Did you have an internal exam after having baby? Are they routine?

(38 Posts)
ayria Mon 04-Jan-16 16:08:06

I found my son's birth traumatic. There was no communication whatsoever and they just done their job without explaining anything to me at all. I'm currently having therapy and going through the bits I found highly distressing. I was left with PTSD as I felt truly violated. There's a lot I wont go into but I was losing blood throughout the delivery, they panicked (son's heartrate dropped, only found out from debrief) then she cut me.

I asked my sisters. Neither of them had an internal examination afterwards or any stitches. I got cut and tore halfway around and had an internal tear (only know this because I found out you could have a debrief nearly 4yrs later!). The injuries listed on my medical records are wrong so that didn't help me, it didn't explain why I could feel stitches inside. They didn't tell me what they were doing, looking for or why. They just started stretching me open with something, then, after a good while of fumbling around, I felt the stitches going through my skin with no warning. It was horrendous. Worse than giving birth! Then one of them put her finger up my backside twice, didn't warn me or explain what she was doing. Basically I was treated as a piece of meat. The only reason I assume she checked me internally was because of the blood (didn't know I had lost any at the time) but they don't always check because of that, do they? My sister said that they only do an internal exam if you tear but how can they know if you've torn without checking inside as well?

Did you have an internal exam after giving birth? Were you told why before it was done and was it explained? Did they tell you the findings?

I'm just curious as to whether it is done routinely or not as I'm informing the hospital in writing about the way my son's birth was handled has now left me with a mental illness.

TIA
xx

Whatevva Mon 04-Jan-16 16:28:17

I think I did with the first one - checking tearing. I did get stitched with not enough local anaesthetic - I said 'ow' and the doctor put more in, although it was as prickly as the stitching in the short run.

With the twins, it was just a good look and fee around the entrance as there was just 'grazing'.

I did have an 'external' - where they felt for the second twin,- without telling me - it felt like she was trying to get through the to the underneath of the the bed though my tummy hmm - after injections without telling me, by the registrar who I did not even know was in the room yet (they had missed the birth of DT1).
They were in panic mode and probably felt justified as it was a fast delivery (although we had had the previous 8 months to prepare for this hmm and the hour or so I had been in hospital and the registrar in bed). It is really not a good position to be in, it is deeply unpleasant and I feel for you. No one tells you anything, you don't know what/if anything is going wrong. Their notes sound rubbish. My midwife was not very good at advocating for me which did not help.

It sounds like they were checking you for tears. Some people tear into the muscles around the anus so they should check for this if there is tearing, as it is important.

Whatevva Mon 04-Jan-16 16:32:39

I did get the impression that some sort of an examination was usual as my dippy midwife suddenly remembered she should do it, when I asked for my legs to be taken out of the stirrups (they seemed to be forgetting about this......). I expect how far they go depends on the circumstances.

Crumpet1 Mon 04-Jan-16 18:12:59

I think an internal examination after a tear, but you should definitely have been asked first. I had a finger up the bum twice to check if the tear had affected up there as well but they asked each time.

I'm not surprised you've got ptsd, that sounds awful! I hope you can find a way to come to terms with it.

PotteringAlong Mon 04-Jan-16 18:15:26

I had an internal exam both times and both times had my anus and back passage checked.

FrozenPonds Mon 04-Jan-16 18:17:37

I had a third degree tear, and forceps.

At the six week check and, the GP examined the baby, and asked whether I was OK (I was). No physical exam.

I have had three children since then, each easier than the last. No issues at all.

Buttwing Mon 04-Jan-16 18:27:01

Yes I think it's rountine to check for damage to your cervix. I had it with all four of mine despite I had no external tearing. I only had the finger up the bum with dc4 though and the doctor apologised first but said it was necessary and he was incredibly quick.

CarrotPuff Mon 04-Jan-16 19:43:11

It's appalling they haven't told you what they are doing, I'm so sorry. They shouldn't touch you without your consent.

My MW did warn me and explain what she was doing and why. I also had finger up my bum. It was the most unpleasant part of birth, worse than the delivery itself!

I would complain and ask for debrief, I've heard it could be quite healing experience.

ayria Mon 04-Jan-16 20:02:55

Thank you for all your replies. I am gradually getting there with therapy. I wouldn't have even been able to venture on to the Childbirth section and talk about it before!

I have had a debrief in July and I know now what they didn't explain was done for a reason that I found so relieving. It's just the way they approached what they needed to do and then left me like I didn't matter afterwards with a load of unanswered questions that I feel has effected me more so than the physical birth itself. Although I had a birth plan (which wasn't read anyway) I knew things could go differently and took it all in my stride. It hit me afterwards when I realised I actually had no idea what happened, why or what was done to me then believed there was no reason for them to not follow my birth plan. It also made me angry that they did not even make me aware of or reassure me about my son's condition during labour.

It's their uncaring bedside manner and lack of communication or explanation that I want an answer for now. I want to know if that is their normal practice or if they actually treat women with respect. God forbid you be treated as a human being with feelings during and after having a baby! Short staffed is not good enough. Respect and caring about patents is part of the job. It was pretty much done half-assed really. They go to sleep at night thinking they done a good job. Yes, I'm grateful that my son's heartrate decel was actually acknowledged but it's left me living a debilitated life since.

Dixiechick17 Mon 04-Jan-16 21:27:56

They examined me to check for tearing, and checked internally, I had a small tear which was deep and would have been missed had they not checked. The only time a finger was up my back passage was for a pain relief suppository, I was told it would work quicker than taking one orally and asked if I was happy to have it. I was given gas and air for the examination and stitches, was offered as standard.

Sorry to hear that you had such a bad experience and that it has now resulted in therapy. Hope you get the answers and closure that you need.

Runningupthathill82 Mon 04-Jan-16 22:28:43

Yep, I had an internal - or so I'm told, I was semi-conscious at the time. Forceps birth here.

stairway Mon 04-Jan-16 22:30:51

I wasn't warned about the bum examination either. Fortunately I'd read about it on here beforehand.
Why they don't feel it necessary to communicate with the patient beforehand I don't know. Otherwise mine was a competent Dr but the lack of communication was terrible. She then shoved something like a boulder up there and seemed surprised when I asked what the hell was that.

ayria Mon 04-Jan-16 22:50:01

Thank you. I just can't help thinking had they just told me what they were doing rather than pulling my body apart and letting me wriggle about in pain I would have been fine. I had no problem with the VEs because the midwife told me first.
Initially the trauma was caused from the intervention, then thinking my son wasn't alive without knowing there was concern for him. This part has only been brought up as I started to question them intervening, then I realised they didn't even explain this to me either. So... everything they've done wrong has just been rolled up into a big muddle and exacerbated everything else.

Scattymum101 Mon 04-Jan-16 23:46:03

I'm so sorry you had such a negative experience. It sounds appalling.
With dd1 I had a second degree tear and they stitched me with local anaesthetic and checked to see if the tear had gone through the muscle to my back passage but she asked first.
I never had another internal exam after that, mw just had a look at my stitches the day after then that was it.
With dd2 I only had a graze so no internal at all after her although I think I had the graze checked more as it wasn't stitched so was more vulnerable to infection.

whatsoever Mon 04-Jan-16 23:57:55

I'm pretty sure I will have had the exams you mentioned but I was in theatre, haemorrhaging after a rather traumatic instrumental delivery and I had had a spinal so couldn't feel anything. They told me afterwards (ie that I'd had a bleed which they'd sorted out and also stitched me up).

I would have been as scared and unhappy as you if I could have felt any of that going on but I was blissfully ignorant and pain free.

PouncerDarling Tue 05-Jan-16 11:19:37

My midwife asked if I wanted the bum business. I said that, all things considered, I felt I'd had enough going on in that area for one day. She looked sad and then said that if I didn't want an examination, she had some bum medicine for me. I said that I was capable of putting medicine in my own bum if she popped it on the side for me. She, again, looked very disappointed with me. She told me it would be much easier for her to do it. I explained, politely, that although I appreciated her offer, I really was more comfortable with doing these things for myself.

It left me to summarise that they thought I was a bit weird for not accepting their invitation. I expect it's so routine for them that they forget that other people might not appreciate it.

Sounds horrid, OP. I'm sorry they didn't ask. They should. Then at least you could mull it over.

BillBrysonsBeard Tue 05-Jan-16 18:00:05

Sorry about your bad experience OP, this is the kind of thing I was anxious about because I know I would have freaked out, so requested a c-section. It's awful hearing about uncaring staff at a time when women need the MOST care and understanding. We are at our most fragile. I just don't get it.. Understaffing explains some of it but where is the kindness and empathy?

crappyday Tue 05-Jan-16 18:03:49

I had internal checks with DS 1 both vaginally and rectally. They asked both times and explained why- I'd torn a bit and they wanted to check I'd not torn between one and the other. I couldn't feel any of it (epidural) but they still asked & explained.

ispymincepie Wed 06-Jan-16 11:17:56

Im sorry you felt you weren't kept informed during your delivery and had such a negative experience but it sounds like if you were haemorrhaging and your baby's heart rate had plummeted, a doubly serious obstetric emergency was occurring. I realise this link is rather technical but episiotomy repair is very difficult and is very important that it's done correctly which will involve several vaginal and anal examinations. Perhaps reading up on this might help you feel a bit better about what happened.
emedicine.medscape.com/article/2047173-technique#c1

ayria Wed 06-Jan-16 16:29:27

Does blood loss have anything to do with the baby's heartrate? I was also in the semi-recumbent position for the whole time delivering in hospital which was 2 hours.
I know when I had a debrief that the woman going through it said that blood loss could have been placenta previa but as far as I know there was nothing wrong with the placenta.

I wonder if they do internal examinations if there's been a certain amount of blood loss?

I would have been fine had they told me what they thought, then explained why. I would have been content with them doing what they needed then. But it seems they were just rushing through everything and didn't take the time to explain anything. I didn't get a chance to breath, they did everything straight after one another. I didn't get to hold my son through any of it either. I think I found it more distressing than other women seem to because I wasn't told she was about to it or expecting the pain because I didn't know she was going to pull me open and have a gander inside. I thought she was just going to gently inspect the cut, then stitch it.

I have looked at everything I can to see what they do when repairing tears and episiotomies. I had to for peace of mind so I could understand what they were doing. I have even watched episiotomies being done on Youtube which helped. I know some would find that really weird, but had they explained I don't think I would have needed to do that.
The only reason I know why she checked my backside twice was because I asked my mum on the postnatal ward. First time to check stitches, which I didn't know could happen, then again for the suppository. And it was my mum who told me how to look after stitches as well. I didn't even know what degree an episiotomy was until I went to the doctors after the stitches came apart.

I now know after all this time they didn't do anything physically wrong which I found SUCH a relief, it's unbelievable. It was just being made to feel like I was in one of them Hostel films or something.

ayria Wed 06-Jan-16 16:39:11

BillBryson It's upsetting to hear other women's experiences as well. But in their heads, they see and do it everyday so I guess they lose the sympathy if you've been through it before or not. One of the midwives, who I thought was a midwife at the time because she was wearing the uniform, wasn't even a qualified midwife. I think it's wrong that I was left with someone that doesn't have the experience as a first time mum.

I looked at the NICE guidelines and it states that consent should be obtained, the injuries should be explained then consent should be obtained for the suturing procedure after it has been understood by the mother. I think maybe to prevent things like THIS happening. hmm

Out2pasture Wed 06-Jan-16 17:54:47

Ayria, your blood supply provides oxygenated blood to the placenta and therefore your baby. So your blood loss translates to a loss of oxygen to the baby. The baby needs that oxygen to survive. So your bleeding does affect the babies heart rate.
If you are bleeding profusely you would be positioned with your head as low as possible to try and prevent additional blood loss from the pressure of your body. Sometimes the head of the bed is tipped backwards.
Vaginal and rectal exams following a vaginal delivery is a gold standard requirement following a vaginal delivery. Tears into the rectum or stitching through to the rectum are serious complications.
It's obvious this was an emergency situation, and sounds like all the staff were busy saving your life and your sons.

spaceyboo Wed 06-Jan-16 17:58:46

Relative had a 3rd degree tear and had regular internal and external checks every few days for a month. They told her at the time that follow up depends on the location and severity of the tear & that 3rd degree tears can cause blood poisoning if not checked properly

ayria Wed 06-Jan-16 18:38:29

I don't know when the decel was noticed. They didn't try anything to improve it but then I don't know if they would have even had the time to try different things with no guarantee of it working. But really what I'm talking about is... there were 3 of them. One of them could have spoken to me afterwards and explained things to me. She had time to tell me 'You're getting a bit tight' when I wasn't. She could have told me 'Your baby needs to be born now' and I would have agreed, then questioned afterwards. I just wanted to know if I had been injured unnecessarily or not. Because it seemed like it from my perspective as I didn't know what they did.

I said to the woman doing my debrief the only way I will be able to deal with the panicked and rushed episiotomy being forced upon me was if it potentially saved my son's life. When she said 'Yes' I cried.

Out2pasture Wed 06-Jan-16 19:24:36

Non creepy internet hug.
3 staff in an emergency situation is not a lot.
Where I'm at 3 would be the minimum at a straight forward delivery; dr. tending the delivery, nurse taking vital signs of mom and charting another nurse checking the fetal heart rate preping to care for the baby. Not all staff are equal, your nurse may have been new, the physician present for an emergency delivery may not even specialize in deliveries.
In my life I've called "any dr. to delivery suite A emergency" a few times.....which on one occasion meant an orthopod arrived smile
Emergencies are scary

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