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?

Legally, you absolutely have the right to refuse consent to any medical procedure.

In practice, it's quite common for some midwives to simply perform an internal exam without asking for consent, unfortunately. You need a good, supportive advocate with you - your DH, doula or whoever.

You can absolutely refuse it’s within your right, nobody can touch you without your consent although that can be implied consent not verbal.

They might want you to sign an against medical advice form in the case that if anything goes wrong that could have been prevented by checking your progress that it’s your decision and not their responsibility. I signed one of these post labour when they recommended I stayed in for IV fluids and I wanted to go and see my baby in the NICU.

Think about why you don’t want to be examined and whether that’s greater than wanting optimal care for the baby to be delivered. I was examined countless times when I failed to progress and needed induction.

My friend had an emergency C section after the midwife noted the cord was prolapsed while examining her, saved her babies life.

Generally they are practising evidence based medicine not just doing things for the sake of it, but it’s completely your body and choice.

You might find that they refuse you an epidural if they don't know how far dilated you are - some hospitals have rules about not giving an epidural too early or too far in labour.

Agree with the PP, if you make the midwives aware of any particular circumstances, whether that be a previous birth trauma or other traumatic situations you have been through, they should make sure that all staff working with you are aware of your needs/wishes, and should treat you as sensitively as possible. They will be accustomed to supporting women with a wide range of needs or traumatic experiences.

No they don’t have to do it, and if you tell them they will find other ways to check the progress of labour that are perhaps less accurate. Just be aware that if you say no to them checking then they might put a time limit on your labour before you get a c-section and may require continuous monitoring of the baby. Water birth may also be out.

Yes you can refuse but you also need to accept it could cause complications as they won't know what they are dealing with. Ie if you're not dilating and should be, or dilated very quickly. They do it for s sound medical reason. The midwife will also have to be down there for the birth.

Obviously you don't need to say why you have an issue with this, but the whole birth process clearly involves your vagina and medical staff.

If there is a reason such as trauma, could you discuss it with your consultant and look to maybe a c section, if you find the idea of natural birth traumatic? Because honestly the intimate examinations are the least of it

No one is allowed to do anything to you without your consent.
It really is that simple and it’s so important that we all know this.
Speak to your midwives about your concerns. They are on your team, so to speak, and will want you to be as confident as poss about the birth.
Experienced midwives tend not to rely on VE’s and many women (including me!) find them extremely painful.
I’ve have four DCs and only had three internal things - one where I discovered how much I hated them, one to fix a monitor to DS2’s head and one (with consent) to break a stuck bag.
They’re not normally necessary and you don’t have to have them.

OP, read The Positive Birth Book by Milli Hill. She covers this in the book - basically, no you don't have to consent to any internal examinations. Apparently most women get a purple line on your bum that lengthens as you become more dilated. Anybody saying the only thing that matters in labour is the baby is completely wrong, you are just as important.

Haven’t read the whole thread sorry. Of course it is your choice.

But if I hadn’t been checked with DD2, she would have been born in the triage room, as the midwife didn’t really believe I was in labour and was pretty shocked when she examined me to find I was 9.5cm dilated.

Being born in the triage room wouldn’t have been a big issue given she was healthy, but would have been dangerous for her if anything was wrong and she needed assistance (not much equipment in triage room).

With DD1 I had to be transferred to another further away hospital during labour (fun!) and all indications of how far along I was were valuable in managing that. So again there were a lot of benefits in being checked.

Hi OP. Yes I was the same. Unfortunately I had a very long labour at home initially, and it got to the stage where they had to check me as they wouldn't admit me or give pain relief until I was 4cm, and I was desperate to be admitted. They brought me a canister of gas & air to have during the examinations after the first one had me screaming. First time around I was 1-2cm and then second time 4cm a few hours later after a trip home and back. I was then admitted and had an epidural so didn't feel the later 4 hourly examinations.

Please talk to birth reflections at your hospital prior to and after the birth, that's what they're there for, your midwife should refer you. And definitely ask if you can have gas and air during any examinations if you need to have one to be admitted. Good luck, I'm sure it will be fine :)

I hate this too. To say you won't care in labour isn't necessarily true. Trust me I still really struggled with it. But I had complicated births and without the correct medical intervention my children may not be here now.

So yes you can say no. But is it really worth it? This is coming from someone who can't physically cope with any internal examination at any other time. The intense pain will help override this a little but you will probably still care.

I'm sorry OP but you need to know that IME, MW and doctors will go ahead and examine you even if you say no. It's all about the safety of the baby and their policies. I think you need to prepare for this outcome.

Yes, of course. I only had mine checked once in my first labour (awful, never again). The second time I just said, no thanks, I don't want that (I said this to them before I was in labour). They never even asked and no one was bothered. Honestly, it tells them very little, so there is hardly any point. You can be at 5cm for days (as long as you and baby are fine, it doesn't matter). Or you can go from 1 to 10cm in minutes. But yes, you can. They really didn't care at all and were very respectful of my wishes.

Yes you can refuse, I'm not sure of the implications (if there are any), so it might be worth speaking about with your MW at an antenatal appointment to understand why they are done so you can make a fully informed decision? And to express your wishes so they can be noted.

When you are there in that moment having your baby. You won’t worry about it at all. I am a very private person and I was fine.
You will be so big and so tired of carrying that baby it will be such a relief to finally give birth. Please don’t worry about the little things, it’s just making sure baby is healthy that matters.

With dc2&3 I had an arrangement with the midwife that I would have an internal when I got to the point I wanted an epidural. I never got to that point.
However I think they would have been more reluctant to agree that for dc1.

Crazybunnylady123 the thing to bear in mind is that if the OP has been through abuse/assault/previous birth trauma, this may not be a "little thing" to her, but may be a huge issue.

You can't say that Crazybunnylady123, you just can't. That's so patronising. I didn't feel like that and you can't know the OP will.

Jeez why can some people not see that other people think differently to them?

OP just speak to your midwife. She will have heard it before and the main thing is you need to be informed so you can make the decisions that are right for you and your baby.

I agree that some of these answers are extremely judgemental. Like you OP, I couldn’t stand the idea of internal exams, following a dreadful first smear test experience. I had to be induced with my first baby and consented to allowing a student to put the pessary in (I have no idea why I did this, and regretted it - she was really rough, and just added to my phobia of internal exams).

My subsequent births, I refused any internal exams unless it was thought to be dangerous not to, and my wishes were respected. A good midwife should be able to gauge how things are progressing from other parameters, and you do not have to consent. I would recommend saying that you ideally do not want them, and if it is considered extremely important at any given time, they must discuss the pros and cons with you.

When else in life would we think it’s okay for somebody to put fingers in our vagina without permission?

Of course you have to give consent for this to happen! Same as anything happening to your body. Being pregnant still means you have the same human rights as anybody else.

Some women choose not to have vaginal examinations (perhaps due to trauma in their past). It isn’t something you’ll necessarily ‘not care about’ in labour.

I had no problem with having VEs but my midwife was actually fairly keen to avoid doing one, even upon arrival.

Of course there will be situations where they are recommended. I would look up the reasons for them, the pros and cons in different situations so you can make a decision on what’s best for you.

I'm sorry OP but you need to know that IME, MW and doctors will go ahead and examine you even if you say no.

If that happens, then that is abuse. It is YOUR body. Make sure you have a birth partner with you who knows your wishes and can advocate for you.

Oh I do love all these people who know so much better than the medical professionals, and have read up all about how to have the perfect birth.

Honestly - when you have a baby, you get it out any which way you can - as long as it comes out in one piece and alive. Believe me, I had the perfect birth plan - no drugs, in the pool, la la la. By the end I actually remember saying - I don’t care if it comes out of my fucking ear - just get it out 😂😱😁

You should be able to ask, and they should do what you want.
However, you might want to prepare yourself that they may need to check. Or rather, you may end up in a situation where if they don't check, you or your baby could be in danger.
I went into hospital in tears and panicking at 34 weeks because I had a heavy bleed and lots of pain. Was told repeatedly that it was probably BH contractions and asked to calm down. Eventually they checked (I think to shut me up) and realised I was 3cm. They quickly changed their reaction and helped me safely deliver my premature baby. If they hadn't of checked and sent me home, it all could have gone very, very wrong.

You might find this old thread useful did you know you don’t have to have VEs In labour?

It’s from a few years ago but has some useful view points.

It’s not about the ‘perfect birth’ though 🙄 A ridiculous percentage of women going through labour are sexual abuse survivors so strangers putting fingers into their vagina/doing things without consent is a pretty big deal. Given the shocking amount of women (at least 1 in 3) who end up with a degree of mental trauma after birth, wanting to have a bit of control and your BASIC human rights respected doesn’t equate to being silly and wanting some sort of magical experience.