Manual dilation?

[Beckamaw]

Hi,
This question is nearly 10 years old and I figured that maybe someone else has experienced the same?
Background - I am 35 weeks with DD3. First was a very traumatic instrumental birth due to foetal distress - baby stuck in pelvis. Failed venthouse, front to back episiotomy, successful forceps delivery. Just horrible. DD2 was a requested homebirth but ended up with induction, pushed for 2 hrs, baby stuck in pelvis, EMCS. The experience was beautiful compared to first. For 3rd delivery I am begging for an ELCS, hospital like the idea of VBAC. I do not.
Back to the point. During first labour I was given pethidine. Liked it but I stopped dilating at 4 . As pethidine wore off and foetal distress noted, the registrar said he would 'get me dilated so I could have this baby'. He inserted his hand into me and used a fist to dilate my cervix. I have never felt pain like it. And to be honest I felt bloody violated. When he withdrew his hand he advised 'You are now 9 cms. Would you like to push?'
I didn't want to push. No desire whatsoever. So they gave me a spinal, had me sign a consent form for whatever was necessary and pulled out my daughter.

I look back to that with horror. Cannot ever get my head around it. I assumed it was normal, but it isn't, is it?

I really need to discuss this with my consultant but I am concerned that I will go into meltdown. I want them to give me a section but don't know how to talk about this.

Anybody else been there?

Also just read the article - most mothers were not warned and were led only to expect a simple vaginal examination - also refers to highly hysterical mothers.

That actually made me feel sick.

revoltingpeasant I apologise but that para needs quoting exactly to really get the full idea of what it says and so no one thinks you are paraphrasing.

Tolerance and pain
Successful digital dilatation calls for co-operation and tolerance, and most mothers were remarkably tolerant. None was told in advance to expect increased discomfort, nor were they led to expect more than a simple vaginal examination. Pethidineor Pethilorfan' (50.100mg), Entonox', nitrousoxideandair, or * Trilene', provided satisfactory analgesia, but many mothers received none at all. Occasionally one encounters highly hysterical mothers, apparently petrified even of a vaginal examination; they require a combination of inhaled and injected analgesics, and sometimes limitation of digital dilatation to two or three contractions at a session.

The word 'consent' jumps out at me here.

The more I read, the more I wonder why I was ever encouraged to write a birth plan.
I appreciate that the primary objective is to deliver healthy babies and reduce mortality rates, as it should be. I'm not sure that these health professionals have the vaguest idea of how traumatic this procedure can be. I had no pain relief and gave no consent. I remember thinking afterwards that it would probably be less painful to have your leg removed with a hacksaw.

Having read that, it seems that it is entirely possible, and absolutely fucking horrific. 'Labour saving' for who exactly.

The only saving grace is that article is now so old that it's no longer standard practice, but that some consultants don't seem to realise that it isn't how things should be done and certainly not without informed consent.

I don't think I was being misleading youareallwrong

But yes, informed consent seems to been rather - er- missing!!

I think the article actually is a bit reassuring in way because it also positions itself as different from the norm and says sth about most gynaes not doing this. And it's now very old.

But not old enough but that some people who trained under the guy who wrote will still be practising....

Becks out of interest, did he apologise or anything? Did you say anything?

That article came across as written by a misogynistic woman hater. "Hysterical" indeed, it made me feel sick.

I saw a doctor do this as a student midwife some 20 odd years ago, I objected and was sent out but could not stand by silently while the mother was so distressed by the doctor's actions.

It's horrible and there is just no need for it, I cannot see how they do not risk tearing the cervix by this action.

The doctor in question had not trained in the UK and I do wonder if it was just commonplace in his previous European country. Many European doctors use American Obstetric textbooks and these are much more intervention based than the UK ones.

Someone was on a thread about having a sweep earlier today, and described something not dissimilar to manual dilation. Apparently her cervix was not even 1cm dilated all the way through so the doctor did it in three stages - got a finger through the cervix in the first stage (which I'm assuming would take a bit of force), then stretched until he/she could admit two, and then the third stage was the normal sweep. She said that the doctor seemed disappointed that she didn't cry and said that the poster would definitely need to hold someone's hand to squeeze it during the procedure.

That to me does not sound like the way to do a sweep and I was fucking appalled by the description.

I'm afraid I can well believe this may happen on occasions - I know a woman who consented to a VE to see how dilated she was, the obstetrician then performed a sweep, telling the woman as she did so that she was "getting the labour going for you" - the woman had not, and would have not consented to a sweep. She complained, had a meeting at the hospital then received a letter denying that a sweep had happened at all and that the VE was to determine the way her baby was lying. However, at a labour ward meeting I was told by a consultant that she frequently obtained consent for a VE but would then carry out a sweep "whilst I have my hand up there" rather then stop the VE, seek consent, then carry out a sweep - at this point all the midwives at the meeting buried their heads in their hands and a senior midwife pointed out to the consultant that what she was doing is technically assault.

I was given a sweep at 40 weeks without being informed it was anything other than a standard VE. I drove home in tears bleeding onto a big sanitary towel they gave me.

I also had a sweep without consent when I went in for suspected SRM.

When I left the hospital I swore I was never going back ever.

Cervix are you not a midwife??? did you not say anything?

No, not a midwife. I'm ashamed that I was more apologetic to the doctor as I was embarrassed that I made a fuss during it.

Sorry mixing you up with someone else I'm really sorry for what happened to you

Oh don't worry, there are a few cervixes on here so probably another one is :) Was somewhat traumatized but could have been worse and wouldn't let it happen again. You live and learn!