Should cervical checks hurt? - Mothering Forums

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#1 of 34 Old 04-13-2005, 02:33 PM - Thread Starter
 
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My sister and I were discussing whether cervical checks hurt. She says that hers ALWAYS hurt -- particularly before labor began. I countered with the idea that if internal exams are hurting, then there's a good chance the practioner is "stirring things up" or sweeping the membranes without the knowledge of the mother. I have checked with other friends, and many of them say it hurt like the dickens and they had spotting and cramping afterward.

Which leads me to my larger point: is it safe to assume that if a cervical exam causes significant pain (beyond the normal pregnancy aches and the discomfort of having your cervix touched), the practioner is sweeping the membranes?
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#2 of 34 Old 04-13-2005, 02:38 PM
 
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No I don't think you can assume that. I had cervical checks with my DD and only once did they attempt to sweep my membranes with my permission. That hurt like hell and I actually made them stop. The other checks weren't particularly comfortable but there was a big difference between that and the attempted sweep. Painful might be a strong word but as we all know pain thresholds are relative. I did know right away that I must be quite far along when the midwife checked me at the hospital and I didn't even really feel it (I was 7-8cm). If your cervix is still long and high and closed then checking it at all can be fairly uncomfortable I think. If a cervical exam is very painful, takes a long time and is followed up by a lot of bloody show then yeah I'd start wondering about being swept but not if something was just painful. Of course with my first four exams I was totally closed so sweeping wasn't an option so you have to throw that into the mix as well.
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#3 of 34 Old 04-13-2005, 03:03 PM
 
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Hmmm, interesting. I didn't have too many cervical checks, and the ones i did have were requested but none hurt.

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#4 of 34 Old 04-13-2005, 03:30 PM
 
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I think it depends on you and how you are "positioned". My hospital midwife with my last pg said that I'd find they didn't hurt like they did with my OB, and was certain I'd be more relaxed and in less pain- and I wasn't at all. She was quite suprised at how far up my cervix was and acknowledged why it must have hurt. I am positive she was not stripping because this was during and after preterm labor, and I was far to early to "go". They had me on bedrest, so I doubt my mdiwife was cruelly trying to encourage labor- you know?

I hate being checked, it hurts SO BAD and I spot afterwards as well. Thankfully now I have a HBMW who is content not to check me at all.
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#5 of 34 Old 04-13-2005, 03:36 PM
 
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Wow, interesting thread, as a mama expecting my very first baby, I had no idea that they hurt. My HBMW is not planning on checking me, and I didn't really understand the arguments for or against cervical checks...

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#6 of 34 Old 04-13-2005, 04:22 PM
 
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They never bothered me. I had vag checks at 37 and 38 wks with my first and a couple times during that labor (which was the same day as the 38 wk check, during which my NP stretched cervix for me, after I asked her to). That didn't even really bother me. With my second, I had one vag check and that was when I got to the birth centre and it didn'tbother me at all.
On the flip side, at almost every birth I have attended, the moms have been in complete pain during vag. checks. Grabbing the bed, arching their backs, trying to get away from the person doing the check...it's been almost universal. I guess it just hurts some more than others. Namaste, Tara
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#7 of 34 Old 04-13-2005, 05:13 PM
 
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Nope, none of mine hurt.

You can be darn sure I won't be allowing them this time around though just because of the possibility.
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#8 of 34 Old 04-13-2005, 05:20 PM
 
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nak
Most of my cervical checks didn't hurt, with one exception. I went into the hospital at 30 weeks having contractions every 2-3 minutes. The nurse that checked me had short fingers. I had to put my fists under my butt to raise it up so she could reach my cervix. That really hurt! After that she did a fibronectin test that was even worse.

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#9 of 34 Old 04-13-2005, 05:29 PM
 
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With dd I had a male OB and internals always hurt. With ds1 I always saw woman OBs or midwives and internals did not hurt. With ds2 I refused internals until I thought I was in labor. The midwife checked me the daybefore ds2 was born and it did hurt a bit. The male OB who delivered ds2 hurt like a whenever he did checks, I even screamed at hime to get his fingers out of me when I was in transition.
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#10 of 34 Old 04-13-2005, 05:31 PM
 
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Quote:
Originally Posted by Eaglevoice
Wow, interesting thread, as a mama expecting my very first baby, I had no idea that they hurt. My HBMW is not planning on checking me, and I didn't really understand the arguments for or against cervical checks...

I guess there are a couple of reason's not to do them:

1. progress check imply that the cervix effaces and dialates in a linear fashion. However, the reality is that these things don't always happen at a predictable rate. For example: you could possibly labor for hrs/day to get from 2-4 cm and then for from 4-10 cm in less than a 1/2 hr. So being 4 cm after many hrs might lead you to think that you have many long and painful hrs to go when in reality this isn't nescessarily the case.

2. progress checks give a path to foregin bacteria (esp important to not do these after membraine rupture)

3. possiblility of "accidentally" repturing membrains

4. this one may just be me but it's a psycological control issue. What they don't know can't be used against you, KWIM.

This goes back to reason number 1, IMO OB's and LD nurses seem to treat effacement and dialation rates as if it were linear, so they may use the assumption of liner dialation rates to put you on the clock. You are esp vulnerable to this if you have been induced or have an epidural. It's where that failure to progress diagnosis gets used.
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#11 of 34 Old 04-13-2005, 06:17 PM
 
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in my practice, I try to be as gentle as possible. sometimes there is pain associated with checking the cervix - in labor the cervix is sensitive and this can cause pain. Before labor, if the cervix is posterior (behind the baby's head), I will pull it forward and this can be crampy, but not really excruciating. Some women who have experienced sexual abuse will note that any violation of their genitals is painful.
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#12 of 34 Old 04-13-2005, 07:38 PM
 
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You can't make that assumption. I am just very sensitive. Every time I am checked nomatter how gentle my doctor or midwife tries to be I hurt. It may be because I hate people sticking their fingers up there so bad that I tense up making it more painful for myself, but none the less, it always HURTS! Pap smears, that other thing they do when they feel around for your ovaries (YOUCHHHIEEE!) or cervical dialation checks. I hate them all. This is the one and only reason that after all these years I still haven't been fit for a cervical cap. The idea that my midwife has to put something in out in out in out, I just can't do it!
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#13 of 34 Old 04-13-2005, 07:47 PM
 
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Cervical checks have always been uncomfortable for me. I'd say a bit painful, but not horribly. It's just sooooo far back there and I remember always wincing a bit when they'd be done (at least prior to labor - I don't remember too well about the ones during). I've been told that my uterus is posterior though - not exactly sure what that means or if it would affect anything. In the future there will be no checks for me.

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#14 of 34 Old 04-13-2005, 08:22 PM
 
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See I think mine is way up there too. They always seem to have to really reach to get to it and I don't think I could even do it myself.

I am refusing checks this time for exactly the reasons Simone gave. Yeah sometimes I wonder if the cramps and contrax I've been having are doing something but I know that time will tell not an exam of my cervix.
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#15 of 34 Old 04-14-2005, 09:10 AM
 
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I've actually tried, I can't reach myself... Isn't that wierd?

Pamamidwife- that may be it- just being messed with feels painful even if it is on some sort of psychological level.
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#16 of 34 Old 04-14-2005, 12:58 PM
 
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I don't think we're really designed for people to be attempting to handle our cervixes. I am not at all surprised that some women find it quite painful. I've never found it that way, personally... although the inventor of the speculum should have been drowned in a small bucket of nasty things.
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#17 of 34 Old 04-14-2005, 01:12 PM
 
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LOL at the speculum inventor comment :LOL

With DD#1 I was checked at 36 weeks and was dilated about 2cm. I didn't have another check until I went into the hospital at 38 weeks due to water breaking and fast contractions and was at 7cm. I went into the shower and a little while later came out - another check and was at 10cm and ready to push. None of the checks hurt. I had asked about getting one at 36 weeks because I felt a lot of pressure. I was about 50% effaced and the 2 cm dilated and walked around like that for another 2 weeks!

I won't be able to tell you until August if this time it hurts. But I'm assuming I won't be checked unless I ask, or I'm in Labor and waiting to see if I can push!

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#18 of 34 Old 04-14-2005, 03:46 PM
 
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OH yeah I have had painful checks but they were on my request and my midwife couldn't really get to my cervix because it slipped behind the baby's head. Yeah that was a painful check.
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#19 of 34 Old 04-14-2005, 09:26 PM
 
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they are excrutiatingly painful when the nurse has half inch long acrylic nails and has a definite mean streak after you've told her not to touch you again

i don't think we were designed to have someone other than ourselves or an intimate anywhere near our cervixes!

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#20 of 34 Old 04-14-2005, 09:50 PM
 
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I can never reach my cervix by myself, any exam by a doctor has been nasty.. not sure about a midwive I have never been in that situation. I do think it should *not* hurt though, and my logic for this was when I asked my hubby to check for me my last pregnancy it was never painful at all.. in fact I was sort of amazed how there was no real sensation of anything pain or otherwise with it.. surely if he can manage that.. other "care providers" could as well? I dunno...... good food for thought though.
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#21 of 34 Old 04-14-2005, 09:54 PM
 
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They hurt in labour, but I never had any before that. They don't really yield any meaningful results, and the risk of infection or whatnot isn't worth it. My mw was at 5 cms for 5 weeks. I cannot understand why some people do it, and she theorized that some people just need to feel in control.

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#22 of 34 Old 04-15-2005, 01:58 AM
 
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Quote:
Originally Posted by georgia
they are excrutiatingly painful when the nurse has half inch long acrylic nails and has a definite mean streak after you've told her not to touch you again
WTF!!! Why would a L&D nurst have long fake nails???? (we aren't even allowed to have fake nails or nail polish where I work) Ouchie! I woulda punched her.
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#23 of 34 Old 04-15-2005, 11:19 AM
 
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Quote:
Originally Posted by pamamidwife
in my practice, I try to be as gentle as possible. sometimes there is pain associated with checking the cervix - in labor the cervix is sensitive and this can cause pain. Before labor, if the cervix is posterior (behind the baby's head), I will pull it forward and this can be crampy, but not really excruciating. Some women who have experienced sexual abuse will note that any violation of their genitals is painful.
Yes to all of this , I would add that before labor and in a non-pregnant woman if there is much pain I consider the possiblity of infection- BV, mycoplasma(sometimes the only sign of mycoplasma), chlamydia and recommend screening.

also some practioner are very rough, and almost anyone would experience pain while getting an exam from then---- give feed back to the care provider as it is being done-
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#24 of 34 Old 04-15-2005, 03:19 PM
 
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the first time they checked my cervix it hurt so badly i actually asked if she swept my membranes! she didn't, i just had a very high and anterior cervix. i had the absolute minumum of internal exams during labor, but we needed to figure out why the baby wasn't coming even though i was in transition, those exams didn't hurt as long as she did them really fast between contractions, my cervix got up to 6cm. i suspect it didn't hurt as much because i was already flooded with endorphins (i was drug-free) OR perhaps it was because the cervix was finally easily accessible?

(i ended up with a c-birth because the baby was hung up on a very short cord, her head was dipping down low enough to dilate me but then i'd "reverse dilate" it was really weird and i ended up with about 6 internal exams in 2 hours before surgery, ugh)

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#25 of 34 Old 04-15-2005, 09:04 PM
 
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It has *always* hurt me. Maybe I'm just especially sensitive -- I'm one of those people that can't even wear her hair up in a ponytail.

MamaTaraX wrote: "...at almost every birth I have attended, the moms have been in complete pain during vag. checks. Grabbing the bed, arching their backs, trying to get away from the person doing the check..."

My god, why were they doing them then? It's not like it's necessary.
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#26 of 34 Old 04-15-2005, 11:58 PM
 
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Well I did have one today : (just had to know if those several hours of regular contrax had done something) and it was not painful only a bit uncomfortable as she was checking effacement. My cervix was posterior though so she had me put my fists under my butt and then she was abe to reach it just fine. No one has ever had me do that before and she didn't use stirrups either so maybe it really does have more to do with the practioner than anything else. I definitely felt like she was being very careful to take her time and not just ram her fingers up there to check things out.
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#27 of 34 Old 04-16-2005, 11:23 AM
 
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I personally have not had much discomfort with cervical exams. The very first one I ever had was when I was 6 cm dilated during my first labor. I was 17 when I had ds, and was pretty nervous about being examined, but I really didn't feel much at all. And that was a male OB.
I do find that cervical exams are uncomfortable for a lot of women, though. I don't find that those women who have pain are necessarily the ones I have a hard time reaching the cervix or anything, though. I think some women just have more discomfort than others, and some have so much more anticipation of pain to overcome than others. I do find that if I move slowly, and tell the woman exactly what I'm doing, and definitely wait as long as necessary for a woman to get in a comfortable spot and not be having a contraction, that sometimes women who thought other exams are painful sometimes are surprised that they have less pain.
I do very, very few exams. It's one of the reasons I stay in hospital if I have someone in labor, because if I'm not there the nurses feel obligated to keep checking the mom so I can get there in time. Pretty unfair to keep bothering a laboring mother to fit with the doc's plans, I think. When I'm present, I don't do any exams unless someone wants pain meds for the most part.
I don't do exams in the office setting at the end of pregnancy, unless a woman for some reason can't be talked out of it. I don't think knowing you are closed, or 2 cms, or anything is of any help with knowing when you will go into labor. Last year I had 2 moms due the same day. Both just had to know if they were dilated at all at their 39 weeks visits. One was closed and not effaced at all. The other was 3 cms and 80% effaced. The closed mom started laboring that night, and delivered in the early morning, less than 24 hours after that exam. The 3 cm mama went to 41 1/2 weeks! (But she had a shorter overall labor) So I don't think knowing cervical dilation at the end of pregnancy is really helpful. I don't think knowing cervical dilation during labor is all that helpful. I especially don't think it's usually worth causing someone pain to know cervical dilation, especially when otherwise mom and baby are doing fine.
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#28 of 34 Old 04-16-2005, 06:01 PM
 
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The cervical checks to me were the most painful part of the whole labor and delivery.
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#29 of 34 Old 04-17-2005, 01:00 AM
 
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doctorjen, have i told you lately that i you

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#30 of 34 Old 04-17-2005, 01:06 AM
 
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Quote:
Originally Posted by georgia
doctorjen, have i told you lately that i you

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