Thursday, February 26, 2009

Cervical Checks - are they necessary?

Thanks again to Enjoy Birth, who lead me to these musings of a very interesting midwife, or more accruately, Midwifery Ramblings who thinks just like me :). I dare you to read the link above, Cervical Checks - are they necessary. What? Double dare ya ; ) Yup. Okay, the bottom line is this, It is not really anybody's business what your cervix is doing. It has become so common place for people to ask a full term (or near full term) woman, friend/sister/co-worker/neighbor..., "how dilated are you?" I love it when the answer is, "I have not had a pelvic check". I love it more when in labor, someone asks and the answer is the same or, "I do not care to know". It's great that women today know more about their bodies, the birth process, and their choices! But that does not mean that we have to poke, probe and prod (as in cattle prod)! As with anything, there are risks and benefits. But do your homework. Most of the time the benefit is that the institution (hospital) can plan their customers comings and going. Like a restaurant, with surgical birth hospitals take reservations, but with those mom's that just 'drop in' there may or may not be enough nurses (waiters or waitresses). So they rush you in the restaurant (hospital). And if they check your plate (or your cervix), they can better judge when you'll be done. If you linger the waiter sometimes will take things off the table or bring the check. Don't you just hate that! Well, at the hospital sometimes staff will say something about how slow your eating, oops I mean dilating. Same difference.

I personally like to go to a restaurant where I can dawdle and enjoy the meal, the ambiance and my campanion/s. I like to have a luxurious meal, where I can digest my food and enjoy my wine. Don't you?


  1. This last Friday/Saturday I was the doula for a woman who had her first baby - a vaginal birth. Her sweet baby girl weighed 10 lbs 9 ounces. Mom labored at home as long as she wanted, getting to the hospial she was 6-7 cm. dilated. Did we know how far along she was? No. Did we care? No. Did the doc that gave her a very uncomfortable pelvic exam put fear into mom and slow progress? Yes. Cervical checks, are they really necessary?

  2. Anonymous8:14 AM

    I don't think cervical checks at any point (unless there are medical issues) are necessary. I'm about to have my first and allowed the 36 week exam since I was already indecent for the strep b swab. HOLY PAINFUL! It wasn't until after that I clued in something wasn't done right. I spotted for 2 days, had bad cramps for 4 and literally couldn't sleep or get comfortable sitting, standing, laying down, anything, for a week. At my next appointment, I grabbed my chart outside the door and read it. The receptionist came in and tried to take it from me saying that I shouldn't be reading it. I pointed out that she shouldn't be barging into an exam room where the door was closed without knocking since the chart wasn't outside, I very well could have been having an exam and that it is MY medical information and I have every right to look at it. What they didn't want me to see was that the doc the week before had done a membrane sweep without my consent or even telling me afterward. From that point on, I refused the weekly checks, which led to an argument with my doctor. She tried telling me I HAD to have them. My response? I reminded her that no one HAS to do ANYTHING they're no comfortable with, especially with their own body and I demanded each time why it was medically necessary, since the progress made no difference unless I was in labor, and that even then, frequent checks don't prove anything. She had no argument in which to come back with, so I was left alone from that point. I also pointed out that the only thing the checks during labor can do is give the mother and doctor both unnecessary frustration (and discomfort!) if things don't go the way the doctor thinks they should and many times, leads to unnecessary medical intervention because everyone wants things to go quicker. I'm a week from my due date and have no intention of allowing checks, aside from when I'm first admitted while I'm in labor and will only allow a check when I have the urge to push.

    Keep in mind ladies that it is still our bodies and childbirth is undignified enough. Adding to those won't do any good for your emotional state, self esteem or the health of your baby. Don't be afraid to speak up! If your practitioner doesn't agree with you, bully's you, or tries to make you feel guilty-find someone else, even if you've reached your due date. If you don't think there's anything wrong with your little one, don't give in-your instincts won't be wrong!

  3. Anonymous9:14 AM

    I thank you so much for posting this! I was in labour which ended up being false yesterday. The nurse was being gentle by checking my cervix though it still hurt, I was 4 cm. Then my doctor came in, and she went charging in there with no stopping at my cry of pain! She not only checked the cervix, she swept the membranes too. I have had heavy bleeding since yesterday morning and really bad cramping. Thanks to your posts I am going into my next apt armed with info. No one should have to be put in that pain. And like you said emotional, I cried so bad yesterday and this morning. I also fear my labour now, seeing her again. It should never be like that, never. I hope other ladies come across this and know their rights to their own bodies! I am saying no that is for sure!!

  4. 8:14 - I am so sorry that you had to endure such a unnecessary painful exam but I am so glad that you found your voice, learned your rights and are sharing this information with others! I am happy for you and your baby that this happened BEFORE your labor & birth! Congratulations and birth blessings. Love, Rosie

    P.S. I love your last statment "don't be bullied, find someone else"!! I pray that your birth expereince, and the way your precious baby enters the world will not be undignified but be a time where both of you are treated with the upmost dignity.

  5. 9:14 - First of all let me say how very sorry I am that you were treated so roughly and disrepectfully.

    I especially want people to take note that the rough doc was a FEMALE. For some reason many women believe that if they get a female care provider (OBGYN, doc or midwife) they will be treated better, gentler. NOT TRUE! But how can you know who will listen to you, be respectful, be sympathetic, empathetic before you hire them? You can get referrals from other mommies, you can go to birth story circles and mommy & me groups, la leche league meetings and ask questions. But more importantly listen, really listen to the answers and comments of other women. Then, pay attention to the level of respect your care provider gives you during appointments; Does he/she take the time to listen to YOU, your concerns, your wishes, your hopes & dreams? Maybe someone who takes time to listen will take time during examine vs. "charging in there".

    I would guess it is probably not your labor you fear, but the treatment you will receive during labor. You can fire your doc and get another or the hospital doc who is on-call the day you give birth (check with insurance)? You and your support people can stay at home as long as possible and then decline any medical treatment aside from monitoring baby intermittantly. By 'support people' I mean husband, sister, friend, doula. Surround yourself with people who LOVE you and who you trust. Make sure they know what happened to you, how it made you feel, and what you want. So that when someone comes into the hospital room while you are having a long contraction your support people can be paying attention for you, noticing if this person is 'gloving up' for an exam. You shouldn't have to be giving birth and guarding your space at the same time, although birthing women, like mama bears, do this when they have to. Your support people can quietly take doc aside and inform him/her that mom is adamently against any vaginal exam until she is grunting/pushing (if then). Hopefully when your contraction is over the doc has already gotten the message to be hands off!! The ideal would be that you speak on your own behalf, but at the end of labor words should not be necessary.

    Thank you for sharing. Please share your birth story when you are able.
    Birth blessings, Rosie ♥


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