Vaginal Exams?

Why do you get a vaginal exam when you are in the last weeks of your pregnancy?

Here are some reasons some moms shared with me and some reasons I have heard.

vaginal exam

Curious if you are dilating?  “Because I was all excited to know if I had dilated any.”  Dilation does not mean anything.  Moms could be dilated several centimeters for weeks and not go into labor. This could cause anxiousness either way- I am not dilated and my body is not working or oh my goodness, I am dilated so I must be about to have a baby any moment. “Trying to make a decision about an induction” If you are considering an induction it is helpful to know how dilated you are to find out if your cervix will need ripening or if you can be directly induced.

Want to have your membranes swept or stripped? ” I was hoping to avoid an induction with Pitocin since I was already a week past my guess date.” This is one of the lowest interventions to getting things going if you are sitting on the ready button. So if you are postdates and facing an induction it may help release some prostaglandins to get you going. Did you know if your baby and body are not ready the sweeping could cause your uterus to become irritated and could even risk having your water break without contractions, thus leading to induction methods to continue the labor your body was not yet prepared for.

The nurse told me to take my panties off. “Because that was what the doctor and nurse told me to do…but in my last few pregnancies I said no thank you. The nurse was always confused and somewhat put out that I was not agreeing to what she told me to do. My doctor though was fine with it.” You must remember there is risk to an exam; risk of infection, risk of your water breaking, risk of information that may make you anxious and nervous, risk of having an irritable uterus. This can lead to contractions that are painful enough to keep your attention and now allow you to sleep without really putting you into labor. Entering labor with little sleep is no fun. So, you get to decide if you want to take your panties off. You can receive a GBS test with the mere use of a swab without any fingers entering your pelvis at all.

I thought I had to have an exam. “Everyone was asking me if I was dilated any and what the exam at the doctors office showed. “ We have clients who never get an exam unless there is a medical indication for having one. Yes they manage to go through the last months of their pregnancy without an exam and some even do not have any or very few during their labor. There is really very little value in the information an exam provides.

I had some medical concerns. ” I had a cyst that I wanted them to check out. Turned out to be no big deal.” There are reasons to have an exam if you feel you have an infection, are bleeding, or contracting very early in your pregnancy where they may need to stop your labor. But thinking your baby may be too big is not a reason to have an exam.

Remember to use your B.R.A.I.N. Ask what is the benefit of this exam. Is there a real medical indication that an exam is needed? What are the risks to having this exam? Do the benefits outweigh the risks? What is your inclination internally- what does your intuition lead you to want to do? What would happen if you decided not to take your panties off? Is there an alternative to having an exam? And here is the most important thing to ask. What will happen now that you are examined next?

For instance one of our moms had an exam at 35 weeks since according to her doctors she was showing some signs of pre-preeclampsia.  She did not understand any further reasoning behind the exam except that she may end up needing an induction. But they would not be inducing her anytime soon- she is premature at this stage and not showing any signs of full pre-eclampsia. They are just being watchful. But what if during the exam her water had broken- or they introduced some germs that could cause an infection that caused her water to break? Then she could end up having to be induced and having a baby who was early and had some problems. Was that exam worth the risk? If she was actually showing more signs of pre-eclampsia- not just an increase this visit in her blood pressure, maybe so.

But you get to be part of that decision. It is your vagina, your baby, your body, your birth.

Some more food for thought-