On the subject of vaginal examinations..

[ohthegoats]

.. what do they do that might make them more painful than contractions? Why (apart from previous issues related to them), might they be so awful?

Signed,
Naïve.

I don't really know how to describe the smell, its not like any other smell.

Interestingly not all women get it and also some midwives seem unable to smell it. I've got a poor sense of smell but I do notice it, maybe in only 50% of women though.

Also the smell doesn't always stay until the baby's born. Sometimes it only seems to last 5 minutes.

Just wanted to add my midwife was extremely respectful and before each internal checked I was happy with it and whether I wanted her to do it, she actually said she didn't have to each time. I had one on her arrival (6cm), one when she thought I was fully dilated (8cm), one when she thought I was fully dilated again (9cm, arrgh!) and one when I was finally fully dilated. As a first timer I was very nervous about how fast I was or wasn't progressing so I agreed to each one very emphatically.

My main goal for next birth is to put the clocks away and just let my body do it at its own pace.

My midwife was a very senior community one, so I don't know why I was acting like I was in transition for fucking hours on end!!

I had lots of internals during labour, 2 sweeps and my waters broken, baby had blood taken from head and a clip put on by a consultant and none of them hurt at all.

If the soles of my feet weren't together and up by my bottom, I wouldn't have know they were happening!

Guess it depends on person doing it and readiness of cervix?

Viva la beaver or anyone else - do you know if it's necessary to have a VE at the beginning of induction, i.e. before established labour? Also is it necessary before getting in the birthing pool? I find them excruciating even with gas and air as I have mild vaginismus so I just involuntarily seize up and make the whole thing worse for me and the m/w. Much more traumatic than the birth! It's so helpful to read that others hate them too - I thought it was just me!

Well for an induction you need either prostin gel or a pessary putting up there so yes you need to be examined. Its important that the gel or pessary is in the right place, behind your cervix, so the midwife needs to see where your cervix is. Plus if its a gel there's different strengths of it and the midife needs to know what your cervix is up to to decide which gel to give.

The pool is a good question. Where I work and I'd say at most hospitals you have to be 4cm to be "allowed" in the pool. It would be nice to think that a midwife could use their discretion and just say that this woman appears to be in established labour, her contractions are regular and palpable. In reality I'm not so sure.

Sorry not to be more reassuring. Did you see what I said about asking for gas and air for the examination?

Yes I will insist on gas and air. My situation is so extreme that the midwife couldn't get the pessary right up there as I was clamping on her. I presume thats not normal?! Luckily my labour was already under way and I gave birth 9 hours later! Thank you for your reply

Its not common but it does happen. Its not normal to have a total stranger sticking their fingers up your fanjo when you're already feeling stressed and vulnerable.

I'm not surprised some vaginas clamp down.

Haha good point - thank you!

When I've had painful examinations, (with gynes not midwives) it has always been a matter of not enough lube. I had one examination once following a repair op on my fanjo and it was excruciating, despite local anaesthetic. I asked again and again if they could please use more lube. They finally chucked a load on and the pain was gone instantly. They could do what they wanted and it didn't Hurt. something to think about...

Unfortunately, some MW will refuse to give you pain relief, including an epidural or the "allow" use of the pool until you submit to a VE.

I had 2 ve with my first dc (I don't recall any more than that). Don't remember feeling them at all, so not painful. Pap smears are much more painful ime.

I was given 2 without my consent in my first labour, they weren't painful but the surprise element was very traumatic for me. With dc2 I made it very clear that I expected to be asked first and luckily I had a very respectful mw who asked first and made it clear that I could decline. I only had one which wasn't painful in itself but laying on my back so she could do it was really uncomfortable so I refused to have any more after that.

When I have a smear or other very long and I've had enough vaginal exam outside pregnancy, I don't have pain so much as after a while my fanjo seems to think "right enough of this" and pushes the speculum out! They say 'don't squeeze it out' and I'm like 'I'm not, it's decided to do it on its own!'

I am going to mention this to my MW as I don't know whether it could affect and examinations etc' in pregnancy.

interesting to read all these comments. in my first pregnancy I had a sweep and hadn't expected it to hurt - it was excruciating so in my second pregnancy I refused one. I also had VE in my first Labour which were very painful - and also quite disheartening; I had had very very painful contractions in my back (DS was back to back) and assumed it wouldn't be long, I was only 1cm dilated - a couple of hours later I was 9cm but that initial VE kind of ruined my mindset I think. in my second pregnancy I put in my birth plan that I didn't want VE unless vital and discussed with me first (ie; I had the final say) - on arrival to hospital the midwife began prepping for a VE without reading my notes, I explained I didn't want one and to be honest I was treated differently from that moment. I was fortunately left to 'get on' with things but there came a point I could no longer cope with the pain and asked for some gas and air and was flat out refused. the attending midwife (who fortunately finished her shift shortly afterwards) told me she couldn't give me entinox because she couldn't be sure I was in active Labour without a VE. she then stood and watched me have 2 or 3 excruciating contractions waiting for me to basically give in and beg her...of course I had to let her examine me (the worst part really being made to lie down when I'd been very active beforehand) - I felt I'd got completely out of my 'zone' and of course I was in established labour. I suppose my question is - now I'm pregnant again - is is this standard stuff? do I have to relent to get some pain relief? I felt so empowered second time around until the pain got too much - this time I want to be able to say no strapping me down and making me stay still for monitoring when I want to walk around, no VEs, no making me feel like I don't know my own body, but please be on hand with the entenox if it all gets too much - is that too much to ask?

ps I asked my midwives about the alternative ways to measure dilation in my second labour...only the student admitted to knowing about any of them - DH took a picture of the red line up my back as he'd seen it in my previous labour. and I've heard that the smell is a combination of cut grass and semen!

I've heard that the smell is a combination of cut grass and semen!

Interesting. I think the smell of me has 'changed' since I've got pregnant - boyfriend says not, but it definitely has. To me it smells slightly of semen, even when no semen has been anywhere near me for a few days. I'm going to be sniffing out cut grass too now. TMI!

I found the VEs in my first labour (well, technically I've never been in labour, but I've tried for painful days to get there :) ) really painful - whether by gentle, experienced doctors/midwives/nurses/surgeons or the inexperienced beginner. Second labour (again, not really labour), I was bracing myself for the pain, but they were all fine - even the rougher ones.

That's awful about the gas and air Nice - I managed to get some on the pre-natal ward. I went in, barely dilated - never even got to 2cm, but I'd been having strong, frequent, regular contractions ramping up over the week - I wasn't coping, and was knackered. I jumped through their hoops of a warm bath, had some blessed pethidine which got me an hour's sleep, and then DP basically camped out at the desk until he got me a mobile Gas and Air rig. I wouldn't have been able to - I was having very painful contractions 2-3 minutes apart and could barely think, let alone argue my case for pain relief despite not being in labour!

The first one I had in labour was horrendous, but it was because my cervix was still high and posterior so she really had to rummage for it. The one I had at 6cm was painless.

Mine were awful. It wasnt the pain of the fingers inside me, but the remainder of the hand against the outsode that caused the pain. The MW pushed so so far up inside that the fingers, knuckles etc left outside were absoloute agony amd I felt bruised long after.

I needed G&A for the VEs. Not for any contractions.

I never even felt my VE (I had two during labour, one at 2cm and one later). BUT I had been sucking G&A pretty much constantly from my arrival at the unit. I also find smears no bother at all.
I feel quite lucky reading some of your stories.

IME, MW will hold any pain relief hostage until you give in and have a VE. Cruel and unnecessary, especially when it is obvious that you are in active labour.

NiceCup - sadly with some MW you will have to relent to a VE if you want pain relief. The MW have all the power and some of them will abuse it.

The vaginal exam during labour with #1 where they used the biggest speculum I have ever seen to force my cervix open was a damn sight more painful than a contraction....

(and I have had natural births).

On the plus side, I didn't even realize the sweep I had with #2 had been done until she told me I could get down from the exam table :)

they used the biggest speculum I have ever seen to force my cervix open

So there's the answer to my question! If they are forcing a CERVIX open, compared to using one to SEE your cervix, then I can understand why they are so painful.

While I can see every woman should have a choice regarding any examination or medical proceedure,surely the purpose in doing a VE is so the midwife/doctor can offer the best care and management of labour to the patient, it's not for their own benefit, they're only doing their job.
I've recently had DC4 and have also had several miscarriages so have had multiple VEs/internal scans, none of which I felt were unnecessary or forced on me.
In fact I had the opposite issue with DC4,I was induced on my due date with prostin gel and labour progressed fairly rapidly. I had paracetemol and then codeine tablets which I promptly threw up.I was offered pethidine but didn't want to take it too close to delivery so asked for another VE as last labour I ended up having it and then needing to push minutes later, midwife had assumed I wasn't as far along as I turned out to be.I was told the policy was to examine every 4 hours, if they did it more frequently they would need to document it and justify why ,and how it would change how they managed the labour. As a compromise they said they would exam with a 2 hr gap.I got up to go to the toilet just before the exam,my waters broke,I felt I had to push and DD3 was here within 10 mins!