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Childbirth

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

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Original poster

Did you know you don't have to have VE's in labour?

248 replies

TheMule · 20/04/2015 21:48

Hi all. I've actually posted a media request too as I'm writing an article about consent in childbirth. I'm not getting much response so I hope you don't mind my asking here too. I'm just curious to know how many women are aware that they don't HAVE to have procedures such as vaginal exams in labour to check dilation - unless of course they want to. I often hear women express surprise when they are told that they are not compulsory. So I'd love to hear your thoughts or experiences on this or any other issue related to freedom or consent. eg if you did not know that you could decline, if you tried to decline but met resistance, or if you declined and wished you hadn't! Thanks for your thoughts everyone, I realise this is a sensitive topic. I'm writing for the Telegraph online. I'm Milli and I write about birth and run an organisation called The Positive Birth Movement. Email me if you don't want to comment [email protected]. Best wishes, Milli x

OP posts:

Toothfairy7 · 22/04/2015 09:03

rose this is also a good pointer... I can see benefit of this too.... I think it's good just to know where you stand and options ... But definitely I can see how this can help... Progress and how to cope through a bit longer

HarimadSol · 22/04/2015 09:38

When I arrived at the hospital and said I'd rather not have them, the choices given were 1) have the VE or 2) turn around and go home - a 45 minute drive each way. So I had them.

The VEs didn't give helpful information to my MW, either. When I requested pain relief, I was at 3cm, so she said I could only have pethidene. I expressed concern about the baby being born with it in the system, but she said that as it was my first, I was hours away from the baby being born. An hour later, I was pushing. DD was born with pethidene in her system and I would guess that's why she seemed very sleepy and was very slow to breastfeed.

Other than that, it all went fine! But next time, if there is one, I have a different plan.

NeedABumChange, I guess I technically didn't HAVE to give birth in a hospital, but as I have fibroids, my chances of PPH were significantly higher than normal. I didn't feel like taking that sort of chance.

Springtimemama · 22/04/2015 09:43

This reply has been deleted

Message withdrawn at poster's request.

NotCitrus · 22/04/2015 10:09

Unlike other medical treatment, when giving birth there's always that subtext of "this is the policy that should result in a live baby and refusing exams may put your baby at risk". And no-one can tell how true that might be during any given birth.

My birth plan said no-one was allowed to touch me at all without my explicit consent (or DP's consent if I was incapable). Which worked very well if a bit tedious when taking blood pressure hourly over 30 hours - I had I think 2 VEs with ds in order to tell what was going on when nothing appeared to be happening, and only one with dd which was after an epidural. No complaints about treatment, but I think making it clear that any finger on me needed consent every time helped ensure my agreement was never taken for granted for what might be seen as sensible or routine.

Sparklingbrook · 22/04/2015 10:16

Having DC2 was easier WRT what I did and didn't want, knowing what DC1's birth was like 2 years previously.
But he arrived in 35 minutes and there was no time for anything at all in the end.

I said I wanted to push but was told I didn't. He was very nearly a car park baby.

HexagonAlley · 22/04/2015 10:40

Hi toothfairy. Always good to know there's others like me around. I have always been made to feel as though I have a mental illness when it comes to my vaginismus. Lots of nurses doctors and mw doing the head tilt and telling me it's all in my head

Toothfairy7 · 22/04/2015 11:15

Me too hexagonalley .. I never judge someone with something unless I know what it's like myself! I wish I didn't have vaginismus and it was just perhaps a little uncomfortable or whatever but it really does hurt :(

lunalovegood84 · 22/04/2015 16:34

I didn't decline VEs in labour and probably wouldn't if I felt there was a valid reason for performing one (did decline all offers of a sweep pre-labour and also declined forceps so am well experienced in declining things!). I'm just wondering though - for those of you who decline VEs in labour, what happens afterwards to assess tearing and repair if applicable?

Springtimemama · 22/04/2015 16:48

This reply has been deleted

Message withdrawn at poster's request.

Sparklingbrook · 22/04/2015 16:52

I found 'being repaired' way more invasive than a VE.

StarlightMcKenzee · 22/04/2015 16:52

My reason for refusing was to do with not wanting interference during labour to trigger negatively for the outcome for my babies.

Once they were safely born I didn't mind being inspected.

Birth 3 was the best because though birth 2 I had insisted no-one touch me, the midwife grew concerned that my moving from keeling to one foot on ground would risk baby being born out of water and do pushed me down.

My natural instinct to move in that way was to make space for the superman arm that was coming which subsequently tore me because I wasn't in the position I was trying to get in,

No 3. I had a homebirth with a strategically placed pool which meant no-one could reach me.

Springtimemama · 22/04/2015 17:19

This reply has been deleted

Message withdrawn at poster's request.

MrsPeabody · 22/04/2015 17:28

I had no problem with VE being carried out as needed (requested?). My only problem was on being admitted to the labour ward. The midwife said she was going to check my progress. I was then doubled over in agony. On my mutterings on why they had intensified I got a curt reply that it was due to her giving me a good sweep. This was not agreed to and as my labour was progressing very fast anyway I was very unhappy about this violation.

BeckieTM · 22/04/2015 18:46

BeatriceBumble I am very sorry that you feel this way and that you have been subjected to this but please do not assume all doctors and midwives are the same. My only agenda is to do my best for the woman and her family under my care. I (and the majority of my colleagues) will ask for informed consent. That means we sometimes have to explain the pros and cons of a procedure under difficult circumstances when a woman may not be able to give her full attention. It's is a very grey area when caring for women in labour. A woman may state in her birth plan "no this or that" but if there is a concern then we have to be sure she understands the potential risks to declining that procedure. A VE is not just an assessment of cervical dilatation, we can assess cervical abnormalities, position of the baby, as well as changes to the cervix other than purely the dilation. There are plenty of other ways to assess progress but if there are other factors (infection, fetal distress, opioid or epidural analgesia, BP problems etc) then these can be masked or difficult to interpret. Rather than insisting on NO VE's I would suggest you ensure you know exactly what they are looking for and the reason why and what the results will mean. Ask your birth partner to ask these questions if you are unable to. Any care giver worth their salt will be able to answer you appropriately and if they can't, then refuse.

carrierpenguin · 22/04/2015 18:56

I was not allowed pain relief until I had a VE, so technically you can decline but unless you're happy to labour om paracetamol alone, you have to allow VE. It is a disgrace.

lizanne135 · 22/04/2015 18:56

BeckieTM or any other midwives reading this thread. Hi, as a first time mum due in two weeks, I am aware of the consent needed for procedures. I have my personal reasons for not wanting a VE if at all possible, but I am interested if you could detail the other methods of assessing progress? Especially when you first arrive?

I'd like to be forwarned with as much possible for my husband and I. Luckily, according to my antenatal classes the MLU where I should hopefully give birth do not seemingly do them as routine, and so I hope there will be no issues with being refused pain relief if I feel the need for it.
Thanks.

PenguinsandtheTantrumofDoom · 22/04/2015 19:00

Regarding examination after delivery, I agree with a lot of what has been said. I didn't refuse all internals, but I didn't have any in labours 2 or 3. I had been clear I would only agree in situations of direct concern where the HCP felt that there was specific knowledge to be gained. For me:

being on my back was agony during labour, I was only going to do it for a good reason, not because it had been four hours since they last did. That didn't apply for post-labour exams and stitches;

I am someone who needs to go into myself and 'far away' to labour. Internals take me out of that, so negatively impact on my labour. Every time I had an internal in my first labour, my contractions became more erratic. That didn't apply post labour;

There is reason to believe I labour in a fairly non-linear fashion, so I didn't feel that much useful information would be gathered. Examining me for stitches was very much useful information!

-Being examined for stitches didn't put me on a treadmill of timeline expectations.

Most of the pain comes from them touching my cervix, which they don't need to do for stitches.

My third labour was also my best. My amazing community mw trusted me and my body. Including when I was squirming around in the birth pool during pushing and getting into positions which actively inhibited it. I think, in my first (hospital) birth I would have been told off for fighting against the pushing. That time, my MW had the wisdom to realise that my body was telling me there was a problem and how to fix it (I lose all ability to speak in established labour, so I couldn't have explained that to her at the time. I literally cannot string words together. The couple of times I tried, nonsense came out)

ItsAllGoingToBeFine · 22/04/2015 19:02

Yes I knew. But they wouldn't let me into labour room/birthing pool without one.

Sparklingbrook · 22/04/2015 19:03

The sensation of the stitching and having a stranger's face that close to my nethers made me feel very uncomfortable and exposed.

They took the end of the bed off and sat on a stool peering at it all and I just wanted it to be over.

I never thought to ask if the stitching was necessary either time.

StarlightMcKenzee · 22/04/2015 19:06

'but I am interested if you could detail the other methods of assessing progress'

If a midwife spends long enough with a woman, then there are subtle changes in her behaviour. But as all women are different you cannot tell by just popping in once every 4 hours.

Personally, I think asking the woman is vastly underestimated and underused. Admittedly by birth 3 I knew my body, what was happening etc. in fine detail but nothing I knew then could have not been known in the first birth, or expressed if I'd been asked the right questions.

In fact, in my first birth I was TRYING to tell the midwives things but anything I said was dismissed as they manhandled me onto the bed. Had they listened, the birth would have been smoother. My body was telling me what to do and I was 'trying' to tell THEM.

eurochick · 22/04/2015 19:09

Yes, I knew but after four rounds of ivf and 2 iuis I was fairly blasé about them. As it was, it was academic as my home water birth turned into a planned CS at 34 weeks due to IUGR.

However I have declined other medical procedures in the past that were supposedly standard but I just couldn't see how they benefitted me or my care.

StarlightMcKenzee · 22/04/2015 19:10

Penguin, I put in my birth plan and TOLD the midwives that I'd be pushing out the head in a squat, (so if they want to see that bit they'll need to be behind me) but that once the head is out I'll sit back and the baby will be delivered in front of me (so if they want to see THAT bit they'll have to come around the other side).

The didn't listen, both births when I did that and completely missed the baby actually being born, which was nice actually because it was a private moment for me and baby as I picked each one out of the water and untangled their cords. Everyone was behind me wondering how I could move so fast........lol.

lizanne135 · 22/04/2015 19:15

Thanks Starlight I do feel that as a 'first timer' we are expected to just go along with the perceived norm and not question things as 'we don't know what it's like'. That's my impression I have been given again and again throughout my pregnancy, but it is in my nature to know as much as possible about a situation before I enter it. My philosophy is they know more about medical care than I do, but I know my body and reactions better than them and my gut has proven me right every time I've had an issue in pregnancy.

Again, I have been told that in the NHS MLU I should be in, we have one attending midwife, and she is 'mine' (till a shift change!) and is caring solely for me, so hopefully she'll be able to assess without them.

avocadotoast · 22/04/2015 19:21

I haven't been told anything about how my hospital operates during labour. Is there a way to find out what their procedures are ahead of time?

PenguinsandtheTantrumofDoom · 22/04/2015 19:26

In an MLU, mw's do tend to be better at staying with you. But do plan for the possibility of being on the CLU for whatever reason. And also if the MW does keep vanishing.

On my CLU (there was no MLU in the area at the time) my MW was supposedly only looking after me. In fact, she was mostly at the nurses station drinking tea and gossiping. I should have complained really.

Starlight- Impressive. DC2 shot out in a single push. DC3 no way could I have changed position mid delivery. Physically couldn't move at that point! Can't talk. Can't move. I'm painting a beautiful picture aren't I

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