Do I have to have a cervical exam in labor?

Cervical Exams in Labor?

Are they a must? Can you refuse? Should you refuse? Do you want one? Hmmm... Good questions. All of them.

The purpose of the cervical or internal exam is to give your birth team information about what is happening with your cervix RIGHT NOW. Not in ten minutes. Not in 5 hours. But what is going on RIGHT NOW.

Is that important? Well, yes, sometimes it is really important! Sometimes, having an idea of what is happening “down there” helps to make the decisions about what should or needs to happen next. But, generally, if your labor appears to be progressing and you and baby are doing well, there may not be a good reason or a need for an exam in labor.

should you get your cervix checked?

Here’s my opinion — and this is just my opinion…

There are 4 good times for an exam:

1) When you first get to the hospital to see what is happening. I mean, if you are 2 cm dilated and went in because your water broke, maybe you want to go home, rest, eat, have sex or use the breast pump to get things moving along, or just be patient. (Most labors commence with in 24 hours of your water breaking.) Many care providers will send you home if all seems well - meaning that your water is clear and baby is moving well.

2) If labor seems to be troublesome. What I mean by that is that things just seem "off". Note: I didn't say SLOW...Slow labor can be just fine! Sometimes, the internal or cervical exam can give valuable information that doing Leopold's (that’s when they feel your tummy to see the "lie" of the baby) doesn't tell us. For more on station and position of your baby, go and check out some of the posts on our Instagram post!

3) If you decide that you want an epidural. Especially if you suddenly feel like you want an epidural when all along you said that you didn’t want one… Sometimes, that is "Transition" talking. You know that "I'm done, you have this baby, I want to go home" train of thought that goes through a person's mind when they are in Transition. That is a really good time to have an exam cuz more often than not, you might be ready to push your baby out. No kidding! And if it’s not quite “baby time”, and you still want that epidural, well then, by golly, YOU are the boss of your body. Get that epidural!!

4) What if you just want to know what is happening down there? Well, then that can also be a good reason to get the exam. Remember how I said that you are the boss?

Is there a time when you shouldn't get one? Perhaps. If you are GBS positive or your water has broken, you might want to reduced the times you "get checked" to keep the risk of infection lower. Or, if you just don’t want one.

Let’s talk about Informed Consent…

I truly believe most care providers are exactly that. CARING Providers. However, here is what should happen before an internal exam occurs.

Your care provider should explain exactly WHY they want to do an internal exam. EVERY TIME. They should explain HOW they will do it. And BEFORE their fingers go anywhere…You should get all of your questions asked and answered. If you decline, then your “NO” is NO. If your care provider pushes the subject, you can simply say, “I would like it documented in my records that I am declining this internal exam”. Practice speaking those words out loud so that you feel comfortable saying them.

If you have consented and now the exam is being done, they should tell you EXACTLY what they are doing when they are doing it. It might go like this…

Care Provider: “You will feel my touch. If at any time you want me to stop, just say so and I will stop. (Pause) You will feel my touch. I have some gel on my fingers so that may feel cold. (Pause) You will feel one finger touching…And now, two fingers. Are you doing okay? May I continue?”…

You: “I’m okay. Thanks” or “Just a minute, I feel a contraction coming on” or “oh, please stop. I don’t like this” and always ask “Can you please tell the me station and lie of my baby after you are done”…

When an exam is done in this manner, it is being done WITH you and not TO you.

At 4TFM, we always say that birth should happen WITH you and not AT or TO you. Being in control of what is happening to you starts with preparation during your pregnancy. Search out care providers that are aligned with what you hope to have happen. Search out care providers who are known for honoring birth plans. Search out care providers who are known for informed consent. Not sure where to start? Start with the doulas in your community. Really. They have seen many different care providers in action and have been to many different birthing venues in your town. Truly, they will be a huge resource for you. Take Childbirth education. Check out our Birth Ball Basics clinic (online or virtual) where all of this and so much more is taught.

If you aren’t sure where to start, contact us for more information. We are here to help you!

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