Sil has just written her birth plan and......

[calvemjoe]

Has said that she doesn't want any internals until she feels ready to push. Is there any chance that she'll get this?

[SlightlyMadSecret]

I our hospitals policy is that once they give you your first internal (consented of course) they are comitted to give you them every 4 hrs.

I don't see why she shouldn't get this but it can be helpful for MW to confirm it is a head and not a bum, facing the right way etc...

[calvemjoe]

I've warned her that if anything goes wrong the world and his dog will be in there and her dignity will be the last thing that they are bothered about. I think she'll be fine once she is in labour and so close to meeting her lo but right now she is stressing.

[liath]

I requested no internals on my birth plan and the midwife was quite happy to go along with me labouring intinctively. Mind you it was a second labour & home birth. I gave the birth plan to the community midwives a few weeks before delivery & it meant any issues could be discussed well in advance.

[calvemjoe]

She'll be 40 weeks on Fri so not really much time now to discuss anything in advance.

[flack]

I would guess that as long as she consents to external monitoring (fetal heartbeat) that MWs will go with it.

[NineUnlikelyTales]

I know everyone is saying you leave your dignit at the door etc (I certainly did after it all went pear shaped!) but she is being very sensible to adress her fears now and think of ways round them. If you are stressed during labour, it slows things down. So if she fears 'being on show' it makes sense not to plan to birth in the pool, in the nude, and to decline examinations.

I still bet she doesn't care when she's in labour, but you never know.

[NineUnlikelyTales]

*Dignity (Doh!)

[MKG]

Just because she wrote it in her birth plan doesn't mean she'll get it. I wrote a lot of things down, and when I went over it with the doctor she told me that certain were not policy and I wouldn't be able to do them. When she reviews it with a practitioner they can discuss the issue and make a plan together.

Odds are when she's in labor she'll want a couple. I know I was like, "Please check me and tell me we're getting somewhere here"

[princessCROComel]

I refused any more internals after the first one was so awful with ds. I had to have gas and air before she could do it.

Once I'd had my epidural ( at 10 cm, didn't realise as wouldn't let them check )she could feel about as much as she liked!

[TeeCee]

With Dd1 the midwife had a quick look when I arrived to establish if I was dilated, I was fully so that was that. She just looked and I refused to lay down she had to look while I stood up over the bed.

With no 2 the midwife arrived and just let me get on with it, she didn't look or interfer in any way. There was no monitoring or anything. When I felt like I was going to start push I told her and she said'ok'.. That was it! So obviously you don't have to be examined.

[BizzyDint]

i had a fab midwife who just did one internal when i arrived at the hospital. after that she just relied on my body signals, such as involuntary pushing. i was in water a lot of the time so it was very hands off. is your SIL considering a water birth?

[Piffle]

I've never had an internal in labour until my 3rd one where had stop start prolonged labour..

[OrmIrian]

Didn't have any with DD (no #2) and growled at the poor student MW when she tried to check . But as she was my second I felt that I knew what I was up to and how my body was behaving and felt confident to get on with on my own. Unless she feels like this I think an internal might become neccessary. What will happen in an emergency? Will she still be refusing if something goes wrong?

[chocolattegirl]

I was more worried that people would try examining me without introducing themselves. They may have seen hundreds of labouring women but they hadn't seen me and I hadn't seen them! So names and job titles first for me before their hands went anywhere.

I do like good manners .

[homemama]

Hi Cal!
If it helps, I was never examined lying down as I never got on the bed. Also the mw was fab and didn't need to 'look' to examine me, she just felt IYKWIM. I was stood over the side of the bed, she crouched down and put her hand up my nightshirt. That was all she needed to do to tell me I was fully dilated.

That was my first internal and I didn't find it particularly intrusive. She only checked because I said I wanted to push.

I have to say, it's much less dignified when you're being examined for cuts and grazes afterwards as you're then on your back with your legs spread.

I've never had stitches but the amount of women I've spoken to who've said that's the worse bit, both in terms of pain and lack of dignity is surprising.

Hope she gets as close to what she wants as possible though as others have said, her desire for dignity is likely to be overtaken by her desire to see how well she's doing.

p.s Hope your lo is doing well!

[Mumpbump]

Dignity goes out the window anyway! The stage at which she might need to be examined will depend on how labour is progressing. Ds was induced and they were talking about giving me a pessary and leaving me for 6 hours to see if anything happened. I was very glad to be able to say that the consultant had found I was already 3cm dilated so they could just break the waters. They had to check again, but I got the feeling they would have just given me the pessary if I hadn't been so against it. Think she might need to consider in due course how she would feel about internal exams if the labour has to be induced.

[akaJamiesMum]

I used to be a midwife (a long time ago though) and looked after a few women who specified no internals in their birth plan. All went absolutely fine for these women but your SIL may need to think about what happens if all does not go according to plan.

[LowFatMilkshake]

x-posts but i would say not, and I would say woth good reason.

I was labouring for a good 8 hours with no progress, even though I had been told the head was low, then on my last internal I was told by a more experienced MW that baby was caught behind my bowels and if I had a poo (sorry TMI) I would help things along. One very uncomfortable poo later and I felt DS drop like a stone and was out within 20 minutes!!

[shonaspurtle]

Tbh, I think in many cases, including mine, birth plans are of most use in giving you something to do/think about before the event and making you feel more in control if you're worried about that aspect of things. When it came to the actual event I didn't give a toss!

Having said that though, I had a couple of internals in the antenatal ward because I was induced but when I got up to the labour ward I didn't have one until I was almost 10cm. The midwife seemed to be able to tell that things were progressing fine and she knew I was transitioning because I went a bit mental...

So it might be good for your sil to have this plan as it'll make her feel better now and she may well (almost certainly!) lose all her inhibitions when she's actually having the contractions

[chocolattegirl]

I forgot to take my birth plan with me and someone just sat down with me and wrote down what the hospital policy was ie giving vitamin K to the baby after delivery. I forget the rest now.

It was only about 6 lines by the time she'd finished. Then she went off on her rounds and left me on my own with my waters broken, starting to bleed and in established labour. That was more undignified IMHO as I crouched on the floor like a hurt child hoping that someone would turn up to look after me .

[terramum]

I would hope so - if an internal were given to me without consent Id press charges - I class that as assault. Id also expect anyone looking after me in labour not to try to pressure me into something that I didnt want to do - & put a similar line in my borth plan. Of course she might change her mind & want to know how she were progressing...like I did as my labout went on & on for several days ....or she may not - her body, her labour & she is well within her rights to do what she wants to do.....

[terramum]

sorry about the typing errors

[DaisyMOO]

It matters not one bit what hospital 'policy' and 'procedure' are, you do not forfeit your rights at the hospital door and normal rules about gaining consent before doing anything be that a vaginal examination or giving you and epidrual still apply.

[Snaf]

If she doesn't want them, she doesn't have to have them. A mw (or doctor) must gain verbal consent before they do anything to you and tbh that goes double for internal exams. (They also have to document in her notes that they have gained consent before proceeding.) It would be considered assault if they attempted to give her an exam without her express consent. The reason for each exam should be properly explained to her and her birth partner. Lots of hospitals have a policy of 4-hourly exams - it's rarely justifiable. And hospital policies do not ultimately override her own choice - whatever the staff may tell her.

If everything's proceeding normally then the mw should be able to assess her progress without needing to do regular internals. There are plenty of other signs! She won't need to consent to external monitoring, either. CTGs won't tell you about progression in labour and internals don't tell you how the baby's doing.

However... there might be some situations where an internal exam would be helpful to guide a course of action (I'm thinking induction, giving pethdine, etc) but again this should all be properly discussed with her and she must give her consent.

And in the end, she may change her mind and want to know 'how far along' she is. If so, fine. Birth plans are not written in stone - and nor are hospital policies