When are internal exams necessary?

[GoooRooo]

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.

Internal exams actually tell you a lot of very important information about how you're progressing and what your baby is up to. Of course it's absolutely your right to refuse an exam, but it's not something midwives just do for the sake of it. You may feel an extremely strong urge to push, but if there is even a tiny rim of cervix left pushing can make your cx swell and not allow your baby to pass through. Allowing an exam will ensure that you're fully dilated before you push so this won't happen. A midwife may also unexpectedly feel an ear (or a foot or a little bum!) which obviously completely changes the situation and how it may progress. It's important to see that you're continually progressing too; a woman may get to 6cm very quickly and then completely cease to dilate any further, for example. That's not something anyone can predict, a midwife can only tell what's happening by feel. It's not safe by any means to assume.
There's lots and lots that an exam will tell you about what is actually going on during labour, just for those people who feel that doing a ve is meaningless and doesn't tell you anything important. If you're unsure if you want a particular exam, then ask your midwife why she is doing it, what she expects to feel, does she have a particular need to do it etc? Make sure that you consenting or not consenting is a fully informed choice.