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Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

Internal exams

24 replies

frakkinnakkered · 22/09/2010 18:15

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?

X-posted with general health but thought midwives with relevant knowledge might be more likely to hang round pregnancy. Or indeed other informed ladies!

OP posts:
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CuppaTeaJanice · 22/09/2010 18:18

I didn't have any in pregnancy.

In childbirth, the midwives need to know how far dilated your cervix is so you don't start pushing too early (not everybody gets the urge to push!)

lilmamma · 22/09/2010 18:20

didnt have any in pregnancy and neither has daughter who is 27 weeks.why did they do one,and how far are you in your pregnancy ?

Applemuncher · 22/09/2010 18:21

I'm only 14 weeks so I don't have any experience of this so far (thank God!).

I'm very cagey about this sort of thing - takes SO much courage for me to go for a smear so I'm hoping I manage to dodge that bullet too!

Bunbaker · 22/09/2010 18:22

I don't think it is usual to have an internal examination during pregnancy. I never had one. In fact the only time I did was when I was in labour and they wanted to check how dilated I was.

TheCrackFox · 22/09/2010 18:34

I have 2 DCs and never had an internal during either pregnancy, the subject never came up.

I had a couple during labour but TBH they were fine and the MW was lovely about it all.

FWIW if you don't want one you do not have to have one. It is your body and they need consent first. Smile

weegiemum · 22/09/2010 18:38

There is no need in pregnancy - if all is OK.

I had 2 in my pg with dd2 (3rd dc) as I had a lot of weird symptoms related to a kidney condition - but on each occasion they explained why and it was to do with my kidney issues and once to swab for thrush and check my cervix.

Otherwise, I think I was checked in labour once/twice each time. Every time, the midwife knew I was ready to push by the noise I made!

QueenofDreams · 22/09/2010 18:41

I'm 26 weeks pregnant with DC 2 and have never had an internal during pregnancy (unless a stretch and sweep counts as an examination?). I was examined a couple of times during labour to see how dilated I was.

frakkinnakkered · 22/09/2010 19:24

Mine was a smear but instead of a speculum and spatula there was full on fingers and poking and it brought back awful memories from when I was raped and I had all the tests afterwards. It was so bad I don't think I can deal with another one ever. I very nearly kicked the doctor out the way and had a panic attack. I wanted to know if they were necessary, cos I might need therapy to help me past this if they are and the sooner the better really.

OP posts:
QueenofDreams · 22/09/2010 19:35

ok - maybe you should speak to the doctor/midwife who did the examination and find out what it was for?
It wouldn't have been a smear as you don't have those during pregnancy. Sounds as though they were checking your cervix though for some reason. How far along are you?

No experience here but AFAIK you can request not to have any internals during your labour. Hopefully someone more knowledgeable can comment further!

frakkinnakkered · 22/09/2010 19:41

Oh I only posted in pregnancy for the midwives! And the pg/birth perspective.

Incidentally in France you do have smears in pregnancy which I thought was odd cos surely they can't do anything even if the test was reliable?

OP posts:
traceybath · 22/09/2010 19:44

Frakkin - I've had many smears and never had anything but the speculum and swab inserted.

Did the Dr explain he/she was going to do a thorough exam like that?

Tangle · 22/09/2010 22:10

You can state that you do not wish to have any internal exams. If they give you an internal anyway then its assault.

Lots of PCT's say that women should have VE's when they arrive in hospital and every 4 hours thereafter, and that they should have a VE before they start to push. But as you're not their employee you're under no obligation to abide by their policy.

There are reasons why a VE might be a good idea. If labour doesn't seem to be progressing then a VE might give an idea as to whether dilation is happening quietly or not at all. If you've started pushing (either actively or passively) and there doesn't seem to be any descent then a VE might provide useful information and help resolve the issue before it becomes a problem. But there should always be a clear explanation as to why a VE is recommended, including what information they hope to acquire and how it will be used.

When I had DD1 I didn't have any VE's at all - but I did have the advantage of an IM at home that new me and that was with me for the entire labour, which meant she was able to judge how labour was progressing through observation of me rather than point checking my cervix. With DD2 it was all a bit different as I had to be induced in hospital with gel inserted in the cervix, then a 2nd dose, then checked about 6 hours later, 6 hours after that and once just before 2nd stage.

So after all that, you can plan and insist that you will not have any VE's and (short of getting your committed under the mental health act) there is nothing they can do to force you to have them. But there are a few discrete situations where a VE might yield valuable information - its up to you whether or not you think the information is valuable enough to justify having the VE.

I'd suggest talking to your MW and explaining your position. They ought to be sympathetic and prepared to work with you to make the whole birth as untraumatic as possible. If your MW isn't helpful, talk to the Head of Midwifery at your maternity hospital directly - preferably in writing (its amazing what changes when things are in writing). If you still get nowhere, AIMS should be able to give you advice, or you might want to look into an Independent Midwife - they're not cheap but they tend to be very focused on providing woman centered care.

You might find these phrases by Mary Cronk useful to remember.

I'll caveat now and say that I'm a lay person that takes an interest in pregnancy and birth, having been through it with two very different experiences - and that a lot of it may be UK specific. I hope some of that is useful and pertinent to you in France (assuming I've got that bit right). I'm sorry its bringing back so much trauma and hope the rest of your pregnancy and birth can be more relaxing for you.

emmyloulou · 23/09/2010 00:17

hmmmm VE's don't tend to be done at all if everything is ok.

If you ever have to go into day assesment for any reason though with issues, every time, in every pregnacy they have done a VE for many reasons, including.

Checking cervix, to locate bleeding, to see if waters have gone, swabbed for thrush, GBS and infection, which is like a smear.

For the others they may use fingers if they can't "see". It's all dependant in your situation I'd imagine if you can weigh up the flashbacks with what they are testing for.

For example lots of my issues this pregnancy it turns out (infections) have been caused by GBS, found on a VE, which I will know recieve preventative treatment for before the birth to protect baby.

nunnie · 23/09/2010 07:52

I had one in previos pregnancy at 27 weeks to check if my cervix was closed due to previous medical history. Then had another to check how far dilated I was when in labour.

This time round I have not had one, and presume I won't till I am in labour again (35 weeks).

nunnie · 23/09/2010 08:06

Are you in France? I seem to remember a lady mentioning not long ago that they do them at every appointment in France. Will try and find thread for you, as if this is the case, then my experience is not helpful to you sorry. I am sure you will still have a right to refuse them.

usernamechanged345 · 23/09/2010 08:10

This reply has been deleted

Message withdrawn at poster's request.

nunnie · 23/09/2010 08:12

www.mumsnet.com/Talk/pregnancy/1021025-17-weeks-pregnant-and-had-previous-LLETZ-treatment-that-the

Here it is, it is on the first page near the bottom ish.

CardiCorgi · 23/09/2010 08:25

I'm in Germany and the doctor takes a swab at every appointment. It's not just checking the cervix, but for any infections and undesirable bacteria. I don't like it at all, but it seems to be normal here too.

tablefor3 · 23/09/2010 11:07

frakkinnakkered As everyone says, in the UK internals are not performed routinely during pregnancy and only sparingly during labour. But most importantly, only ever with your permission, so you absolutely may say no.

I don;t know whether you are aware, but on the Birth page (or poss Pregnancy) another poster was asking for advice on best dealing with her pregnancy and birth as a rape survivor. I have no experience of this, but there seemed to be a lot of helpful advice (most importantly, OP thought it seemed helpful) about all sorts of options, from pre-emptive discussions with Supervisor of Midwives, counselling specifically on birth, notes on birth plans, to clothing options etc. Although some of it was UK-centric, much was generic.

I wish you the best of luck for the rest of your pregnancy and on the birth of your baby.

traceybath · 24/09/2010 10:31

Frakkin - I hope you're ok - it sounded a really horrid experience.

japhrimel · 24/09/2010 18:16

You may well need internals if anything goes wrong and that can include suspected MC, vaginal infections, etc.

So even if you make sure everyone around you knows you don't want them done, it may become a necessity.

Also, if you have any issues getting pregnant, they can become routine - I had more VEs TTC than I have since getting pg (now 28 weeks).

Obviously there's lots that can be done to reduce the trauma, e.g. asking for female staff to do any exams, asking for a smaller speculum, etc. But if you want to start trying to get pregnant, it may be worth looking into counselling, CBT and/or relaxation techniques now so that you can cope with them.

Miffster · 24/09/2010 19:50

Frakkinknackered

sorry to hear of your fears, good luck honey, you might find this thread from a rape survivor about triggers including internals helpful?

lilly13 · 25/09/2010 14:39

you should definitely insist on getting an explanation why they decided to do internal exams. these were quite common about 25-40 years ago in some european countries from what i heard from my mom... i was not aware these were done in the uk nowadays... would be interesting to know the reason why these are done... good luck!

lulabelle · 27/09/2010 14:35

This reply has been deleted

Message withdrawn at poster's request.

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