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whether to decline internals?

Genevieve_krisGenevieve_kris member
in Natural Birth

I've started the weekly appointments, and at my last appointment, the MW said that we'd start doing internal exams today.  Is there any reason not to decline the internal?  From everything I've heard they increase the risk of infection and can be pretty painful.  I've also read and heard that what they find up there (dialated, effaced, or not, etc.) is generally pretty meaningless - meaning that I could be 2 cm dialated for weeks or converserly could not be dialated at all and could go into labor tomorrow. 

Has anyone else declined the weekly internals?  If so, how did your practitioner react?

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Re: whether to decline internals?

  • lesleytaylorlesleytaylor member
    my midwife did an internal at 36 weeks after she took the swab for the GBS test.  I do not get my next internal until 39 weeks.  I would decline having an internal at every weekly appointment because if I was told that I wasn't dilated, etc, I would feel disappointed. 
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  • ErinMSBErinMSB

    With DD, my CNM offered them every week. I agreed to one at 39 (I think?) weeks. I knew it was pretty much meaningless, but it was nice to know a starting point when I did go into labor. And honestly, part of the reason I agreed to it was because I felt pressured from my CNM. She didn't seem to understand why I just wasn't interested in knowing. And although she respected my decision for the most part, it was obvious that if it was up to her, she'd check me every week.

    This time, my HB MW hsn't even offered them.

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  • tastyburgertastyburger

    I'm declining any internals until it's go-time, for all the reasons you listed: risk of infection, can cause cramping/bleeding, doesn't really give useful information since you can walk around dilated for weeks or go from closed up tight to baby quickly, and also because it could accidentally rupture your bag of waters. 

    my doc would start them at 38 weeks but has no problem that I'm not doing them.  it was kind of funny, she's like, "Um, how about when you're in labor? can they check you then??" I said "sure!" and she sighed in relief, "whew, okay.  I wasn't sure how we'd tell what's going on during labor without them."

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  • rg8482rg8482 member
    My OB is doing only 1 when he takes the cultures for the GBS test.  He said they're not really necessary and can just lead to more bacteria, so there is no reason to consistently do them.
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  • nosoup4unosoup4u member

    Frankly, it's your body, your decision - if you have a provider who gives you a hard time for declining them, that's not your problem. Do what you're comfortable with, not what they want. 36 weeks seems really early to do internals, especially with a first pregnancy.

    I declined them at regular appointments, and had one the day before I went into labor when my midwife was threatening induction - there was nothing going on, but I started early labor the next morning, so for me, they didn't predict anything. I really didn't want to know how much I wasn't in labor those last few weeks! I'll be declining them until I show up at the hospital in labor this time, too.

    DS1 - Feb 2008

    DS2 - Oct 2010 (my VBAC baby!)

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  • jtenebackjteneback member
    My MW routinely has clients go whole pregnancies without internals.  I see no reason to do them, they don't tell you much about what's going to happen.
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  • MassageMomma2010MassageMomma2010

    Yesterday was my 36 week appt. They did the swab for the GBS and my MW offered an internal if I wanted to know. I said "sure" but just knew I was sealed shut. Before she did it, she told me that if I have a thick cervix that she may recommend Primrose oil to get things to start loosening up. Turns out I'm 0cm and 80% effaced so the primrose oil is not needed.

    On one hand, I'm glad I know what's going on and that I have some progress. On the other hand, that knowledge does me no good because it doesn't indicate when I'll go into labor.

    But, in my experience, it did not hurt any more than a usual internal exam. The more relaxed you are the less it should hurt. If I had declined the internal, my MW would have been just as well. It was my decision either way.

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  • outnumberedoutnumbered member
    I have 3 children and I never had an internal progress check outside of labor.  My first two were birthed through midwives and they never even suggested an internal.  My last was with an OB and she said that it was fine to decline them, but they did like to check at 41/42 weeks.  
    Smiley: April '05 Rocky: May '06 Tex: July '09
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  • HRMJPCHRMJPC
    I actually asked for one at my last appointment b/c of the immense amount of pressure I feel down there. I basically just wanted to know what my "starting point" was when entering L&D. It wasn't terribly uncomfortable, took a minute, and he put on sterile gloves for the procedure.
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  • LindseyJWLindseyJW member

    i haven't had any (i'm 40.4) and my HB MW has never offered. i read up on her birthing philosophy and she doesn't do internals during labor either. she prefers moms to birth based on what their own bodies are telling and guiding them to do.

    i am quite curious, however, what's going on in there and i checked my own cervix this morning in the shower, which i learned to do while charting for fertility signs. it was high and totally closed. but i think i'm having labor contractions right now. with my son, i walked around at 4 cm dilated for weeks without labor starting.

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