Quick Q for midwives or women who have given birth?

[HelloMonday]

It's an obscure question, google didnt give an answer. I'll try keep it brief..
During birth, midwife would wipe 'down there' with cold water(?) before every internal exam. My question is why? Cant recall the reason if one was given and only happened once out of three births.
(Someone was discussing birth debrief earlier today, and it reminded me of this, as it's one of the only bits during giving birth that i never really understood.)

Probably because there was some meconium stained liquor (baby had poo’d and it was in the amniotic fluid draining from your vagina), so she will have wiped before doing the vaginal examination.

I am a midwife - never done this.

Sorry pressed too soon. If I have wiped then I use warm/body temp water x

@Zebraantelopegiraffe I’ve only seen it done when there’s MEC, seems to be preference over anything else.

Nope another midwife who doesn’t do that either!

However when inserting a catheter we do a quick wipe down and clean the area, it can be a little erm “stringy” down there!

I'm a midwife. Internal exams slightly increase your chance of getting an infection - no matter how clean we try to be we can never make it a completely sterile procedure. She was probably just trying to make it as clean as possible to minimise the risk, and the water probably felt cold because she likely used a little packet of sterile water (stored at room temp, which would have felt cold compared to your skin) to wet the cloth, rather than warm tap water. I haven't seen many midwives do this - I think the prevailing school of thought is that anything that's on your vulva (often there's some mucous, blood, discharge, amniotic fluid etc) has come from inside your vagina anyway, so it's not introducing any new/foreign bacteria to just leave it there. Exceptions to this might be if the baby has passed meconium, as a PP mentioned, or if you've opened your bowels, or they already suspect you have an infection (e.g. you have a temperature - might indicate that the bacteria brewing down there isn't healthy). Or it might just be a different method she had - maybe that particular MW does it routinely for everyone because she feels it's cleaner.

I’m not sure, I’ve also never done this, but there is variation between hospitals/trusts as to how sterile an internal examination should be. I’ve worked in hospitals where you just wore normal disposable gloves to do an internal exam, but in others I’ve had to wear sterile gloves. Perhaps in that hospital they go one step further and require you to wipe down the vulva before doing the exam?

(Disclaimer: I’m not a midwife)

Crossposted with Gilliganskitchenisland there. I obviously type slowly but she’s explained it far better than me!

I do remember when training (back some 10 years ago) that some of my older mentors did it - I think it's a bit old school - one used to wipe down with hibiclens

@Zebraantelopegiraffe i don't mind that it was cold tbh, it's more that i didnt recall why wiping was needed. She did it every single time she examined, i think. Don't think I'd be less confused/curious if she'd used warm instead tho lol

I'm a midwife and if membranes are intact I don't wipe down if membranes have ruptured I do wipe down with warm water to try to prevent introducing any bacteria into vaginal tract. I always examine with sterile gloves though better fit on hand and haven't fallen on floor and been shoved back in box for others to use. Only use unsterile gloves for handling soiled linen cleaning equipment.

@Thedogscollar ....perhaps you were my midwife, hehe

Very intetesting info, and does explain it.
Thank you all for the replies & answers :)

Oh God yeah always sterile gloves.

Im a student midwife and my trust absolutely insist on wiping as an infection prevention method (yes we are aware this is a bit silly but do as we're told - always gain consent etc) and always sterile gloves, membranes intact or not. Only use sterile water if membranes have broken otherwise I always make sure it's warm

They said I probably did had PROM, (leaking for 36hrs at 40w+3, rather than a gushing break of waters). So perhaps it was sterile water and room temp/cold, as membranes not intact.
She did ask consent to examine each time and said she was doing a quick wipe. But never why wiping was needed.
I had a baby at the same trust a year later, no wiping occurred, but I'd put on my notes I'd like to have as few internal checks as possible (perhaps subconciuosly to avoid all this).

Funny this has put my mind at ease, thank you.
Was an odd lingering question, that I kind of felt silly to ask. I've had 3 easy births, praise God, and this is so minor a niggling question.

Why did it bother you?

And remain on your mind a year later?

Gloves, they used non-sterile.
Sterile does make more sense tho!

Seem odd wiping down to prevent infection, then using none sterile gloves, especially with PROM.

@LaMarschallin
Why did it bother you?
And remain on your mind a year later?

Because it never occured before. Only happened during that birthing experience (my second). Didnt happen again the next time.
I really wasnt sure why it was needed.
Not particularly comfortable.
We only wipe things that are dirty, generally in life. Idkw, just always bugged me but these answers made sense of it :)
The belly strap for monitoring, bothered me too, so asked not to have that either, a year later.