Did you know you don't have to have VE's in labour?

[TheMule]

Hi all. I've actually posted a media request too as I'm writing an article about consent in childbirth. I'm not getting much response so I hope you don't mind my asking here too. I'm just curious to know how many women are aware that they don't HAVE to have procedures such as vaginal exams in labour to check dilation - unless of course they want to. I often hear women express surprise when they are told that they are not compulsory. So I'd love to hear your thoughts or experiences on this or any other issue related to freedom or consent. eg if you did not know that you could decline, if you tried to decline but met resistance, or if you declined and wished you hadn't! Thanks for your thoughts everyone, I realise this is a sensitive topic. I'm writing for the Telegraph online. I'm Milli and I write about birth and run an organisation called The Positive Birth Movement. Email me if you don't want to comment [email protected]. Best wishes, Milli x

[BringBackCabinPressure]

I was refused any pain relief or gas and air until I was examined. I felt very bullied :(

[BringBackCabinPressure]

Just to make it clear I wAs trying to decline but they withheld gas and air or anything until I consented. I believe that's not unusual

[SpangleMaker]

I didn't object to a VE but they wouldn't let me have any pain relief until they'd done one. With DS that was v annoying as because he was 4 weeks prem the MWs had to wait until a doctor was available to do the exam - by which time I was 8cm dilated.

[Sapat]

Yes of course it is always made clear, possibly too much as they are always asking for your permission to do stuff rather than just getting on with doing what is necessary.

Personally, based on my experience of three labours VEs were kept to an absolute minimum. No medical staff did it for fun, and for my second I actually had to ask them to check me, which they refused to do as they said it was going well and was not necessary. Tbh, I was too busy to worry about such things.

[PenguinsandtheTantrumofDoom]

I was asked to consent - but more as a formality than anything else. Then I was treated as hysterical and 'not coping' because I wasn't very dilated.

I refused them for no.2 and no.3.

[LooksLikeImStuckHere]

I asked the doctor to stop, several times, and he didn't. Wish I had known then that I didn't have to consent.

[museumum]

I only really had one - on arrival at the mlu. I was aware I didn't need to consent but I don't know what would have happened if I said no. It appeared to be the main/only way they triaged arrivals. I was 8cm so glad they could Rush me into a birthing pool in the first available suite.
Without the VEci could have had my Ds in the waiting room!

[Justwhy]

My birth plan basically asked people not not touch me in in general. I didn't actually think of VE when I wrote it, more patting and back rubbing. It wasn't until after the stress free birth that I realised I had no VE at all. She waited for DC head to break my waters and didn't come near me until the very end of labour. She was fab.

[hoobypickypicky]

Consent was neither sought nor given when I was in labour. I was in so much pain that I didn't consider the option of telling the staff no although I wish I'd thought of it.

We've a couple of soon to be mums in the family; I'll be directing them to this thread.

[PenguinsandtheTantrumofDoom]

On consent but not VE, I was told they would be, not asked to consent to, breaking my waters. They also failed to give me vital information which would have led to me refusing. I think the mw felt she got to make the decisions.

[BeckieTM]

As a midwife I would hope that I always gain informed consent before performing an internal examination. I actually find it I hard that women are constantly asking for VE's to assess progress and when I tell them that there are many other ways of 'checking progress' they think I'm performing witchcraft!! As long as everything is within normal perimeters I would not suggest a VE. However on a main obstetric unit you are under pressure to do the 4hourly VE's as per NICE to monitor progress.

[CulturalBear]

I knew you could ask not to have them but didn't really believe that was the case. In fact, I am sure that it was the fear of having them that kept stopping labour after my waters broke - every time I had to ring up or go in I was shaking with fear at the thought, and shortly after ringing up having 3 cx in 10 minutes consistently, I let myself be talked out of going in and they went inconsistent again.

I did put on my birth plan that I wanted as few examinations as possible, due 'to previous bad experiences', and people were very respectful of that. In fact, I actually requested the two VEs that I had from the MW, one at 4cm, the other at full (90 minutes later). And I was very happy that they were on my terms.

After that, though everything went wrong, and I ended up with a very rough registrar (male), and a theatre delivery that was traumatic (to me) because it was all my worst nightmares coming true! I do wonder even now (nearly 2 years on) if I was less scared of VEs if things may have progressed properly.

[SweetPeaSoup]

When I had my first, 5 years ago, I didn't realise, no.

What are we supposed to do to get pain relief if it's being withheld on the basis that we may not be d far enough along?

I clearly remember being fobbed off with a paracetamol until I was eventually given a VE and found to be 6cm. This time round, if I want pain relief, I want to be believed and given some without having to go through an excruciating VE that would put me on my back through a contraction.

[AuntieStella]

Yes, I knew.

Yes, consent was sought.

[TheEmpressofBlandings]

Yes I knew. I'm not surprised many don't though. I went 18 days overdue with one of my DC and the reaction is ALWAYS 'I didn't know they 'let' you go so far without induction'.
No one seems to realise that being induced or not is your choice and that NICE guidelines recommend monitoring as an alternative to induction if induction is not wanted.

[HumphreyCobbler]

I did not know that you were 'allowed' to not have them, but I knew I couldn't bear to tolerate them. My midwife was very supporting, but when things got a bit stressy with the baby the doctor performed a VE anyway, despite the midwife trying to stop her. When I protested she told me to push her hand out, and that is the way to push.

I don't think she was doing anything other than trying her best to get the baby out safely, she was a nice person. But as a whole situation it was less than ideal.

[Jackieharris]

I knew I could refuse.

I put it in my birth plan. But that was never read.

I was told they wouldn't admit me to the labour ward without one.

Then later they just did them without my consent.

Consent in childbirth is a joke.

[Letmeeatcakecakecake]

My first birth was in a MLU in London and the midwives were horrendous and forceful. I had no idea I could decline yet they were so indidtsnt on doing them, I found them agonising and worse than the contractions.

I gave birth at home to my second child on Sunday, I'd spoken to the home birth team about my anxieties regarding VE and was told I could decline. On arrival my midwife asked if she could do an exam as j was progressing very fast and from the description of my contractions the baby was at a funny angle. She was so gentle I barely felt a thing.

[Toothfairy87]

Hello... I wasn't aware of this but glad I am now.. Knowledge is power as they say !
I cannot cope with VE's and have had to be put to sleep for smears because of vaginismus ... It is very painful to be examined ( not just discomfort but it is actually painful ) so what other ways can be utilised to check progress?
Interested to know... Any midwives?

[ChunkyPickle]

I was aware, and was prepared to refuse them when having my second - but to my surprise they weren't agonising as they were the first time.

What I didn't consent to was the sneaky stretch performed by one of the consultants when I wasn't progressing, I was bullied regarding the monitoring too (which I was happy to consent to, but not lying on the bed because it was too painful), and I ended up with my arms black and blue from poorly inserted, unused canulas which they wouldn't let me refuse. (the anaesthetist in theatre for my EMCS automatically put his own in)

I stood my ground on water breaking, epidurals (had spinal block just for theatre), and I got pain relief (after compulsory VE) at less than 2cm dilation because I sent DP to insist (and only after I'd had a warm bath, which funnily enough I'd already tried at home over the previous week of contractions, and did nothing at all to help)

VEs are the least of the problem. The problem is not actually listening to a knackered woman in pain and working with her to find a workable solution.

[Toothfairy87]

Chunky pickle ... That sounds awful :( indeed, the worst thing has to be somebody just not listening full stop when it's your body and baby and you should have some sort of say !

[IdaClair]

Indeed I did know.

Hence I have never had a VE in labour.

I understand the question though, it is very upsetting how many people do not know this. I did come under pressure to have one with my second child and had to decline repeatedly. I got better care as a result of not having VEs.

[StarlightMcKenzee]

I knew about consent in my 2nd two births. In fact my refusal of consent extended to not allowing anyone to touch me or my baby at any stage during the birth. I delivered both myself in water (though with a midwife present).

This came after having my 1st assisted delivery using fundal pressure applied by a SHO without so much as even telling me he was going to jump on my abdomen. The hospital subsequently denied it could have happened as it 'isn't a recognised medical procedure' and it does not appear in my notes.

My 1st child suffers from an expressive language disorder and has a diagnosis of ASD. I cannot believe this is unrelated to the abuse I suffered during his birth, and subsequently HIS abuse.

[BeaufortBelle]

I didn't know but I did refuse them 20 years ago on an open ward with just a cotton curtain between me and the lady, her husband and two sons in the next bed. They didn't like it. And when I couldn't bear the pain anymore the midwife said "I know, you need some pethidine to relax you and the needle was in before I had a chance to say no". It was absolutely disgusting and I didn't allow anything like it to happen in my next pregnancies.

[nickelbarapasaurus]

you'd be amazed how many women go "i had to have this done"

"i had to be induced"
"i had to have my waters broken"
"i had to have a sweep"
"i had to have a VE"
"i had to have an epidural"

etc.

it's bollocks - they can advise you and they can tell you what they believe to be the best course, but they can't force you to do anything