Do I need a vaginal exam?
Whether you are at the beginning or end of your pregnancy, considering what your wants and needs are for your labour and birth is so incredibly important. There are a lot of guidelines and protocols, especially in hospitals, that midwives and obstetricians need to follow. One of them are vaginal exams. If you have been pregnant or birthed before you will most likely been asked the question “can I do a vaginal exam?”
The most important things to know here is: YOU and only you make the decision on this. It is a guideline or policy, NOT the law. You do not have to agree to a vaginal exam if you do not want to.
So what are the pros and cons of having one?
Check how many centimeters dilated you are
When we get to the stage in labour where we really want our baby out, it is easy to ask for someone to confirm how far we’ve come to get an idea on how far we have yet to go. This is great when someone shouts out 9 centimeters and almost time to push! However, it can also throw us off as women when we haven’t “progressed” as much as we had hoped. It can switch on the side of our brain which is our logical thinking brain - and that is not where we want to be when in labour. “Is something wrong”, “why am I only x centimeters?”, “I’ve got so long to go" etc.
Stretch and sweep
You will most likely be offered one during pregnancy to check your cervix or to be given a “stretch and sweep”. It is worth taking into consideration that there is always the risk of introducing bacteria when fingers and gloves are introduced to such a vulnerable area.
Also worth knowing is that a stretch and sweep only has a 24% success rate of getting labour started within 48 hours.
Check how you are progressing in labour
Some hospitals have a (very outdated) policy of ensuring women are progressing 1cm per hour. As we now know in 2023 is that women in labour progress very differently and at different rates and expecting 1cm per hour is simply not realistic or helpful in anyway.
Check position of baby during labour
If labour is not progressing it can be beneficial to find out if there is something in the way of the baby.
So what are my thoughts on this?
I had vaginal exams with all three of my babies and they are all healthy and well. However, looking back at it now with the knowledge I’ve gained I would have skipped 99% of them. Simply because they were not needed.
Having someone inserting fingers into the vagina while your brain is trying to help you through your surges is more often than not, not helpful.
Researching the differences and making an informed decision before agreeing to vaginal exams is crucial and I would highly recommend spending time reading reports and evidence before making your decision. Having your support person also be well researched and not easily scared or swayed is ideal. Below you will find a report from the very well researched and knowledgeable Hannah Dahlen, I highly recommend reading it!