Someone please reply, internal examinations

[ttcchapter1]

38 weeks, just got back from hospital as had a gush of fluid and have been told my contractions are 3 in every 10 minutes. They checked and my waters were intact. So been sent home.

However, i have a history of vaginismus and the internal examination was extremely uncomfortable for me even with gas and air. Can I decline internal examinations in labour in the NHS?

Yes and that is absolutely your right. There are other ways they can monitor your progress. No interventions should be done without your consent. Good luck!

@ttcchapter1
Internal exams are so painful aren't they :(
But they do show things that wouldn't be found externally... so whilst painful, just think they they're able to look after your baby better during labour :) x

@cat709 i really did try but I just wouldn't relax which made it more difficult her to check and stressed me out more which stressed the baby a little, so thats why I'm wanting to know if I can just point blank decline.

In what other ways could they monitor it? Does anyone knowv

Of course you can. It's your body. It would be a good idea to put this in your birth plan. Realistically, if you're having a baby vaginally, there is going to be some contact from the midwives as you actually deliver, but you can decline vaginal examinations to check dilation.

As with all birth plans, though, think of it as guidance, not set in stone. When you're actually in labour, you might you feel differently.

@ttcchapter1
Maybe just call your midwife and ask for advice for a different way? You might as well find out your options now, before you go into labour and become venerable and less confident to ask for what you want x

@cat709 will call my midwife tomorrow, because honestly I can't get over how awful it was, I had some what mentally prepared myself but she was really rough I think.

Try to talk this through with your midwife pre-labour. VEs are mainly used to check dilation, but they can also be required for other things, e.g. monitoring the baby. Get her to talk you through this in advance, to help you feel more in control, and to help you decide whether you will consent to VEs in some circumstances, but not others.

Make sure that your birth partner understands your wishes.

@MissLucyEyelesbarrow will call her tomorrow definitely.

You absolutely do not need any, it’s pretty obvious how much the contractions are ramping up in labour. You might end up wanting some to reassure you though.

Pregnancy yoga classes were really helpful for me to learn how to release my pelvic floor muscles by the way.

The most painful part of labour for me was the internal examination the midwife tried to do when I first got there, I pulled her hand out and and she didn't put it up there again! Baby was monitored with a handheld Doppler and I was lucky to have a fairly straightforward birth (although I did have a 3rd degree tear). Obviously if baby had gotten stuck then it might have been necessary for baby's safety, but you can always request epidural / c section.

@sparklingstars12
Out of interest, when you told her to not do it again, what did she say?
I know some midwifes can be so bossy that the female becomes too submissive xx

Contractions alone don’t necessarily correlate with how dilated you are.

Discuss it with them, but don’t rule it out completely. They need to do their job to keep you and the baby safe.

You absolutely can decline. Treat birth like any other medical procedure, they can't do anything without your consent. If you have time/are interested I would recommend Give Birth like a Feminist. I found it absolutely fascinating.
I also suffer from vaginismus and will be declining VE.

@FTM91 have you had a baby before or will this be your first? I have no issues with the pain or pushing and stuff, no anxiety there, with vaginismus its more anything going in.. like ive trained my body on how to insert things slowly but thats why i cudnt handle how rough she was.

Did they offer you any pain relief ? Like gas and air. Like others and your self have said a good chat with the midwife will be of great use and hopefully they would be a bit more gentle with you if they are aware you find them very painful
Like others have said you can refuse any treatment, any exam the midwife does needs to be with consent from you

I mean I get at times they'll need to make contact but checking dilation won't speed up the process in any way? Im sure they can monitor if baby is distressed in other ways. Will see what midwife says.

@cat709 I think she said something like I can't give you any more drugs if I don't know how dilated you are, but that was fine by me I was happy enough on gas and air.

You can definitely get through labour without needing any internal exams - but as others have said there are certain situations where you really need to have a check. It’s pretty standard to check on admission to labour ward so that they know the starting point, but I think you can probably decline that one; and then standard to check around every four hours after that to make sure there’s progress. That’s because if you’re not progressing there are extra things that can be done to help make sure things go well, as very prolonged labours can be difficult for both mum and baby. If you don’t have an epidural, it is often pretty straightforward to tell whether you’re making progress (you will feel different, and you behave differently coming to “transition” which is when you’re nearly ready to push). It’s often a good idea to have a check just before pushing though because occasionally if baby is back to your hack, you can feel like pushing but only be 6-8cm or less. But again you could decline that one assuming all going well and your midwife s seeing signs of progress. If you have an epidural it’s a lot harder to judge progress without an examination - but you’ll also not really feel the examination so that would hopefully work out ok! If baby is distressed at any point they will also want to check dilatation and that can’t be done without an internal (unless they can already see baby’s head). Not sure if that’s helpful at all - but hopefully you can talk it all through with your midwife. Good luck, sounds like baby will be here fairly soon anyway!

You can decline them but be prepared for them to preach about the importance of it. Good luck Op x

I declined them the whole process including on admission

I have vaginismus and am currently 30 weeks with my 2nd baby. The first time I gave birth I was given a few internal exams at the hospital to check how dilated I was, and it was very painful and distressing. They did give me gas and air upon request, but I didn't find it helped (it didn't help me with my contractions either) - but it might work for you as I know lots of people do find it beneficial. You could definitely stipulate that you are not to have an internal without gas and air.

Once I got to 4cm I had an epidural and after that I couldn't feel a thing - had they not told me they were going to do an exam I wouldn't have known it was happening! I also had to have ventouse and stitches, and again I didn't feel these. This time round I have agreed with my consultant that I will be having an epidural as soon as I request one (so I don't have to wait to be 4cm) and that they will do one vaginal exam prior to the epidural upon arrival at the hospital, if I am comfortable with that at the time. I am also stipulating that I will not be induced, and will go straight to c section if required - I know I wouldn't cope with the internal procedures that are required for induction (e.g. pessary insertion)

Please make sure that your midwife is aware of your vaginismus and the extent of your concerns, and be prepared to be your own advocate. Make sure your birth partner is briefed and knows your preferences too and that it's all in your birth plan .

Sorry that was really long! It's just something I feel really strongly about as I know a lot of people don't understand vaginismus as a condition and the impact it can have

@ttcchapter1 its my first. Like you, not too worried about baby actually coming out. For me it's not just about the pain/discomfort of them actually doing it, more that I don't want anything done that will cause my body to tense/seize up when I'm meant to be relaxing and letting something out! Plus VE isn't to monitor if baby is in distress, they use the heartbeat and a couple of other methods for that. It's to track your 'progress' on a chart and intervene if you dont follow the average, which of course many women don't.

It's to track your 'progress' on a chart and intervene if you dont follow the average, which of course many women don't

Most VEs in pregnancy are to check dilation, but they are used for lots of other reasons, including taking samples from the baby, if there is concern about fetal distress. External monitoring of the baby is enough in most labours, but not always. That's why it's important that the OP talks to her midwife, and understands the different reasons why VE may be suggested.