Internal Checks — The Bump
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Internal Checks

Please forgive my naivete (I'm a first time mom).  I've read that when you are in labor and your water has broken, internal checks can cause an infection.  Is there a risk of infection if your water has not yet broken? 

I've also read that the dr may start doing internal checks around 36weeks or so.  What is the purpose of this, and is it necessary?  Thanks!

Re: Internal Checks

  • Every time you put something in your vagina, it moves bacteria further up toward your cervix. So every check does carry some risk, it's just higher if your water is broken.

    There is no purpose to doing checks that early. I didn't have any at all, and I still have a baby. It's a bad habit more than anything; it gives you no useful information. A reasonable doctor will allow you to decline. For me, it wasn't about the risk of infection, it was about letting someone get elbow-deep in my vagina for no reason. Many women find cervical checks pretty uncomfortable.

  • imagetokenhoser:

    Every time you put something in your vagina, it moves bacteria further up toward your cervix. So every check does carry some risk, it's just higher if your water is broken.

    There is no purpose to doing checks that early. I didn't have any at all, and I still have a baby. It's a bad habit more than anything; it gives you no useful information. A reasonable doctor will allow you to decline. For me, it wasn't about the risk of infection, it was about letting someone get elbow-deep in my vagina for no reason. Many women find cervical checks pretty uncomfortable.

    Thanks for the quick response.  I just wanted to be prepared in case the dr wanted to do any internal checks later on in my pregnancy (I'm 32 weeks right now).  I don't have anything against the dr checking if it is necessary, but if it's not necessary, I'd like to avoid it.

    Can anyone tell me under what circumstances are internal checks necessary? Prior to and during labor?  I just want to be prepared to accept or decline on sound judgment. 

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  • imagemairanellis:
    imagetokenhoser:

    Every time you put something in your vagina, it moves bacteria further up toward your cervix. So every check does carry some risk, it's just higher if your water is broken.

    There is no purpose to doing checks that early. I didn't have any at all, and I still have a baby. It's a bad habit more than anything; it gives you no useful information. A reasonable doctor will allow you to decline. For me, it wasn't about the risk of infection, it was about letting someone get elbow-deep in my vagina for no reason. Many women find cervical checks pretty uncomfortable.

    Thanks for the quick response.  I just wanted to be prepared in case the dr wanted to do any internal checks later on in my pregnancy (I'm 32 weeks right now).  I don't have anything against the dr checking if it is necessary, but if it's not necessary, I'd like to avoid it.

    Can anyone tell me under what circumstances are internal checks necessary? Prior to and during labor?  I just want to be prepared to accept or decline on sound judgment. 

    I didn't have any internals during my prenatal visits (I went to 40w3d).  The only way I would have wanted an internal would have been if there was a medical need for an induction.  This way I would know how favorable an induction would be and what type of induction would be most appropriate.  During your 35th week (I think that's when they typically do it) they will recommend a GBS test.  This is just a swab around the entrance to your vagina, you do not need an internal for that (in fact my office just gave me a q-tip and I went to the bathroom and did it myself).  I'm only saying this because sometimes doctors use this as a reason to poke around up there. 

    When I was in labor I was in the hospital for 7 hours and had 3 checks total.  1) When I was admitted 2) I requested one because I was feeling pressure 3) I requested this one as well because I wanted to see what station the baby was at.  I think it's reasonable to expect one when you get to the hospital and one when you feel the need to push, other than that if everything else is looking good I don't see the advantage.   Oh and my water was still intact when I started pushing, so risk of infection wasn't the primary factor regarding my decision to limit checks.  This is a good thing to write in your birth plan if you are doing one. 

     

  • my MW said she won't even do an internal check unless she thinks there may be a problem, ex:  positioning.  Otherwise will just check when i feel ready to push :)
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  • My doctor did one to check positioning of the baby at 36 weeks. Another reason they will do them is if you are contracting pretty regularly. I had an appointment Monday and was having some serious contractions/cramping and he said had I been 4 cm he would have sent me over to L&D.
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  • imagebdutton0005:
    My doctor did one to check positioning of the baby at 36 weeks. Another reason they will do them is if you are contracting pretty regularly. I had an appointment Monday and was having some serious contractions/cramping and he said had I been 4 cm he would have sent me over to L&D.

    At my last appt my dr was able to tell me the baby's position by feeling my abdomen.  Are they not able to use this method later on in pregnancy?

  • imagemairanellis:

    imagebdutton0005:
    My doctor did one to check positioning of the baby at 36 weeks. Another reason they will do them is if you are contracting pretty regularly. I had an appointment Monday and was having some serious contractions/cramping and he said had I been 4 cm he would have sent me over to L&D.

    At my last appt my dr was able to tell me the baby's position by feeling my abdomen.  Are they not able to use this method later on in pregnancy?

    from what i've read/heard, it depends on the doctor/nurse/MW. some are very good at palpating, and it's great that your doc can do that. most MWs use this method, as well. a lot of docs aren't well-trained in it and have become dependent on ultrasounds and internal checks.

    image
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  • I laboured at home long enough that I arrived at the hospital and my one-and-only internal confirmed I was 10 cm. My doctor didn't push me to do internals, although she kept saying we'd start next week. I was lucky and delivered on time, so there was no pressure over induction.

    I would only do a check before I was in labour if we were talking induction. If I labour longer at the hospital next time, I want only one person doing my checks (it is an estimate, and if you switch people it can seem like you "backtracked") and to space out the frequency as much as possible.

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