Do I have a say in whether the midwife checks how far I’m dilated?

[LibbyAshleigh]

So, I know how they check the dilation of the cervix when a woman is in labour. And I am in no way comfortable with that, I can’t express how much I don’t want them to do that when I go into labour. I’ve been told ‘oh you won’t care when you’re actually going through it’ but I 100% know I’ll very much care. I read that it’s a routine thing to check but it isn’t mandatory, but I was wondering if anyone else has had an experience with this? Has anyone else felt the same way?

oh OP - I refused with my first as I honestly did not want to know, I felt like I was handling my contractions really well and I just wanted to stay in the position I was in etc. Plus I did not feel comfortable having a check whilst there were so many men around me. But the MW did not take no for an answer, she waited until my birthing partners had left to grab a quick break and more supplies, and she intimidated me. I felt so vulnerable and scared and she was telling me it was for my own baby's safety. Whilst she checked she performed an unconsented sweep on me too! I would never have agreed to that and she knows that as she had already asked previously. I feel like that really set the tone for the rest of my labour. It was horrible.

At the NHS antenatal classes we were told that it was our choice and that MWs should be able to go off your contraction timings if you didnt want to be physically checked. (Btw, my friend didnt want to be checked and she wasnt, she had a much more understanding MW)

Consent during childbirth can be a huge problem. Many women feel that no one listens to them, that no one actually cares about whether or not they consent and that they are simply not trusted to make decisions for themself during labour.

You absolutely have the right to refuse. But it's never a good idea to go in with a solid mindset of "I will not consent". You never know how labour will go. It could all be smooth sailing and you say no and that's that. Or things could develop in a bad way and they need to check, and if you continue to refuse then it puts you and your baby at risk. As much as you want bodily autonomy and the right to refuse, you are also responsible for the life of your child in that moment. Sometimes, as a biological fact, we need to give up a bit of control because the baby is coming out of us and may need help. They really might need to check.

If things do go wrong, or there are concerned, that's the time to really think about what's best. You can stiĺl say no, but don't make that decision now. Don't set anything in stone. Just see how it all goes. Honestly, with everything else going on you really barely feel them doing it. I wouldn't consent if there was no reason to and no concern, but I would consent if things were taking too long or there were concerns.

My contractions were every 2.5 minutes for over 10 hours and I wasn't dilating. The baby was in danger and I had many cervical checks.

Some women labour and birth very easily. Some dont. You may need the checks - midwives don't stock their hands inside you for fun, it's their job

I only had 2 checks with my 2nd (none with 1st) & remember feeling nervous, but felt nothing.

You have to give your consent to internal examinations. You should discuss the issue with your midwife. There are situations where a vaginal examination needs to be done eg risk of cord prolapse, insertion of pessary , attaching foetal monitor etc. You should discuss these ( and other) situations so that you have a hierarchy in your mind about when you would accept an intimate examination. Make sure that your birthing partner is aware of your feelings.if course , as we all know, the babies haven't read the manuals and labours vary enormously and very little of the process can be controlled by us mothers so it helps to be prepared to be a bit flexible eg I had a very rapid delivery with my second child and when mw went to assess dilatation ( see what the fuss was about) she managed to catch the baby at the same time .

It is no longer fashionable to be as anti intervention as I was. dh drove me 90 miles in labour to go to what was, 30 years ago an exclusive private hospital where they guaranteed no interventions or pain relief. You were transferred to a local NHS hospital if it was impossible t proceed without them. I had no internal examinations at all, they said they were not necessary, could introduce infections and they could tell the stage of labour without them. It was wonderful. I had DS2 at home with a more conventional midwife (NHS) by that time it wasn't an issue so I let her have one little look, but that was all. Of course you can say no.

Refuse, I will. Its not important information. Probably more about freeing up beds and being overly anxious about lawsuits.

they wont check you more than 4 hourly or unless there is a reason so yes you do have a say , there are signs they can look out for.With everything to do with labour they think of yours and your baby's health first and foremost but unless its a dire emergency they will talk through everything with you .Make a birth plan in advance :)
Good luck

First the "you won't care" comment that always pop up is absolute bullshit. SOME women might not care, but some of us do, at any stage of the labour and birth. You are not suddenly going into a stage of oblivion at any stage, you might be in the final stage of labour and still very much care about your surrounding!

Only saying that so you are prepared. As above, refusing medical help is really not a good idea. you do need to discuss that in advance. Ultimately, it's for your safety and the baby.

You do know it can make the difference between being sent back home, or put in a delivery room?

If you have huge issues about your body, you do need to work on that - I mean you might even consider a c-section for your own safety if that's such a big drama.

Refuse, I will. Its not important information. Probably more about freeing up beds and being overly anxious about lawsuits.

Or that I really wanted to push before I was dilated enough and would have either prolapsed or seriously compromised DS.

You need to chat this through with your midwife. Of course you can tell them you don't want them to. It may become necessary at some stage though, at which point you can change your mind. I got "stuck" at 8cm and didn't dilate further, and my baby was in distress - they needed to check how far dilated I was at that stage (I didn't feel it on that occasion due to the epidural). I ended up with an emcs due to the above.

Sorry to be obtuse but why would you not want the medical professionals there to help you and your child survive childbirth safely to not have all the information they need? Do you go for smear tests etc?

Chattybum a lot of women don't go for smear tests because they can't deal with vaginal exams.

It is something a good midwife is trained to deal with sensitively, whereas a lot of MN posters clearly aren't.

No-one can examine you vaginally without your consent, OP. Discuss it with your midwife, and ensure that your wishes are noted in your records and your birthing partner is fully aware. However it is worth having a discussion with your midwife about why the examinations are done, how often, and how they will manage your care without them. You also need to discuss how you will feel if you need an assisted delivery (forceps, ventouse etc) as obviously this is intrusive too.

@iklboo Ok yeah fair enough.

It is entirely your choice. But I think you need to research the potential risk. Odds on it won’t be necessary. But you are being told by women, who explain why it was important for their baby’s health. For me, I needed an examination to know when to push. The midwife also had to put her hand up my vagina to show me how to push as I wasn’t getting it right.

Some of these replies are a little insensitive. We have no idea why the op isnt keen on internal examinations and saying you should think about your baby and getting them out sagely is the most important thing. I am sure the op wants her baby delivered safely and doesn't need the guilt trip. Also everybody has the right to autonomy over their own body at all times and that doesn't become unimportant because there is a baby in it.

I was checked with my first labour but can not remember it really with my second they didn't even check everything happened so fast. I would try not to worry about it now. They won't do it if you refuse..

I had to have a dilation check on my daughter as I'd only been in labour (from a morning induction where I was not favorable) for an hour or so and I wanted to push. Luckily I was fully dilated but if I hadn't there could have been problems.

Yes you can refuse as they need consent

I do think though you need to get clear in your mind what you do and do not want to consent to with my very fast labour I wanted to push and they needed to check it was ok to (it was) and then some intervention was needed

In essence checking dilation/sweeps are not necessary other checks might be

Talk to your midwife and say you don’t want to consent to anything unnecessary

OP, I would suggest going into labour with a more open mindset. You can state that you would prefer not to have vaginal examinations but if your midwife feels one is needed they can discuss it with you, explain why they think it's needed and what the risks are of agreeing or refusing for you to then make up your mind.

It's much better for you to accept that birth may not go exactly as you want it to, but that you have control (I'm looking at 2nd birth imminently and it's already so far from what I wanted before labour has even started). You and your birth partner can agree in advance what is acceptable (make sure they know your views in case you aren't able to chat for whatever reason), ask questions, tell your midwives that you want to be fully informed and given the risks either way of anything they suggest and stay informed during it all, you can still say no but it's best to know if you're accepting any sort of risk. It may be that an examination is needed because something has developed and it's for your or your baby's health, you are trying to push too early, baby is breach or any number of reasons.

How far along are you? Have you considered how you plan to birth, eg. what kind of pain relief you want, will you active/hypno/water birth, what if you need intervention like induction, forceps or ventouse? You can discuss all of it in more detail with your midwife as well as do your own research.

You absolutely have the right to choose if YOU feel it is necessary- barring exceptional emergency situations. In case of which, you will probably feel it necessary! No one has the right to touch you without your consent. And I hate the whole you won’t care when the time comes sctick. I cared before, during, after. I cared very much!

I’m four pregnancies along the motherhood journey and I’ve never had anyone perform digital “checks” on me, or known how dilated I am. So I am certain it isn’t a necessary part of many pregnancies. I suspect it is done routinely in far too many cases.

You can certainly say no to this or any other check. Unfortunately some medical professionals are very pushy, as others here have mentioned. Will you have a birth partner? It might be good to ensure they know how strongly you feel about this so they can help support you in declining.

I think that many inexperienced midwives are overly reliant on measuring dilation as an indication of how far labour has progressed. In both of my labours I didn't mind being checked, but I had a very strong feeling about how far along I was and whether it was time to push. In each case the midwives ignored this, told me it would be ages based on how many cm dilated I was, and barely managed to catch the baby in time!

In retrospect I can see that aside from how far dilated I was, I was showing all the signs of being about to give birth. The midwives just didn't have enough experience to notice all the other signs.

I am pretty sure I wasn't checked at all for my second labour/birth.
Arrived in very active labour, was coping OK and when it came to push I just got on with it (well you know what I mean - it was instinctive). I was 40 weeks, low risk.

First birth was very different.

Either way you have the right to refuse an examination.

Talk to your midwife and say you don’t want to consent to anything unnecessary

Just to add to this and the more thoughtful posts... If this is due to trauma and perhaps there are examinations you would consent to in certain circumstances, you can talk to them about how you might need to do things differently to avoid re-traumatising you. (Even if it's not trauma you can still have similar conversations).

For instance, slowing their normal pace down, explaining exactly what they would like to do and why, not assuming you will be able to or want to consent, talking through what they're doing and giving you opportunities to stay stop, agreeing a gesture or code word for you to use instead of "stop" if there is a risk of you freezing, just making sure staff working with you know they need to take more care and you might struggle with certain things...

Specifics vary from person to person and depending on the situation, but there are ways to plan and adjust things to support you. It's not a case of "suck it up and get on with it or else" as some posters have suggested.