Gynae internal exams - why?

[frakkinnakkered]

Can any gynaes, GPs or midwives answer why these are EVER necessary?

What purpose do they serve? What info is obtained and is there any other way to get it?

Are they necessary in pregnancy/childbirth and is it possible to have a note on your file that you don't want them carried out?

Thanks in advance

I think nowadays that it probably is possibloe in a normal pregnancy and labour to avoid internals. I didn't have a single one in my last labour and can't imagine needing one in a complication free pregnancy. I hate them too.

I had internal scans early on in this pregnancy but only because that's the way they do it before 12 weeks.

I haven't had any other internal scans at all and wouldn't expect one until I am full term to be honest.

err internals can :

allow docotrs to see cervixs so see if any cancerous lesions, bleeding, erosions

see if cervix open - good for assessing if bleeding in pregnancy more likely to be inevitable miscarriage

look for signs of infection

allow docotrs ot feel size of uterus - to guage how pregant someone might be if htey are unsure of dates or if not right size for dates early in pregnancy

before 12 weeks you cannot feel a uterus ousdie of the pelvis so only way to assess it is internally.

I appreciate they ar enotpleasent but docs do not do this for their own fun and games ( and if they do they deserve to be struck off !)

mummydoc. I had a normal scan at 5 weeks, no need for an internal

well to check for cervical cancer for a start.......smear tests are incredibly important.

As for internals during pregnancy and labour, yes you can decline them. No one can force you to have an internal. I think you should properly look into the reasons why they are done though before you make a decision.

DF
I had an early scan with DD, but it wasn't internal. They managed to find a heartbeat at 6 eeks by doing an external scan.

OH, well I didn't mind to be honest. I had several scans before getting pregnant and always with an internal probe because I had IVF.

I assume the op means an internal with fingers?

Sorry to hear you had a bad experience today.

Sometimes you can have abdominal scans in early pregnancy but not always, it depends on the angles of your uterus and bladder and also on the amount of abdominal fat.

Internal exams are only needed for smear tests or if there are problems either in or out of pregnancy. Out of pregnancy it would be for a suspected infection or suspicious cellular changes.

In pregnancy it would be any of the above plus if there were indications of a miscarriage or if a scan showed a problem with the cervix.

If you do into labour normally and things go well then you can request no internal exams but if you need an induction or if the midwife suspects that the cord is coming out before the baby or they cannot find the fetal heartrate from the outside then there is a very good reason for an internal and declining can put you and the baby at risk.

I've just never had a smear with fingers/poking IYSWIM. It's always been speculum and spatula thingy.

Today was just awful - it hurt, the gynae didn't listen, it brought back awful awful memories (I was raped when I was 19 so lots of invasive exams and never really dealt with that aspect) and I didn't get any kind of explanation. It was so terrible I don't know how I'll cope if they're necessary in pregnancy and labour - full blown panic attack bad.

Can an open cervix not be assessed with a speculum thingy? One of the clear ones that they kind of gawp through?

I've had internal exams in labour at my request to find out how long I've got left.

I've had internal when I've had a sweep, again at my request.

The only other one I had was when I was having contractions at 36 weeks after an infection and the consultant wanted to check I wasn't dialating.

I think these days you can go through a 'normal pregnancy' without having any quite easily.

Gynae exams are internal because the bits they examine are located internally, and they are generally accessible from outside in routine gynaecological exams.

A smear is usually accomplished with a speculum and a long Q-tip; anything else is not a smear afaik. Generally, a prenatal internal exam would involve simultaneous internal fingers plus pressing down on the outside of the abdomen for the purposes of measurement or confirming the pregnancy, and would usually not be done except at one of the first visits. You then get further internal exams during labour to check how far the cervix has effaced and opened.

If you had a horrible experience (and it sounds absolutely awful), complain. What you went through sounds like an assault more than an exam even without the history of being raped, tbh. Complain immediately and loudly and in writing to every overseeing body there is for this particular doctor. There is no way a doctor should have proceeded if you were having a panic attack, or even if you complained of it hurting. Please complain, and soon.

frakkinnakkered - was this an exam for pregnancy purposes?

if so then depending on how far gone you are then I don't think internal exams are routine.

In a normal pregnancy, you shouldn't need internal exams. AFAIK, they're not routine in the UK although they're quite fond of them here in the US.

In fact, they're better avoided during pregnancy altogether if possible. Even sweeping membranes is more associated with infection (particularly GBS) and can cause longer, more drawn out labours.