Being 'examined' in early labour - what does it usually entail?

[ovener]

Can anyone explain what I should expect when a midwife offers to 'examine' me during labour please? I'm pregnant with my second and had a disconcerting experience early on in my first labour. When I consented to an examination, I assumed the midwife would just use her fingers to gently check how open my cervix was. I was a bit shocked when she had what felt like a good old rummage - like a membrane sweep (I'd had a couple of those on the preceding days). It was quite painful and I was left feeling a little... well, violated I suppose. If she had offered me a sweep I might have agreed but the unexpected nature of it felt a little shocking. The word 'examine' to me sounds gentle and careful - just 'having a little look'.

I'll certainly ask the midwife to clarify what she is about to do when I am offered an examination this time round. I just wondered if anyone else has had a similar experience, or if there are any midwives out there who can give an inside perspective (so to speak ).

Mine definitely just had a quick look. I’d have thought the same as you.

I don’t think you can just “take a look” to determine how dilated someone is- unless your planning to use a speculum. Mine definitely had to insert her fingers into my cervix to determine how dilated so very similar to a sweep.

Mine was a proper rummage, six times.., on the hour, every hour for six hours. My cervix is tilted back so there were some issues. One doctor made me cry he was so rough, the midwife held my hand and when he left she said “ you can cry now, every one does” and I burst into tears.

He then walked back into the room to see my crying and the midwife holding my hand and asked me what was wrong, I told him he was rough and he’d hurt me. Have to say he looked beyond horrified and shocked. I don’t think anyone had told him before. He kinda scuttled out the room.

@Zippy1510 Thanks, perhaps I should have said 'have a feel' instead of 'have a look'. She certainly did more than just put her fingers in my cervix.

I got offered gas and air for examinations during induction so I figured it was going to be more than a quick peep! Don't be afraid to ask them to clarify and if it could hurt ask to have the gas and air. If you're feeling vulnerable as DH to ask for you each time.

@Bluntness100 That's pretty shocking! Six times.. I feel for you!

I will definitely be asking for clarification next time. I would much rather know what to expect, good or bad.

Ok so sometimes even if they don’t do a sweep a vaginal examination can feel a bit like a rummage particularly if the head is well down and the cervix is round the back! Plus also it isn’t just how dilated the cervix is that we are interested in; from an examination we also want to feel how low the head is, how thick the cervix is (is it thinning out, how far along is it thinning?) if we can feel waters in front of the head, but also by feeling the lines of the bones on baby’s head you can tell what way round the baby is facing and how flexed (chin on chest) or deflexed (looking up) the baby is- which can give you an idea of why labour is progressing slowly for instance (or give an idea of how it might go).

But if you’re being examined and it’s too painful you always have the right to say please can you stop now. This should always be respected (I’m aware and sorry that people don’t always have that experience).

@Iwouldlikesomecake Thank you, that's really insightful! I wish I had been told that last time, or at the very least been warned it might be uncomfortable/painful. It makes sense you can tell much more than just the dilation now that you've explained it.

I suppose it just comes down to communication in the end. The pain I experienced would have been totally manageable if I'd known, for example, she just needed to reach a bit further to feel the baby's head. I didn't feel able to ask her to stop at the time as I was so taken by surprise. I'll definitely be more vocal next time though, and I feel reassured now I know what to expect.

I am surprised that no one has made the very important point yet that vaginal examinations are OPTIONAL, the conversation thus far seems to have been based on the underlying assumption that you don't really have a choice, but of course you do. You don't have to consent to vaginal examinations if you don't want to. There are other ways to determine the progress of your labour.

www.aims.org.uk/information/item/vaginal-examinations-in-labour

@NameChange30 That is an important point. Speaking for myself, I would need to feel sure of my knowledge before I declined a medical procedure or examination. I might have chosen to decline that first troublesome examination had I known what to expect and what the alternatives were. In the event, I was keen to know how far along I was and in my naivety it hadn't occurred to me it might be painful.

This thread has been invaluable to me. Like many women, I like to be armed with as much knowledge as possible when going into hospital to give birth and this was one area that I didn't know much about. I'll have a good read of the AIMS website thanks - looks like there's lots of info there.

You're welcome, yes knowledge is power 💪

I have heard stories where women have consented to an examination and had a sweep performed at the same time without their permission This is assault but unfortunately I don’t think it’s that uncommon.

VEs can feel a little uncomfortable in my experience though, could maybe depend on who is doing it as well? Good point about them being optional, I felt for me they were the best way to assess labour but it was still helpful to know they were being done on my terms with my permission, and that i could ask them to stop at any point.

All examinations are optional. Remember, the VE or "I'll just take a look" lie has no value to you. The hourly exams are just policy and habit with little evidence of benefit. You can go from 5cm to 10cm in minutes so the hourly check is therefore useless.

Mine felt like when you see farmers sticking their whole arm up a cows arse