Vaginal Exams in Labor

31 Weeks 3 Days

Yesterday I posted my birth plan. Here’s one of the lines from it that I’m sure at least some of you were confused about.

I would like to avoid all vaginal exams unless it is deemed truly useful or I request it.

But aren’t vaginal exams common place in labor? Wouldn’t I want to know how long it’s going to be until the baby is born? What’s the problem with a vaginal exam?

You see, vaginal exams are not a good indication of how long until you’ll go into labor, they are not a good indication of how much longer you have in your labor, and they can actually harm your baby by pushing bacteria up the birth canal where it’s not supposed to be.

Indication of going into labor: Many-a-women are told that they’re 2 or more centimeters dilated and then end up waiting weeks to go into labor. Just as many women are told that they’re so tight that they might as well be sutured and they go into labor that night. There is absolutely no correlation between how dilated or effaced you are and how long it’ll be until you go into labor. Regardless, many doctors (and even midwives) want to do a vaginal check every appointment from 36 weeks on.

Indication of progression of labor: When you get to the hospital, they will want to do a vaginal exam as part of your checking-in procedures. Likely before you even check in so that they can see if you’re really in labor. Even if you’re in the middle of transition they will still want to “confirm” it by a vaginal exam. Then they’ll want to do one frequently to see how you’re progressing. The problem is that vaginal examines are not a good sign of progression. According to hospital procedure, you’re supposed to gain 1cm dilation per hour, which means a 10 hour labor. Wouldn’t that be great! The truth is that even their own textbooks say that labor is 12 hours or more, so how does that add up?

In all actuality, first time moms often take 24+ hours to give birth. Even moms with previous births may take that long. Throughout the labor, dilation will progress, but maybe it’s slower than 1cm per hour. Maybe it’s in bursts and you won’t gain anything for four hours and then suddenly get 2cm in 30 minutes. Some women even go into transition when they’re at 6cm or less and gain that last chunk in the course of 15 minutes to an hour. It can actually be a good thing for your labor to stall if that’s what your body needs (Myth #5). So why are so many women being slapped with a “failure to progress” and given a c-section when the only indication is their dilation?

Harm to your baby: If your water has broken, you should avoid vaginal exams as much as possible. Many medical professionals act that a broken bag of waters is a ticking time bomb when it comes to infection. If your water is broken and you have the slightest fever (which is normal in labor), they’ll want to start giving you antibiotics. The truth is that bacteria are not salmon–they don’t swim upstream. Bacteria aren’t just going to naturally travel up your vaginal and cause an infection, something needs to put them there. A finger, even with a glove, is a great way to push the bacteria up into your uterus. Even the bacteria that don’t cause a problem when on the outside can cause a problem when pushed upwards. Then both mom and baby are at risk because of an infection. Not to mention that antibiotic use in labor often causes thrush (an overgrowth of yeast) in the early postpartum days and believe me, that’s one breastfeeding thing you don’t want to worry about getting rid of.

I am now 31 weeks and 3 day pregnant. Things are mostly the same as they were last week. Lots of sleeping. Feeling irritated more than I should. My back is killing me (though I got a massage last week and that was awesome) and so are my feet. Right now I feel like I’m keeping up with the things I really need to (attending class, laundry, dishes), but anything out of the normal is just so beyond me. I don’t feel like I’m accomplishing anything even though I know I am. I also have a strong urge to hibernate for the winter (meaning not leave my house like… ever). Just a few more weeks in the semester and then I’ll have that off my plate. We got some cute {used} giraffe footie pajamas for Twig. Really, I can’t think of much else we’re going to need. Maybe some wool longies. So cute!