Weekly vaginal checks starting at 36 weeks? Frequent vaginal checks in labor? Does this policy give your provider important clinical information – or is this an obstetric ritual that exists simply because it hasn’t been questioned?
Vaginal checks in labor can be uncomfortable and intrusive. Amy Wright Glenn wrote a two-part series Dear OB: It’s Not Your Vagina and discussed this policy with our own monitrice, Rachel Leavitt. She reminds women:
Mothers-to-be, laboring women, pregnant friends – listen to me.
You have the right to determine who – if anyone – will put his or her hand in your vagina during pregnancy and birth. You have the right to inquire about any procedure that is being suggested as part of your prenatal, labor and delivery care. You have the right to consent. You have the right to request a vaginal exam. And you have the right to refuse one. Period.
But, is this an important piece of your clinical care? Does your provider NEED this information to provide safe care?
“We look at a lot of different signs to determine progression. We do very few cervical checks. We use signs such as change in contraction pattern, how the woman is coping, physical signs such as shaking, nausea, bloody show and moaning. You can see how a woman begins to turn inward and the ability to concentrate decreases. These are the typical things we will look for and chart. We only check when women first come in, and if they refuse, we don’t worry about it. We will also check if it has been a long time without any external signs of progression or if there is a clinical need. Again, a woman’s right to refuse is acknowledged.”
of Evidence Based Birth examined two studies that looked at the effect of weekly checks at the end of pregnancy. Her conclusion:
I think in summary the evidence really shows that there is no benefit to doing the weekly exams. It may satisfy your curiosity or your doctor or midwife’s curiosity, but it doesn’t really have an effect on your health either way. You are asking me what’s the evidence, what references can I use when I go to talk with my doctor, and I would say when it comes to a situation like this you don’t have to give your reason why. If you don’t want the vaginal exams, either because they make you uncomfortable or you just simply don’t want them or you think they’re unnecessary for whatever reason, your reason is your own and you don’t have to explain it to anybody.
Be sure to read the entire excellent Q&A or watch the video: