Saying NO to an examination...

[peeapod]

I wanted to share my experiences from yesterday but didn't really want to so publicly. I hope this helps someone here as I can write more open and anonymously.

So yesterday I was experiencing tightening pain across my tummy. These started at about every ten minutes and wasn't disapearing after a bath or relaxing etc.

They were pretty damn painful and when they got to every 6 minutes it was decided that it was best to go to hospital to make sure everything was ok.

When I entered the assessment unit on the ward I was asked to undress from the waist down and cover myself up. I did so, but when the midwife came in she was like you'll need to take your knickers off. I said uh, why?

She said, so I can examine you. I said what do you mean? She said well I need to know how dilated you are and I can only do that by examing you.

After explaining that actually thats the exact reason why I am booked in for a C section next week (and completely freaking out over these pains because I have such a low pain tolerance) she huffed and said well you wont get a C section based on a few contractions. I stood my ground (with my ohs help) and she eventually said that she would go and get the doctor to explain it to me.

When the doctor came in he was really lovely. He showed us that the monitor I was on wasn't recording any contractions, and that thats what its job was (as well as recording baby's heartbeat). He asked if he could feel my tummy which I agreed too, luckily it co-coincided with one of these pains and he was able to reassure me that these were just very severe braxton hicks because he couldn't feel any tightening of the uterus.

I just wanted to share with you my story because I really think its important for women to be 100% clear on examinations, especially internal ones. I was in such a vunerable position and it was just assumed that I would consent. The midwife wasn't able to deal with my refusal without resorting to threats and misinformation, which without my partner being there could have forced me into consenting to what would have been an incredibly traumatic experience, could have actually started labour and increased the risk of infection. Ironically if I had consented it would have actually made my C section more in doubt because thats the reason why I needed one..

If anyone is in a position they don't feel comfortable in whether thats in labour, pregnancy or anywhere remember that no-one should have the power to force you into consenting to things you really don't want to do. Especially remember that its your body and your boundaries and that health professionals need to respect that.

I don't look on it as the midwife or the doctor being in charge of my care, but I see it as a collaboration and a negotiation. If a procedure needs to be completed in a certain way and only that way I never assume, and I always ask questions and I always feel 100% comfortable before I consent to it. In case of emergencies I try to plan in advance and my oh also knows my tolerances etc.

Work with the professionals, they might know whats best clinically but they don't know you and your personal situation.

You are right to highlight that it's a personal choice whether to have VEs or not, OP. I had one in my first labour but not in the second two (home water births). It wasn't even suggested by the community midwives who attended me, I think they are much more comfortable with just letting women get on with it than hospital midwives seem to be.
It also amazes me how many people don't realise that induction (or not) is also a personal choice. I chose not to be induced and went 18 days overdue, and I don't think I've told anyone in RL that without getting the response, "ooh, I didn't think they 'let' you go so far overdue". Not up to 'them'!!

Don't be rude, BobPatand.... the OP can withdraw consent at any time, you know. She wasn't 'asking for it' because she took her trousers off - for all she knew they might have asked that simply to feel her abdomen.

'its normal'not it's journal..

And yes the op didn't consent because she took her trousers off ffs, they often get you to do that to Palpatine your stomach etc.

lizzie I went to 3 wks overdue and got lots of, ooh they don't let you, why haven't you had to be induced etc.

Induction is often presented ad a fait Au complait and not just one option. It's all I will book you in for induction, when it should be a discussion about the options of induction versus expectant management etc.

You are right that you should give consent and it is your right, etc. of course it is. Everyone should be aware of this, so from that point of view this is useful to those who aren't already aware they can say no.

But to be honest I don't understand all of this 'the midwife having power over you when you were vulnerable'? She was just doing her job, I think you're being a bit harsh on her.
I would have happily consented to an internal examination if I was in pain and possibly in labour, I think most women would, so your case of not giving any consent without medical reasons are incredibly rare (not saying you may not have medical reasons but none you made the midwife aware of, she was probably confused when you did undress and then said no point blank) compared to all the women they see each and every day. I think I'd be a bit taken back as well if a lady possibly in labour didn't want me to check her out, I'm assuming possible early labour as well considering you went to the assessment unit.

Wow poor you OP, I don't get the confrontation on this thread at all! HCPs are indeed in a position of power and it's hard to be completely together when you're scared, in pain and someone doesnt give you the opportunity to engage with them.

But obviously, you took your trousers off, do you should just lie there and let her do whatever she wants - shut up and put up right?!

The HCP probably does see it as routine and as something people don't have a choice over - it doesn't mean she's right though. I think people do need to be educated about what is necessary and what is something a patient can make an informed decision about.

I'm glad you found your voice and said no. It was the right thing for you, and quite frankly that's what's important. Women are individuals, not conveyor belt incubators.

When I was in preterm labor, they checked once and was in too much pain to complain, the midwife just did it, and told me I couldn't push, I ignored her and pushed. If I was more aware about them and not that my babies were coming early. I still would have said, no.

snoggle really? Midwives can tell in many other ways how your labour is progressing.

Are you a midwife? Or is it just from your own birth experience. From on one single birth. They couldn't tell at all. They didn't examine at all and I was to be sent home first with a sweep. That was my first internal examination and I was fully dilated. I was in hospital for two days at that point waiting to be induced. I had a machine that measures contractions and fetal heart rate too. My DH argued with them that I was having frequent contractions but they didn't listen anyway.

Or maybe the NHS midwives in my hospital were just useless.

I don't find internal examinations that bad, I'm in Italy and see an obgyn every month, where she does an internal and checks belly, heart beat, blood pressure and reviews my monthly blood/urine tests. They are thorough over here, but I trust her judgement and know I can go to her with any problem.

but why is an 'internal' every month even necessary?
(answer - it is not)

had it on my first pregnancy, different doctor, she checks the mucus, any changes I suppose, and notes it down. I used to think Italy was a bit too over precautious but would rather it than not even caring.

arwen I dont' get why an internal every month is necessary either . I guess it's really different as what is normal in different country? I didn't get any internal examination until the midwife wanted to give me a sweep to start my labour. (Which as I said upthread, I was fully dilated at that point). Tbh I'd rather them actually checking me when I was in the hospital for birth.

it is just another way of oppressing women IME

there is absolutely no point or benefit in haveing someone stick their fingers up your vagina once a month throughout pregnancy. In my mothers days there was compulsory shaving and enemas and they didn't complain either, just taking it as 'doctor knows best'

I'm a bit baffled as to what the benefit of monthly internals during pregnancy would be.

I've had a lot of gynae stuff done (IVF, colposcopies) but only one "fingers in" internal, at the beginning of my fertility investigations. Interestingly, very few people here seem to have had them, just scans and blood tests, no manual examination. Given that he had just given me referral forms for blood tests, scan and HSG I did wonder what the point was. I question a lot of medical stuff but didn't question that and probably should have.

Hi op I really wished I had seen this post before I had given birth to my daughter.

I was induced over 4 days and had 11 internal examinations, they were soo painful and some of the midwives wouldnt even stop when I cried out in pain. One in particular told me it was part of being induced. (The pain) I was soo upset that I cried my dp looked on helplessly as he didnt know what to do.

I really wished I had said no as It has traumatised me and I am soo scared to give birth again.

I really wanted to make a complaint but didnt know how to go about It and whether I would be believed, there are other aspects of care that I felt lacked like not giving me any food for the whole day, me asking for a birthing ball or water which they would completely forget about 7hours later.

I don't feel oppressed, my doctor is female, I feel relaxed with her. I don't see the issue with it to be honest. I have found out things about my body, and know I err on the side of caution as she has told me my cervix is soft.

iloveshortshorts your post has really got to me.

I really feel it is never too late to complain especially if you are pregnant again. The process should help with the healing. At the very least you should talk to a trusted health professional about your experiences to make sure it doesn't happen again, or you at least feel more in control.

If it is the one thing stopping you from trying again then it needs dealing with. If you skim the article I posted it should validate your feelings as it mentions how PTSD can be triggered by internal examinations.

Your feelings should be taken into account and this needs dealing with. please seek out support in real life...

OP good for you! I have read other threads on here re examinations and it is interesting that often they are performed as routine and to get something in the notes. I also find them intensely painful even with gas n air and traumatic. I agree with you that it is very hard to stand your ground and I also hate 'making a fuss' There was an interesting article linked to recently which highlighted others ways in which good midwives can tell how dilated you are.

Thank you OP.

Like you I am very uncomfortable with VE's (for reasons I will not got into).

As a first timer, I have had to push to even get knowledge re whether I can reasonably refuse VE's - as I was led to believe by medical professionals (midwives and doctors I have seen during my pregnancy) that they are part and parcel of the process. Which I now know that isn't always the case and there are other measures that can be used before to VE's to get to the bottom of what's going on.

For those women who are comfortable then great for you, but I appreciate the OP highlighting that you can in fact say NO, and that you still will receive the care you need.

arwen I am really glad you don't feel oppressed and you are ok with it.

A trusting relationship with a HCP can really make a difference. Over here in the UK we don't get a named midwife (or at least not when you go into labour) as in the majority of places the hospital midwives are different to community midwives who see you ante natally.

I found this article whilst googling and whilst i dont agree with the extremes it talks about (I think its more about collaboration than redressing the power balance in the womens favour) it is a good article to make people think.

Im really not saying all internal examinations are bad per sea, but that I honestly think there needs to be more dialogue and openess about the reasons why they happen and making sure women know exactly why they are needed and what purpose they serve

I know it might sound weird but if a women is happy and comfortable with VE then I have no problem with that. My problem only comes from the feeling of powerless and lack of control that can sometimes result from VE. As in, it would be equally oppressive for me to tell everyone not to consent as it would to tell everyone to consent. it is a womens own body and they have the choice. it is about making sue women know they have that choice and have the ability to exercise it, even through someone else or in their notes etc.

www.bestdaily.co.uk/your-life/news/a567116/i-was-not-allowed-the-words-that-steal-our-birth-power.html

Wow peeapod that's a brilliant articel - spot on! This week I was told I would be induced at 40 weeks that I would not be allowed to go past 41 wks so this rings very true. For me it's not about disrespecting medical advice it's about being presented with a balanced picture of the benfits/ risks/ whole situation. Thank you for this article!

Thanks peapod It is one of the reasons that is stopping me from even thinking about having another baby, I will read that article and have a look at seeking some sort of help with regards to making a complaint x

I love shorts I'm sorry to read of your experienced they do sound awful. I seem to remember my HV and then GP asking about the birth so I'm sure there must be official avenues you can go down. Good luck

Unfortunately my obgyn will not be overseeing the birth as she works in a different hospital to the birth centre I am opting for which is run by midwives. In order for me to give birth there as I want a water birth. I have to have had no problems with the pregnancy, and provide all blood tests, scans etc that I have done to be considered there. Often when you choose a hospital over here, you see the resident obstetrician and take all of your tests scans so they have a bit of information on you.