Declining internal examinations during labour

[Umberta]

Dear mumsnet,
Has anyone out there had their baby and managed to decline the internal examinations?
Without going into too much detail, I know that it would distress me very very much to have a stranger move their fingers around in there. But I'm a bit worried that when I present at hospital in labour, they'll "need" to do this examination. I'm only 29 weeks now, but I was at my hospital's labour waiting room the other day (had to go there for something else) and I saw a lady arrive in labour with her husband...they made him go and wait outside the building while she was examined, to decide if she was advanced enough to be admitted (then they'd let him back in). If I refuse, I'm afraid theyll just not let my husband in or even make me go home.
I've just had my first NCT class and the teacher was lovely, but when I asked this Q her answer was along the lines of ways of making this examination less distressing...she really didn't get that I absolutely can't have it. I'd rather just have my own baby on the kitchen floor with no medical help at all, if necessary!
Basically I'm asking has anyone else declined these, and how was it managed?
Many thanks!

I don’t have experience of this but books I have read and my hypno birthing course says you can absolutely decline these. Hope it goes well.

I've had two babies and never once was offered examination. They went on how I was behaving and the line up the back. Were both in the birth centre which is very hands off.

You can decline them but important problems may not be detected quickly.

It might be better, if you could, to confide in your midwife. Many hospitals have special pathways for managing women in your situation so you can build relationships with specific midwives etc.

You can decline.
I think you should speak to your midwife about it though:

Why? I beg for them and almost lost my child (and myself) in labour because the midwives were too busy to check.

Would you rather have your baby struggling/dying to avoid discomfort? It is your choice, you can decline them and your baby may be fine, but if something is going wrong, how are the midwives/doctor meant to know it is time to intervene?

They must ask permission and you can absolutely decline. Most hospitals at the moment have a rule of 4cm dilated before husband can come in, or established labour, which they can tell from behaviour as a pop says. Don't worry. X

You can decline, but as pp have said confide in your midwife. At least that way they can have a think of how they can potentially get around this. Have you considered requesting a c section? Not sure if that means they dont need to examine but I would have assumed there would be less need.

Good luck and I am sure they will be able to work out a plan for you.

Is it the fingers specifically that is triggering, or is it any kind of penetration? How would you be with a speculum or an ultrasound rather than fingers? (Depending on the cause for the trauma I can imagine that could either be better or much much worse).

If you refuse they won’t force you (that would be assault), the issue is that if they don’t know how dilated you are and how low down the head is, they can’t tell how well labour is progressing, and sometimes midwives need to use their hands to help re-position the baby to get them out.

Have you talked to your midwife? This seems like the kind of issue where a c-section might be a good idea.

@TheMotherofAllDilemmas survivors of sexual abuse and those with medical conditions such as vaginismus struggle with these examinations, it's not necessarily about trying to avoid discomfort.

birthrights
have a look at this, OP
you absolutely can decline to have vaginal examinations and a good midwife will work around this
however, it might be worth talking it over with your mw
there may be other procedures that are internal, that aren't VEs to assess dilation
for example, they mat suggest it would be good to break your waters
if they are having trouble hearing the baby's heart beat they may want to do this vaginally
you may have to think are there any situations when you would consider an internal? at what point would the advantages make it acceptable/managable for you?

Would you rather have your baby struggling/dying to avoid discomfort?

OP said it would be distressing, even an idiot can work out that is a bit more then 'discomfort'

Speak to your midwife OP, but yes, you can decline.

I am reading the positive birth book at the moment. The author talks about this (which i think is called a 'sweep' in the book) and how she declined with her second child. It may be worth checking out!

It's just the risk factor I guess like if you need an episiotomy or to have stitches, forceps or suction delivery. Childbirth can go horribly wrong very quickly.

Speak to your midwife openly and perhaps they can explain your options and potential consequences. I don’t know enough but I think you need the right support, and correct management of labour to suit you and keep you calm. Best of luck !

I am reading the positive birth book at the moment. The author talks about this (which i think is called a 'sweep' in the book) and how she declined with her second child. It may be worth checking out!

Lots of people decline a sweep. OP is talking about internal examinations when she is in established labour.

First baby my waters went so I went in to get checked over. I declined the internal exam. They listened to baby and all fine.

Went back later when contractions ramped up. When I was begging for gas and air they refused until they had examined me, I would have done anything to get relief at that point so let them. Idiotic woman was shocked I was 8cm dilated

Anyway the point is you have a lot more control and more options than they will tell you. You have to understand their priority is to get baby out safely, not to give you a nice experience. I don't mean that in a horrible way I just mean those are the facts. And that is how it should be. The priority must be getting baby out safely. Any other priority would be wrong.

Ideally you would talk it through in detail with your birth partner so they can advocate for your wishes.

@rt00063 a sweep is something different. They do vaginal examinations to check for dilation. These can hardly be felt. Never had to do maneuverings of any kind so can't say about those.

Membrane sweep is an induction method where they physically separate a bit your uterus from the placenta. Guys! It hurts!!!! I have it written on my "birth preferences" that I do not consent to this treatment. In my personal experience, besides being painful, it never helped speed up labour in any way shape or form. I was nearly 42 weeks for both DDs...

OP, do talk to your midwife about your concerns :) and maybe research about it. What are your limits? Is there a situation where you would accept it? Example: "I don't want any examinations unless your experience tells you something it's going exactly to plan" sort of thing

Have you read The Positive Birth Book by Milli Hill? That ( and various hypnobirthing books) all stress that you can decline. The book I mention has example birth plans, you get access to all different icons you can use and there’s one for refusing internal exams ( there’s one for possible reasons for that too but obviously you’d use whatever you were comfortable with).

I can recommend the book in general, it’s helped me feel much calmer about birth and I was really struggling with the thought of it for different reasons to do with my own past.

I’ve also bought The Positive Birth Company digital pack, it’s a hypnobirthing course with lots of videos and mp3s. It’s very calming and I’m finding it helpful too. The pack also gives you access to a private Facebook group where women share their birth stories - I mention this because I was just reading one where a woman declined internal examinations. She had wireless monitoring though as an agreed compromise with the midwives. The Positive Birth Company have a YouTube channel if you wanted to look at some free videos to see if it might be for you.

I’m mentioning those things because they really stress having a birth plan, even though things don’t generally go to plan. So many people have told me ‘oh don’t bother with a birth plan nothing ever goes to plan’ that I really thought it was pointless- but this has helped me to see that it will actually be helpful to make my preferences really clear, and include plan b and c and d too. For example, what will you do if your baby needs assistance from forceps or ventouse? Would that be manageable for you? If not it might be worth stressing in your plan that you’d prefer a section in that case. If you need induction would you be ok with them breaking your waters?

Definitely talk to your midwife and think through some of the scenarios. Have you got a supportive birth partner who will be prepared to stand up for you on the day?

I had c sections and only had one, and that was at my request because I thought I was leaking amniotic fluid but it was actually wee.

I’m sure there was fiddling around afterwards but I couldn’t see or feel anything so it didn’t matter.

It's your body so you absolutely can decline. Your body, your choice. My birth plan said no internals unless absolutely necessary. I had one, with my permission, when I was starting to push. So all of second stage was done without one, the midwife monitored DD in other ways. There is a book "Why Human Rights in Childbirth Matters" that is good at explaining the whole "Am I allowed" mindset which is so disempowering for women.

I can't answer your actual question, and hope you get a helpful answer. I'm guessing you'll have a fight on your hands though.
But please also be aware that they will also want to examine after for damage. The woman tends to be more aware of that one (no hormones) and is obviously more tender. They may also want to check your bottom.
You can obviously decline those too, I just don't want you to be surprised by it.

You can Absolutely refuse this, Don’t worry, but I do think you need to let your midwife know.

Do discuss the options with your midwife and only then make your decisions.

I don’t have any experience about declining sorry OP. But I just wanted to say they can’t always tell from your behaviour how far along you will likely be. When I went in to the hospital (pre covid) they made my partner return to the car to collect the notes he forgot. Whilst there she gave me an internal exam clearly thinking I was wasting her time and I was 10cm. I knew I was far due to the pain but I’m not the type to scream a place down neither?

I imagine with Covid they will be even more likely to make your partner wait outside until the last minute unless they know for sure how dilated you are.

Hopefully you can speak to your midwife for your options as I’m no expert but is it possible to have a vaginal birth without checks by the midwife? x

I had a home birth with my second and had absolutely no internal exams at all. I didn't refuse, they just weren't done.