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Childbirth

Share experiences and get support around labour, birth and recovery.

Original poster

When are internal exams necessary?

26 replies

GoooRooo · 17/02/2015 09:06

During childbirth with my DS I coped with the contractions fine, but I found the internal examinations absolutely excrutiating and sobbed my way through them. My waters went and because of no progress after 24 hours I was induced, and checked internally A LOT. In the end, I asked for an epidural - not because of the labour but because I just couldn't cope with the internal exams any more. In the end I only had one more internal after the epidural - which didn't work that well, it only worked down one side and I had WEEKS of having a numb bottom before it wore off. I really regret the epidural and don't want another one this time.

I have since learnt that I am within my rights to refusal an internal exam, but obviously I don't want to put the baby at risk.

So what I'm trying to get out is how often are internal exams actually necessary? Is there any other way to tell how dilated I am?

Ideally I would labour at home and only go to hospital when I felt I couldn't manage the contractions myself and deliver there, but I am resigning myself to the idea that I might have another waters breaking and no progress situation, in which case I'll end up induced and in hospital for the duration of the labour.

OP posts:
Beesandbutterflies · 17/02/2015 10:06

Hi, I didn't have any internal exams during labour at all. I agreed this with supervisor of midwives in advance, she was fine about it, obviously I said if there was a concern about the baby then I would have consented. I had a lovely home birth with a doula as well. When the mw came she wanted to do one and my husband just said no and that was that. X

Beesandbutterflies · 17/02/2015 10:08

I will add you have to be very specific as the mw did do one after the birth which I wasn't happy about, I didn't get the opportunity to refuse Hmm

My pg again now and the mw has suggested I have a sign on the door this time! I'll have hubby and doula again so that won't be happening and i think that was down to a particularly crap mw tbh

Petallic · 17/02/2015 10:12

Did you have the pessaries as part of induction? I was told during my induction that the hormones in them can make internals more painful (mine were definitely painful after 24 hrs) and was offered g&a. Not trying to convince you to have internals but might be helpful to know if at some stage you think you might need/want one.

Original poster
GoooRooo · 17/02/2015 10:20

I had a pessary but it didn't do anything and then I was put on the drip which kept getting cranked up. My waters went 3am Monday morning. I had the pessary at 9am Tuesday morning and the drip later that day. I gave birth 9pm Wednesday night so it was a long, long process.

I can't use G&A - it makes me vomit unfortunately which is why I opted for the epidural.

Beesandbutterflies that's interesting to know, thanks very much for sharing your experience. I have my booking in appointment this week and I am going to raise it then I think as it's playing on my mind a lot.

OP posts:
Beesandbutterflies · 17/02/2015 10:29

Good luck OP and stick to your guns. I think it's very common for women opting for home births to say no internals and the mws are used to that and use different means of assessing how far you are but I think hospital mws are a different breed so be very clear and have an advocate SmileSmile xx

Ps for me as long as the baby was okay and I felt like things were peogressing I had no interest whatsoever in how many cms, it's totally meaningless because it can change slowly or very quickly and the mws can't predict that

FromagePlease · 19/02/2015 11:33

I'm sure that, as other posters have said, you can refuse if you wish.

My waters also went unexpectedly, and I had two internals in the whole process. The first was a check after my waters went, this wasn't painful, just a little uncomfortable. The next was when I arrived back at the hospital 6cm dilated. This was painful but ok, but my midwife was lovely and tbh I was probably in a panic at this stage which didn't help.

I then had a water-birth, so no internals at all until the baby was born. Afterwards however the whole world seemed to be up there due to an unusual tear I sustained.

I guess what I'm saying is that you can have a hospital delivery and it doesn't have to involve lots of internals. My midwives didn't want to give me any extra ones, even when I asked as I wanted to know what progress I was making.

Good luck, I hope that all goes well.

GotToBeInItToWinIt · 19/02/2015 12:12

I absolutely hated the internals too and plan to refuse this time unless absolutely necessary. My only worry is that I laboured pretty much silently last time so I'm worried that when I arrive at hospital they will think I'm not in established labour and will send me home if I don't have an internal to see how dilated I am.

Beesandbutterflies · 19/02/2015 12:14

Gottobe plan a lovely home birth instead SmileSmileSmile

seaoflove · 19/02/2015 12:14

I had one, when I arrived in labour, to see how dialated I was. After that, I wasn't checked at all.

This was a midwife led unit though, and they tend to be much more hands off.

Original poster
GoooRooo · 19/02/2015 12:15

I discovered yesterday at a scan that I have a tilted womb (how was this not discovered in my previous pregnancy?!) and the sonographer said this can sometimes makes smears (which I also find very painful) and internals more than uncomfortable so at least I know I'm not just making it up in my head!

I was a quiet labourer too GotToBe. At one point apparently I said "I'm not terribly impressed with this pain you know", while the lady in the next room was screaming "fuuuuuuuuuuuuck". The midwife burst out laughing!

OP posts:
ItsAllGoingToBeFine · 19/02/2015 12:17

Be aware that if you refuse internals you may then be considered a high risk pregnancy and certain options may be denied to you.

I had a water birth in hospital, and I pretty much wasn't allowed in the pool unless I had an internal. That was the only one though until the massive stitching operation afterwards

GotToBeInItToWinIt · 19/02/2015 12:17

Gooo I have a tilted womb too!

GotToBeInItToWinIt · 19/02/2015 12:17

I'm considering it Bees Smile

GotToBeInItToWinIt · 19/02/2015 12:18

Gooo the only time I got remotely vocal in labour was during an internal when I said 'that really hurts you know' Smile

Beesandbutterflies · 19/02/2015 12:20

That's absolutely shocking it'sallgoingtobe Tbh I think that's pretty much assault and refusing you pain relief

Beesandbutterflies · 19/02/2015 12:21

Seriously can not recommend my amazing home birth enough, I think you all sound quite calm women and similarly I was very calm and quiet although I did tell my dh during transition that it was a good job I was doing this (labour/birth) because he definitely wouldn't cope! Lol

Original poster
GoooRooo · 19/02/2015 12:26

I'm considered high risk anyway - high BMI and over 40 - so can't have a home birth or water birth. I don't actually mind giving birth in hospital on a bed as long as anyone doesn't fiddle with me unecessarily!

OP posts:
Beesandbutterflies · 19/02/2015 12:28

I think agree a plan in advance then and make sure everyone knows about SmileSmile xx

PenguinsandtheTantrumofDoom · 19/02/2015 16:41

Actually you can have a homebirth regardless, but if you're happy to take their advice to birth in hospital, obviously that's great...

I requested no internals with DS. The mw was fine with it. An internal tells you very little about the labour or its progress. Knowing how dilated you are at 10am tells you nothing about how dilated you'll be at 10.05am. It's just a series of data points on a chart.

Are you happy for them to touch you externally? My brilliant home birth mw stood behind me during a contraction or two and put her hands on my bump and then on my thighs (I was kind of braced in a semi squat) and said 'yup, happy you're in established labour'.

I said I would be happy to have an internal if there were direct concerns for my safety or my baby's. Otherwise, not unless I felt it would be helpful myself.

BeatriceBumble · 19/02/2015 17:52

You can refuse internal exams. It's assault if one is carried out without your consent. These exams do not benefit the labouring woman. It's a diagnostic tool for the HCP.

Any MW worth her/his salt knows when a woman is in established labour. You may have your baby anywhere that suits you. MW may offer advice. You don't have to take it. You are in charge of your body.

Original poster
GoooRooo · 19/02/2015 17:56

Yes very happy for them to touch me externally. I wouldn't have a home birth even if the midwives were happy for me to have one - I live 40 minutes from the nearest hospital and I'm too worried things would go wrong and I'd have to transfer so I'm happy to go to the hospital to deliver.

This has all been really informative and really put my mind at rest, thanks very much everyone Smile

OP posts:
usernamefeefifoe · 20/02/2015 08:08

If you get the Aim I Allowed book by AIMS, it tells you what you can refuse in a very factual way. It is a book on your rights. Very useful and informative in a non biased way. I too am wanting to state no internals as I hate the thought of them.

RoseOolong · 26/03/2015 00:09

I will state no internals unless suspected risk to baby this time, which will be second home birth. I refused once far along last time but hated them earlier on.

Allisgood1 · 26/03/2015 00:35

I only had an internal exam when necessary.

1: when I arrived at hospital and sent to triage to see how dialated I was

2: to put a probe on baby's head as his heart rate was not right

3: when I suddenly pushed to see where the baby was.

Roseybee10 · 26/03/2015 06:03

I had 3 internals I think with my first and hated them. The first was ok but once I was in established labour I couldn't cope with them.

With my second last month I had a home birth. I consented to one when a MW came out to see how things were going and she gave me a sweep at same time (was 2-3cm). Was glad she did as it got my waters to go not long after she left and cranked things up so much that I had to call her back an hour later. When they arrived I was already in pool and pushing and they were trying to demand I got out the pool to examine me. I believe I told them to 'fuck off' as I could feel her crowning but couldn't tell them that's what was happening coz I was concentrating so much lol.
So I only had one in early labour and it was find.
Good luck x