)... four perfect NCB's! :::
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#49 of 53 Old 07-08-2009, 03:21 PM
 
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I didn't have any checks with DD's pregnancy and do not plan to this time either. With my DS, I had lots of checks and none of them were to any benefit. I was walking around at 5 cm dilated and 80% effaced and still wasn't in labor. When I was 3 cm dilated, the OB kept saying that I would go into labor anytime. A bunch of bologna. I learned after that there was no point in checking for "progress."

Di Linh, mama to DS1 (7), DD(4), DS2 (b 12/01/09)
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#50 of 53 Old 07-08-2009, 03:28 PM
 
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Originally Posted by SandraS View Post
Why do I read, over and over again, that making your wishes known is considered "confrontational"?

I watched a TIVO'd version of The Doctors yesterday, and one of them said, several times, YOU ARE IN CHARGE WHEN YOU ARE IN THE DOCTOR'S OFFICE. He reiterated this. Over and over again.

Making your wishes known (no exams, no tests, whatever) isn't confrontational. It's making a decision with your doctor about your wishes. If your doctor doesn't partner with you, you absolutely MUST find a new one. You are paying THEM for a service, not the other way around. They are not superior to you. They are not on a pedestal. They cannot force you to do anything. They do not always know what is best for you. I don't care about that piece of paper on the wall - my accountant has one too, but he makes mistakes.

Saying "no" is not confrontational. Period.
Well, I don't think it should be confrontational, and maybe I shouldn't have used that word, but in my experience (and it sounds like a lot of other people's), doctors are used to patients going along with what they say. It doesn't mean that it's necessarily right, but it does seem to be the norm. So if you tell them you want to do something differently, especially when they strongly believe their way to be the best course of action, they can be taken aback and probably wonder why you're going to them if you're not going to follow their advice.

In my case, it's a very long story, but DH wasn't comfortable with homebirth, I got risked out of the birth center due to GD, and these are the most natural-friendly OBs I could find who would even talk to me in the 3rd trimester. I do trust that they're good people who truly want the best outcomes, but I don't always agree with the medical model, so I'm not going to just blindly follow them either. I went over our birth preferences with them to see what their reactions were so I'd know ahead of time what they weren't agreeable to and therefore what I'll have to stand up for when the time comes, and also because I think they should know ahead of time where we're coming from. But I see no point in debating over being "allowed" to eat and drink in labor right now, for example.

Amy, wife to Paul 5/20/01, SAHM to Daniel 5/23/07, Claire 7/15/09, and Elaine 9/4/12

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#51 of 53 Old 07-08-2009, 03:32 PM
 
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I have not been checked at all this time. I go in about 3 weeks for the GBS testing and I have to remind my Dr that I do not want him to check for dilation, etc. I am one of those people who can walk around 4 cm dilated for a month. No reason to check when labor is not imminent.

Take care all!

Jen

Jen, mama to  (M-13, N- 10, C- 8 rainbow1284.gif J- 3.5, and rainbow1284.gifJ -2, angel3.gifA (10/4/07) and 3 early losses)
We are expecting baby #7 in November 2013

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#52 of 53 Old 07-08-2009, 06:09 PM
 
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Originally Posted by SandraS View Post
Why do I read, over and over again, that making your wishes known is considered "confrontational"?

I watched a TIVO'd version of The Doctors yesterday, and one of them said, several times, YOU ARE IN CHARGE WHEN YOU ARE IN THE DOCTOR'S OFFICE. He reiterated this. Over and over again.

Making your wishes known (no exams, no tests, whatever) isn't confrontational. It's making a decision with your doctor about your wishes. If your doctor doesn't partner with you, you absolutely MUST find a new one. You are paying THEM for a service, not the other way around. They are not superior to you. They are not on a pedestal. They cannot force you to do anything. They do not always know what is best for you. I don't care about that piece of paper on the wall - my accountant has one too, but he makes mistakes.

Saying "no" is not confrontational. Period.
What she said. Especially in an obstetric/gyn context.

My rule: It's your cr0tch. Access to it is a privilege and not a right. If anybody apart from a spouse or lover wants such access (OK, even them! ) they'd better have a good reason why before you consent.

I told both my DH and my doula that if my homebirth ends in a hospital transfer, any time they see somebody setting up a machine, preparing a needle and/or approaching my nether-regions, they need to find out why and make sure I'm OK with it.

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#53 of 53 Old 07-08-2009, 09:10 PM
 
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I always said no and never had a problem. My basic argument was that I could be at 0 and go into labor that night or 5 and not have the kid for a week, so I really didn't care. The information wasn't useful for anything.
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