How many pelvic exams to expect?

[magicalmama]

How many pelvic exams are women having when they go into hospital in labour?

I'm pregnant with my first child and want to know about what is expected during childbirth before going in, but I can't find any info on how many or how often pelvic exams are done and by who.

Probably they're not considered enough of a "thing" for people to mention this, but I really want to know in advance what is expected. I know you can refuse, but say you don't, when do they usually want to do them?

I can’t give you a definitive answer but I suppose it varies woman to woman depending on risk factors. I’m 39+1 and only had 2 so far. One internal exam like a smear to check for infection after I presented with pains (turned out to be kidney stones) and one pelvic exam to check for dilation yesterday when I was due to be induced.

I had one when I arrived at hospital and then once every 4 hours to assess progress.
Yes of course you can refuse them, but I found it helpful knowing how things were progressing. I didn’t find them painful if that’s your concern.

It was every 4 hours or so when I was in labour.

One on arrival, then one every four hours unless one is needed before that for some reason like waters breaking.
One if your waters need breaking. If the MW does one then calls the Dr it will be another one.

It probably varies depending on individual risks and circumstances and how labour progresses but for a straightforward birth with no interventions I had two (one on arrival to check labour was established and one later as it had been a good 6 hours and my waters hadn’t broken).

For an induction I only had one but it was a lot speedier.

I only had one, when I first arrived at hospital and clearly in active labour, to determine whether I could get into the pool.

Once I was in the pool they checked on the babys heartbeat with a doppler every so often (half an hour intervals, I think) but otherwise no one except DP touched me at all. I remember the experienced midwife explaining to the student that they could see a line developing up my back (?!) and that was showing them my progression, although I was almost at transition by then so may be remembering incorrectly.

After my internal exam on arrival the next time I was physically touched by a medical professional was half an hour after DC was born, when I was no longer having contractions so they gave me an injection to help birth the placenta.

I think I could have had more internal exams if I wanted / needed, but I was low risk, didn't want to get out of the pool, and was only in hospital for 4 hours before DC arrived.

I had none.
You don't have to have them, they are not (always) an accurate representation of anything. For example, i have heard many women say "I was only 4cm but then suddenly progressed and baby was born 2 hours later" or similar. Also hearing that you're "only X many cm can be psychologically very difficult if you've been labouring for hours.

More on the how, why and debates for and against here
www.aims.org.uk/information/item/vaginal-examinations-in-labour
www.aims.org.uk/information/item/vaginal-examinations-in-labour

With my first, I think one? During active labour because DS was taking his time.

With my second, I only had one when my waters broke at the start. (I wasn’t having active contractions). Then I went home, abs by the time I came back I was pushing so none required as DD arrived very quickly after.

1 ds can't remember would have been a quite a few as he was born at 28 weeks but labour was quick I would say maybe about 4, 2nd ds didn't have a single one as when I turned up to the birthing centre waters had gone and was clear baby was on his way

Every three hours during induction, I think every hour when in labour. I was very, very high risk though and everyone was a bit on edge (until they gave me an emergency section, so they probably were right).

I only had 3 although I was induced so may be slightly different. I had 1 before induction started to see if I was dilated enough for waters broken which I was, but then midwife got called away for an emergency so they had to put off breaking my waters. When they finally could break my waters it'd been a good few hours so I was examined again to check what was going on. Then I had 1 examination in labour, but I was 10cm so didn't need any more

I refused one that was being used to try to decide whether I should go home or not, because I know that is a poor indication of progression. Instead I asked them to observe my next few contractions and do ambulatory monitoring. They did. I didn't go home.

I was then offered one when I said I needed to push after just three hours of contractions. I agreed to that one as I was so scared to be in that much pain, given I'd been told my first labour would be long! It was a welcome relief to be told, yep baby is ready to come out!

I don't remember with my first two, but I had a home birth with DS3 and didn't have any.

Thanks all, it is really reassuring to know what to expect. And that it didn't hurt.

Good to know that they will do monitoring instead if you request it.

I feel much better knowing this kind of info in advance and it not be a surprise!

I know it differs for everyone and you may have specific reasons for asking, but if it helps at all, I have no idea how many I had and tbh didn’t even really notice them happening. They definitely didn’t hurt. And I know I had some pre the gas and air arriving (home birth) so didn’t have any pain relief.
Obviously you can refuse them, I just wanted to give a positive story.

Just be prepared that sometimes they have to do internals, it depends on the labour. I was early at 31 weeks and had several over a short period of time. It's not the norm but can happen.

Dd had 2 one when I went in and one to check progress
Ds1 I had one then had my waters broken for me
Ds2 had one when I was fairly far along in labour

I’ve never heard of the 4 hour thing in fact I was always told they keep rummaging about in there to a minimum. It would obviously be based on many factors but they only did them on me after a discussion and whether I wanted them to check progress.

My main fear is being told I have to have these procedures when I don't want them. But I also don't want to set up an antagonistic situation with the midwife or medical staff where they will treat me, but won't be happy about it and I might not have as good outcomes as a result

I've had medical exams before, but the thought of someone just expecting it of you routine, over and over again, without complaint or batting an eyelid really makes me unhappy.

I don't want to have pelvic exams unless I absolutely have to, and I also really don't like the way lots of medical procedures you'll be expected to undergo like this are simply not mentioned until the moment they're expected, and then suddenly you're some kind of picky patient if you don't want them.

I find the whole idea a little bit patronising and paternalistic and don't understand why it doesn't just say on the official websites "pelvic exams are often offered every few hours to check on the progress of labour".

If this is so common, it really upsets me that they don't publicise it and just expect it at a later date without a word.

I had inductions with both my babies, so not quite the same as going in spontaneous labour. DS1 had already had two examinations and sweeps in the weeks beforehand. I think I had 4 during induction/labour. The whole thing took 12 hours start to finish.

DS2 induction was a bit more stop-start, I think it was 8 overall? And took longer, closer to 24 hours, but not in active labour for the whole of that time.

Only one.
I arrived at hospital was admitted but was 'only in early labour' so wasn't offered one due to risk of infection due to having already had my waters broken
I started requesting one as felt I was no longer in early labour. Was dismissed as being a first time mum not coping well and still in early labour ie not even in true stage 1 labour.
After 2 hours if requesting I demanded one and low and behold I was 9cm and crowning.

My next one i am putting in my notes that they can either listen to me and trust I know my body or get me a different midwife. And also that I will be having examinations every 2 hours and pattern they don't like, they can get me a better midwife who understands woman and has some compassion.

From what I remember, the pelvic exams are completely consensual. With DS2 I had a very long Labour so had one at about 11.30pm and went hometown wait for progress. I had another at about 4am when I went back in, and again at 8am. Things were progressing slowly for me and there was talk of being put on the drip so I agreed to try some different positions and check again at 10am, that told them that baby was turning. I can’t remember if I had another, possibly just before I got in the pool to deliver. For me I was actively involved in the decision to have pelvic exams, they made sense in the context of that particular Labour where outwardly the signs were a bit hard to interpret (until I reached what was very obviously transition).

The only thing I will say is that I had horrific back Labour, and a back to back baby, so getting into position to be examined (on my back) was sheer agony. But the exams themselves didn’t hurt.

Have you spoken to your community midwife about this? She should be able to answer any questions you have and to put you at ease. Generally, vaginal examinations are done (with your consent) every 4 hours to check for cervical dilatation. They may do one sooner if you require pethidine for pain relief because if you have it too close to delivery, it can make baby drowsy.
They can sometimes be a little uncomfortable but you can ask them to stop at any time if you are finding it painful and any midwife worth their salt, should explain this and the rational for doing an examination, to you. Best of luck

I didn’t know what a pelvic exam was so I clicked, never seen it called that before, I take it from other answers it means internal/vaginal exam for dilation.

Five pregnancies along, I’ve never had a sweep or an internal exam for labour.

I do remember it becoming an issue in one labour where they really wanted to do it because of a shift change. A shift change was not a good enough reason for me to accept an invasive examination and that’s what I said - they coped. I’m not there to make life easier for them .shrug.

Not mandatory. Even on my high risk pregnancies.

One for me when I arrived at hospital and I was 10cm.
None the second time round. I told them no until I was ready to push. Baby arrived very shortly afterwards.

I had the same kind of worries as you OP, but my experience was really positive.

It’s completely different to other medical procedures, your midwife is there with you for many hours, you can talk to her and ask her anything you like, she won’t just be coming in and demanding you let her examine you.

You should be asked if you would like to be examined and you can say yes or no. They won’t just do it, and they won’t be annoyed if you say no.