Do you have to have internals when in labour?

[milkybarkid]

Hi, I am currently pregnant and have a baby due very soon. I am worried about labour, but not for the same reason most people are. I am dreading having internal examinations. Are they essential when in labour? I know that its important not to start pushing until you're fully dilated and they can tell by an internal if you are dilated or not but I would really like to avoid them if at all possible.

milkybarkid - I don't think you let down the baby at all. Quite the opposite. I think you were brave and good to turn what was awful to you into such a wonderful gift for someone else.

If you are brave enough to tell the MW why you want to avoid a VE then you might find the whole birth a lot easier as she would be much more understanding and you wouldn't have the fear of the VE hanging over you.

Best of luck and lots of hugs.

Thank you so much everyone for your kind and thoughtful replies. They have really helped me feel better about myself. Would be interested to hear what any midwives out there think about the internals

Milkybarkid - can I reassure you that you will not be judged by anyone regarding your first baby. You have shown real courage in going through with a pregnancy and giving another woman the gift of a child. You have not let that child down - you made a very difficult choice by putting the child's interests first.

The issue here is not really about internals but an unresolved issue you have had to deal with. You should not feel in the least bit ashamed of what happened before and to me it is important that your midwife is aware of your history to help you through this next delivery. You may well have to deal with all sorts of unexpected emotions as delivery approaches. You may well have flashbacks to the rape itself as well as the delivery. Your midwife will be able to refer you to someone for counselling to help you with theses issues if they arise. It would be far better for you to be able to discuss what has happened openly with her so you do not have the added worry of being 'found out'.

It is important to know when a woman has had a baby before because it is then helpful if the current labour runs into problems. To know that someone has managed to deliver vaginally in the past can influence the management of labour.
For example, if I am looking after someone who has had a baby before and the progress of labour is slow second time around, it is unlikely that she will be started on a drip to speed things up (syntocinon). A woman who has laboured before should not need syntocinon if she goes into labour on her own. If she is not progessing on her own it could mean that the baby is not able to be delivered vaginally. Starting syntocinon could be detrimental to the mother and baby by making an obstructed labour worse and can lead to a ruptured uterus. I am not meaning to frighten you but there are many reasons why it is important to know that a woman has had a baby before. I would really urge you to speak to your midwife.

On the subject of internals, there is no doubt that far too many are performed. Unfortunately I think many women come to hospital wanting to know how they are doing. The only reliable way to know the stage of labour is by doing an internal. As said before though, if the woman is not as far on as she thought then it can be a huge disappointment to find you are 'only' 2 cm dilated. The best way to avoid internals is to stay away from the hospital as long as possible where your pregancy has been straightforward and the baby is moving about. It saddens me the number of women who present themselves in the very early stages and end up with loads of internals before they even get into proper labour. That is often because they think they are in labour when they are not. You can get a lot of painful contractions which are very short lasting but are also irregular. Instead of being reassured that this can be the normal start to labour, he pressure is then on the doctors/midwives to do something then the next thing you know, labour is being induced.
I think that midwives need to stop doing internals the minute the woman arrives at the hopital and equally I think women need to stop expecting them.

Bravo Mears... thought about publishing this in Midirs

milkybarkid, I just wanted to say how sorry I am for the awful time you've had and I agree with aloha, mears and pupuce, please don't feel guilty or ashamed. My midwife refused to examine me when I wanted to know if I was dilated enough to get in the pool as she said she could tell just from looking at me that I was. I hope you find a midwife you like and are able to confide in her. Good luck.

thanks to everyone for their kind and sensitive replies. My waters have broken so I am really nervous again now and still dont know what to do if they want to examine me internally.

Mears, what can they tell from an internal, cos if they can tell I've had a baby before I would rather tell them myself before they examine me.

milkybarkid, even if they can't tell you've had one before, I agree with mears that you should tell them about the previous birth because it will influence how they assess what's going on in this labour. please don't worry about telling them, I'm sure they've seen/heard everything.
and good luck! - tell them you're scared and I'm sure they'll do their best to support you

Good luck, milkybarkid!

Milkybarkid - I know you're anxious about the examination (if you need one), but this is an exciting time too.

Good luck!! You will see your little one soon and for a while your troubles will just melt away.

Look forward to hearing your birth announcement.

MBK this is the first time I've posted on here - good luck! Good Luck!!

Milkybar kid - it can be possible to tell that you have had a baby before because of the external appearance of the vagina before you even get an internal. The shape is different and if you had stitches before you can see scarring. The cervix never closes completely after you have had a baby so the diagnosis of labour may be incorrect when you get examines. The cervix is different when you have your first baby but when you are in active labour it may not possible to tell once the cervix is effaced (thin) and dilated more than 3-4 cm. However, the baby's head is usually further down with a first baby than it is with a second.
I really urge you to tell your midwife that you have had a baby before. It is really important to have that information. You will probably feel a sense of relief once you have done that. She is there to help you. Hope all goes well for you, mears.

Good luck, MilkyBarKid!

Message withdrawn

Good luck Milkybarkid.
Please do tell the midwife - it will help her to help you with this birth. I'm sure she will judge you when she hears your story - as a wonderfully brave caring person who took an incredibly difficult decision.

Good luck, Milkybarkid, I hope your labour starts easily and goes well. You're a wonderful woman, whatever you decide.

Just wanted to echo everything which has been said and send you (((hugs))). Good luck, I hope everything goes well for you, and look forward to seeing a birth announcement soon. Best wishes Axxx

Yes, your midwife will be able to tell that you have had a baby before, but this is confidential information. I had an abortion I didn't want family knowing about (should they somehow glance through my notes, my mum is a nurse so it was a situation I could envisage). I told one of my midwives at an antenatal appointment and she put it in my notes under a special 'code', just a couple of numbers that only the medical staff would understand.

My own experience of internals went from one extreme to the other. I had one midwife, early in labour, insisting she had to examine me to check my progress. Usually when I was in the middle of a sequence of contractions. I refused until I was ready and comfortable; a few minutes isn't going to make any difference. At times I was actually glad to be examined because it 'proved' to me the pains were getting me somewhere!

In the labour room I was adamant I couldn't face an internal, mainly because I'd found a comfy position to labour in and wouldn't be moved into another position simply for the midwife's benefit. However, she was fantastic. We were talking afterwards and I asked how she knew I was ready to push without examining me, and she said she'd recently done a course that taught how to recognise external signs of progress in labour: with me one of the signs she saw was a dark line that appears between the buttocks, and a bump at the tail of my spine as the baby moved down. So there are ways and means.

Remember that YOU are in control of YOUR labour. Midwives are there to support and assist. Good luck!

My midwife also used the dark line test as I birthed in a pool. When she did have to do an internal at the pushing stage she got a very wet t-shirt, so I guess it was necessary, can't think she would want to go around for the rest of the day drying out on a whim.

Well, i've finally plucked up the courage to post again. I was too embarassed to because I didnt want to admit this, but my waters hadnt broken at all. I feel so stupid for thinking they had, but I must have just wet myself! How embarassing! I cant believe it.

I did have an internal but now its put me off internals even more. It was really painful because I tensed up thinking of the man who raped me and because I felt so embarassed from being told my waters hadnt broken after all. So, I'm still pregnant at the moment.

Thanks for all your support. I'll keep you all informed of any further developments

Don't be embarrassed! You haven't done anything wrong. I do think you should think seriously about telling someone you trust at the hospital about your situation. Good luck.

Milkybarkid - Don't feel embarassed. I think if every MN'er paid £1 every time they had a false alarm, Mumsnet would never have to worry about subscriptions again. Internals are awful at the best of times so you were very brave to undergo this one. Good luck. xxx

I agree with the internal thing not always be right or essential.When i went into the labour ward to have my first baby the midwife took one look at me offered me the bed and the gas and air knowing i was fully into labour without examining me.When i had my third my waters brooke at about 2:15am and i went to the hospital at about 3:30,the midwife examined me and i was left to labour,at about 6:45 i became extremely anxious and unable to cope,becoming very agitated and shoutingetc(not like me before with my nice controlled breathing and all that)anyway the midwife examined me at 6:55 said i was only 5cm and offered me a diamorph injection which i took thinking my god still 5 cm to go. She gave me the injection at 7am and my daughter was lying on the bed at 7:04am.My point here is that looking back my lose of control indicated the transition stage of labour but the midwife failed to notice that and went on what my VE said,so i had an injection i really didnt need and was totally out my face for my dd first few hours not even being able to focus on her.
I too was abused as a teenager though not to the degree of actual rape and i put on my birth plan and had my midwife write in on my notes that under no circumstance was i to be even looked at by a male doc/mw etc and no students either.

milkybarkid, please dont feel embarsased, have you seen my thread, i didnt know whether my waters had gone or not either and still dont! well done for plucking up the courage to have an internal and so sorry to hear what youve been through. best of luck