Declining vaginal exams during covid?

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I understand my partner can't join me on labour ward till I'm 4cm dilated.

I don't want routine vaginal exams. I'll consent if there is an indication baby is distressed but otherwise no. How will they determine if I'm 4cm dilated?

Very worried about being left alone for a ling-time because the vaginal is used as gate keeping.

Will this just mean I

Why would you not allow it?

Well they won't be able to. You are welcome to decline being examined but there is no other way of telling how far along you are. They can make guesses as to how well you are doing but there is no real way of telling unfortunately.

I think it’s horrendous how many women will be accepting vaginal exams against their wishes, just desperate to have their partner with them.
I really urge you to stand your ground. An experienced midwife should know by your behaviour, noise, comfort levels etc. Good luck with your pregnancy and birth and hopefully they’ll have space on the MLU/labour ward so you can have your partner there sooner rather than later.

@NancyBotwinBloom why is it ridiculous? It’s an invasive procedure that is pretty outdated, doesn’t serve a great purpose, and can be very traumatic for a large percentage of women.

There are other ways to tell. You don't have to allow the exams if you don't want to. You do run the risk of him not getting there in time though, if you don't present typically for your dilation.

Are you a first time mum? I can't speak for anybody elses experience, but I was worried that vaginal exams were going to be forced on me because I read other peoples (mostly American) experiences. In reality I was asking for the exams because I was so confused as to what was going on in my body. I never felt pressured into a vaginal exam at all.

People react so differently to labour that there's surely no way they can tell from your behaviour how far along you are. Some people wail from the first contraction and some people hardly make a peep even at the end. You can decline the exam if you want, but the attendants' understanding of how sad along you are will be reduced, potentially leading to your partner not being allowed til it's too late or worse, complications.

Your not being ridiculous, some of the comments here are. We still have choices even as pregnant women, and being touch even for a medical reason is with one those rights.

They won’t just keep you indefinitely in triage, they will use their expertise to put you in the right place.

For everyone else who negatively commenting, you have no clue on people’s personal experiences. I personally have diagnosed PTSD from sexual assault and am only comfortable having vaginal exams with my partner or named midwife present so that I can feel safe.

There is no way you should be bullied into consenting to routine VEs against your will, this policy is ludicrous, misogyny in motion.

But what your partner can do for you in labour is very limited. You can find a mental place inside yourself to go to, with your baby, and do this, whatever happens. I hope your partner will be with you but if you focus on practicing finding calm inside yourself (hypnobirthing or meditation or prayer or the mental aspect of many martial arts - pick what appeals to you most and practice every day) - you know for sure you will have that; if there’s a delay or any issue you will be in the best possible place mentally to handle it. And hopefully hour partner will be there, but that will only ever be the icing on the cake - you have got this.

Be clear with your midwife, she will listen to you, will want you to be ok and your birth to go well, and if you do unluckily get one who seems hostile, you can ask for a swap. If assertiveness is hard for you, practice how you will say that.

Wishing you all the luck in the world.

The thing is, vaginal exams are a fairly standard part of labour in all births, not just COVID ones. You won’t be having extra exams for the explicit purpose of COVID regulations.

You can decline anything you want during labour - it’s your body and your choice. But you also need to consider that if you decline exams you are limiting information to the midwife which could contribute to the safe delivery of your baby. That’s not scare mongering or pressuring, it’s just a fact that midwives use exams to guide them in the delivery of your baby. If you are happy with the associated risks of declining then you have every right to do so.

There are so many midwives who get it wrong about how far along you are till they check. You hear it loads. Including mine. I know this was further along but they no easy believed I was ready to push told me not to push and of course when they examined me they saw. So no like another poster I just wouldn't really trust them to know otherwise

Try looking up the "purple line" - basically its a line that appears up you bum crack.
Id heard about it - but while in labour i asked my midwife if it was a real thing and apparently it is.

Slightly embarisingly she even pointed it put to my parter who didnt believe it.

Apparently when the line goes all the way to the top of the crack you are "done"

She was a pretty oldschool midwife so i dont know how common knowlege of it is. But you dont havw to allow internals if you dont want them

People react so differently to labour that there's surely no way they can tell from your behaviour how far along you are.

It's one of those things that applies to most women but not all. There are other measures that can be used and they will generally know if you're in established active labour, if not exactly how many centimetres you are. Of course, you also risk being in longer than you want to be because they won't be able to confidently send you home if you show up too early, or vice versa- sending you home because they don't believe you're in active labour.

An experienced midwife should know by your behaviour, noise, comfort levels etc

This.
Op my second child is due in November and I won’t be consenting to any VE’s unless absolutely necessary - I certainly won’t be having one just to get my partner into the hospital.
I had bad experiences with VE during my first labour and later miscarriages, this time I will be telling them no and not just going along with what I’m told.

Good luck with the birth.

Cervical dilation is one indicator of imminence and an inaccurate one (it’s possible to massively dilate extremely quickly). The risks of VE (stress to the mother slowing labour, infection risk) may outweigh the benefits to an individual mother and baby, particularly in the absence of any indication of foetal distress.

Cervical dilation is one indicator of imminence and an inaccurate one (it’s possible to massively dilate extremely quickly).

It's also possible for a cervix to contract again in response to maternal stress.

I guess they can measure your contractions to give some indication? I would talk to your midwives and explain your position, they are there to help you. VE are an infection risk after all, especially your waters have broken. It tricky as they can’t always tell how far along you are though, I had a back to back baby and my contractions were all over the place for hours. I was told by two very experienced midwives that I was in ‘early labour’ and denied pain relief. I was on the verge of giving up. When they eventually looked I was about 7 cm. In summary I would just prepare for all eventualities. The whole rule of 4 cm seems ridiculous to me. If the partners are infectious they will still bring COVID to the hospital after 4 cm dilation. Other Wards are reopening for visitors in our trust yet women are still having to labour alone. And the thought of being induced alone gives me nightmares.

Personally I was very impatient during labour and asked for vaginal examinations because I wanted updates on how far along I was - and to be honest the midwives went far more off other signs, even really vague ones. My partner kept going back to them telling them how far apart contractions were, they were like ‘yeah yeah yeah’ but when I said ‘something is different, don’t know what’ they shot into action. Midwives are generally good eggs and I really doubt they’ll force vaginal exams, they’ll be able to tell a lot from your state and behaviour.

The rule on my ward was 4cm. But when my waters broke they had merconium in them and I was rushed to delivery suite. My husband joined me then. I was 2cm.
Good job too because 4 hours later I was 3cm and 1 hour after that I was 10 and pushing...

The midwives will know when you're in active labour without checking if you refuse, which is absolutely your right, but the intervals never bothered me at all, too busy contacting to give a damn. Only annoyed me because I was having back labour and it hurt to be on my back

I think you will probably change your mind when your in labour. You'll want to know how you are progressing. You can just tell them when you would like them to check.

I just let them do what they wanted in terms of examinations. There was also a student midwife so every time it was 2 examinations. I think between the midwives and doctors I had about 10-12 examinations in less than 12 hrs. I am convinced this is how I picked up and infection, myself and baby had to be on antibiotics for nearly a week. We were in hospital 5 nights and 6 days so I don't think your being ridiculous or unreasonable. However they will not be able to tell so you may get to a certain point and want them to check. I was induced and didn't get beyond 3-4cm after 12hrs of labour!

If you don’t want them, stand your ground. Lots of women have VERY good reason for not having them. I will be declining them. Last time, I didn’t have them as I had a v fast second stage and gave birth at home due to that. I know some women say ‘you won’t care’, but I did. I would NEVER feel comfortable removing all my clothes in front of strangers (Obviously bottom half unavoidable but a comment I hear often is ‘I didn’t care at all and stripped off completely’) or having someone doing a VE. You can tell from behaviour, noise and communication where someone is, different responses don’t mean that no signs will be present.

I only ever had one @Shelby30. I knew how I was progressing! I didn't need someone's fingers in my cervix to tell me.

You can decline any option that they give you. It's worth having a good chat with your midwife in advance about not wanting VE so they can put it on your birth plan and what alternative options they can use. Like a PP my baby was back to back and they didn't think my contractions were strong enough until they examined me and I was 6cm, I also need a VE from the obstetrician when baby was stuck so they could determine the best course of action so it's worth thinking about what your options would be in worse case scenarios too.

I believe there's extra support for women who've survived sexual assault who may wish to avoid VE because of this so again, speak to your midwife if this is the case.

You absolutely can decline them. they are not a good indicator of progress and cannot be used as a "gateway" to care, i.e. if you decline one, they cannot refuse to admit you.

You alone decide what happens to your body. nobody else.