when do internal exams start - Mothering Forums

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#1 of 26 Old 12-11-2008, 09:28 PM - Thread Starter
 
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just curious... does anyone know when they usually start w/ internal exams?

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ds (2-23-09)
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#2 of 26 Old 12-11-2008, 09:51 PM
 
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The GBS culture is typically after 36 weeks, isn't it?

Cervical checks are voluntary for patients of my midwife, though last time I remember being really curious towards the end and asking her to check (don't remember whether I was dilated or not though).

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#3 of 26 Old 12-11-2008, 10:31 PM
 
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My Doc said she'd do a swab for strep B at 36 weeks. After that I don't know...

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#4 of 26 Old 12-11-2008, 11:36 PM
 
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Right at 38 , 39 weeks usually. In a military hospital that is. I have no idea how civilians work it.
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#5 of 26 Old 12-11-2008, 11:55 PM
 
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I decline them until I am in labor. I ended up only having cervical checks twice in each labor... I think.

You can request them whenever you want, and decline them whenever you want. I think starting at 36 weeks and then continuing weekly until birth is standard.
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#6 of 26 Old 12-12-2008, 12:15 AM
 
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yea i would say most people get a check at their gbs swab...and some as much as weekly after that.

i decline them until i'm in labor.
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#7 of 26 Old 12-12-2008, 12:47 AM
 
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Can I ask why those of you who choose to decline them do so?

I have thought about declining only because the exams hurt when I was pg with dd (but that could have just been the doctor... he was not exactly gentle) and my dilation didn't mean anything. I was at 3cm from 36 weeks on and thought that meant the baby was going to come anyday... but the weeks just went by.... Kind of frustrating.

But are there risks associated with the exams before labor?

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#8 of 26 Old 12-12-2008, 12:49 AM
 
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risk of infection...risk of them irritating your bag of waters and causing it to rupture prematurely.

i always ask myself "what am i going to do with this information" and if there is nothing i would do differently i need to ask myself "do i need this procedure or this information"
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#9 of 26 Old 12-12-2008, 12:54 AM
 
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??? What is an internal exam? At my last visit, my dr had her hand inside while she was pressing my abdomen... is that it? The last time I was swabbed was to check for STDs. Now I'm scared.....
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#10 of 26 Old 12-12-2008, 02:14 AM
 
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They are typically just for checking dilation and effacement but you can be dilated and effaced for weeks before baby comes so they don't mean much. I only get them while in labor and only a very limited amount.

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#11 of 26 Old 12-12-2008, 02:18 AM
 
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I decline also. There really is no point in them. You can walk around at 3cm for weeks.
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#12 of 26 Old 12-12-2008, 02:37 AM
 
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Originally Posted by milky80 View Post
I decline also. There really is no point in them. You can walk around at 3cm for weeks.
Isn't that the truth! I swear! This time, none for me until labor! I was 3-4 for at least four weeks last time!

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#13 of 26 Old 12-12-2008, 03:00 AM
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My midwife doesn't even bring it up! As for the cultures, she had me swab myself by choice at the last visit. So much nicer than the doctors office!

My last pregnancy she didn't do an internal until I was obviously in labor. There just isn't a really good reason to do one, as far as I can see.
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#14 of 26 Old 12-12-2008, 09:05 AM
 
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What everyone else has said- unless I am looking at an induction, there is no beneficial information to be gained, and a small handful of consequences that can be potentially run into- infection, PROM, pain.
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#15 of 26 Old 12-12-2008, 10:48 AM
 
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I only had 2, and those were when I was in labor! For my GB, I swabbed myself.
Hehehe - all that time with my MWs, and the first time the saw any of me besides my belly, I was pushing the kid out.

No need for the checks at all - besides the risks stated already, there's the lovely thing that happened to my friend:she was getting checked every visit towards the end (a LOT of checks), and she was "not progressing" since she was only 3 cm. Guess who was put on a pit drip upon arrival at the hosp? And ha - without an exam that time.....
So, she even before labor, her provider convinced her that she was not capable of having the baby naturally. And wheeee for the doctor time line starting before labor! As if there was not enough pressure and interference then...

She's not mad about it, but I am.

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#16 of 26 Old 12-12-2008, 11:40 AM
 
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Originally Posted by Mainstream Hippie View Post
You can request them whenever you want, and decline them whenever you want. I think starting at 36 weeks and then continuing weekly until birth is standard.
This is what my midwife does. I think I'll be ready for some news by that point. And any dilation (sp?) would make me feel like i'm at least moving forward....

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#17 of 26 Old 12-12-2008, 12:09 PM
 
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This hasn't been brought up yet, so I'm assuming it's not until I'm in labour (or think I am ).

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#18 of 26 Old 12-12-2008, 12:14 PM
 
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I know my dr will want to do it on Tuesday if I tell him I had contractions last weekend. Not sure what to do about that.

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#19 of 26 Old 12-12-2008, 12:23 PM
 
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For me, never.

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#20 of 26 Old 12-12-2008, 12:33 PM
 
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I know my dr will want to do it on Tuesday if I tell him I had contractions last weekend. Not sure what to do about that.
Just politely decline, if you're not comfortable with it.

As long as you're not having contractions now and know to drink plenty of water and rest when/if they happen again, I don't know what an internal will do in terms of helping the situation. What would he do if you were one cm dilated? Three? It doesn't matter, truthfully. And it would be different if those contractions had led to active labor. They obviously didn't. So I would just politely decline.

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#21 of 26 Old 12-12-2008, 12:35 PM
 
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Kssinca - it's when your practitioner puts fingers inside your vagina. My exams with my MW consist of a blood pressure reading, belly measurement, feeling around to guess position, and listening to the baby's heartbeat with a doppler - no reason to go inside. She hasn't seen me unclothed yet, which actually I feel a little funny about, but t's a good thing I'm pretty uninhibited.

I don't think my MW is big on internal exams. I will probably request one when I feel the urge to push, to make sure I'm fully dilated and ready. But that might be my only one.
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#22 of 26 Old 12-12-2008, 06:25 PM
 
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Originally Posted by Lisanne View Post
I know my dr will want to do it on Tuesday if I tell him I had contractions last weekend. Not sure what to do about that.
just ask him what he plans to do with that information and decide from there.
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#23 of 26 Old 12-15-2008, 01:57 PM
 
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Agree that it starts at 36 weeks due to the GBS test as a standard - and that you can decline them if you want! I get weekly nonstress tests and weekly ultrasounds, which started at only 28 weeks pg. So, as long as the NST shows no contractions then I see no reason to have them done. (I'm high risk though so if there was a concern, then I'd definately let them do them).
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#24 of 26 Old 12-17-2008, 12:27 AM
 
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Ummm possibly never for me this time?

We don't ever get them for a GBS swab though... we do those ourselves (if we choose to get them done, which I am not so I won't have to worry about it anyway). That seems to be standard for the midwives around here at least (and in the the major city practice I was at with my son).

The midwives will offer them here around 38 weeks and further, but it's just that... an offer. And since I'm planning on UCing I may well get through the rest of this pregnancy with none.

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#25 of 26 Old 12-17-2008, 08:40 AM - Thread Starter
 
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I have a high risk OB/GYN. I have a feeling he's going to want to follow the protocol for doctors.

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ds (2-23-09)
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#26 of 26 Old 12-18-2008, 06:17 PM
 
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Add me to the "Never" category. Unless something's going awry, I'm not interested in knowing, not now, not near term, not in labor.

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