How Often Do You Get Checked

cottonlily84 · June 2011

After you're admitted? I'm ok with the initial exam to see if/how far dilated I am when I get to the hospital because of course I need to be dilating. Beyond that, I don't want to be bothered until I feel like pushing and they need to check for that last lip. (at least in my head it plays out that smoothly lol). To me "natural" means no interventions and I don't want someone sticking their hands in there every hour. Is this something I should include on my birthplan upfront or play it by ear and say no when the nurse comes in? I don't know how often they routinely want to do these exams.

Ripli · June 2011

I'm a FTM so I don't know for certain, but I think it depends on how far into your labor you are and how much you're dilated.

You can certainly refuse to be checked but I think it'd be a good idea to put it in your birth plan.

InfamousQBert · June 2011

from everything i've read, it kind of depends on your nurse/doc and the hospital. some are more willing to leave you alone, and some want some hands up in there every few minutes. i'd call your doc and ask about hospital policy and then try to talk to some of the nurses in L&D to see how they feel about you wanting to be left mostly alone.

sschwege · June 2011

I had it in my birth plan and they were respectful of that. They checked me a total of three times (I was there for 7 hours). 1) When I was admitted 2) When I felt the urge to push (fully dilated at that point, but I decided to labor DD down more before pushing) 3) I requested another check to see what station she was at.

I think it's reasonable to request one when you get to the hospital and not get another until you feel the urge to push. I would write it in your birth plan and if someone tries to check you and you don't want it politely decline.

nosoup4u · June 2011

Make sure everyone at the hospital knows your wishes. And don't be surprised if you're given a hard time about it during labor - maybe have your birth partner speak up for you if necessary.

I got stuck at the hospital in early labor with DS1, and was checked every few hours or so (and was given the "let's check you, bc you might need Pitocin if you're not dilating fast enough" line. Luckily, I did dilate fast enough). I had no checks specified in my birth plan with DS2, but showed up pushing - they checked me when I was admitted and that was it. hth

dosafyre · June 2011

I think I was check 2-3 times (once in transition and right after when the urge to push started). It was in my birthplan to not check often...and really, they didn't want to mess around in their either since my water had broken and they didn't want to introduce bacteria.

iris427 · June 2011

InfamousQBert:
from everything i've read, it kind of depends on your nurse/doc and the hospital. some are more willing to leave you alone, and some want some hands up in there every few minutes. i'd call your doc and ask about hospital policy and then try to talk to some of the nurses in L&D to see how they feel about you wanting to be left mostly alone.

This.

I got checked every 2 hours or so with my first. I never had a single check with my second. Different docs, different practices.

I don't think they are necessary most of the time.

tokenhoser · June 2011

I laboured at home so long that the only check I got was the first one. It said I was 10 cm and ready to push, so off I went to push.

So I guess my advice is to stay out of the hospital as long as possible if you don't want hands up your vagina. Perhaps not quite to 10 cm, though. Wink

FyshWyfe · June 2011

My labor with DD was really long (~21 hrs) and I got checked every few hours or so (I honestly don't remember). They never told me the dilation, just said, "Looking good," and left me to do what felt right.

This time I plan to be checked once at 38 weeks, maybe at 40 weeks, and then in labor when I feel pushy. I'm praying to not be in labor as long this time!

Jodi2008 · June 2011

I agree that it probably depends on your hospital/doctor. I got checked once I got into a L&D room, then only got checked if I asked (like when I was going into transition and needed to know the end was close, or when I felt like it was time to push). I was progressing pretty quickly, so either they didn't feel the need to keep checking me, or it just wasn't their way of doing things.

DoulaSamma · June 2011

Ask what normal policy and procedure is now. When it comes to hospital birthing it is rare that they will only check you twice, unless you show up at 7/8cm. That being said every hr is WAY too much. Usually with the moms I work with who arrive at 3/4/5cm or inductions are checked every 3-6hrs depending on their history and provider. If progress is being made it stays that way until delivery. If after a long time is passed and no progress checks do increase until an intervention is working. The best ways to avoid lots of checks are to labor at home as long as possible, not be in the bed, and wait until the pushing urge is undeniable.

I know most people say having to push feels like you need to poop and while that is true there is more to it then that. The initial push feeling is kind of like the pressure you have from being constipated. It only comes with contractions and while it is there it is more annoying then anything and if you can breath it away do so. That pressure will get more and more intense and be present without contractions as well. There will come a point where it feels like you are going to poop your pants kind of and you can't breath it away if your life depended on it. That is the real pushing urge and when it is time to be checked. It will save you a few checks and almost always shortens your pushing time.

iris427 · June 2011

DoulaSamma:
Ask what normal policy and procedure is now. When it comes to hospital birthing it is rare that they will only check you twice, unless you show up at 7/8cm. That being said every hr is WAY too much. Usually with the moms I work with who arrive at 3/4/5cm or inductions are checked every 3-6hrs depending on their history and provider. If progress is being made it stays that way until delivery. If after a long time is passed and no progress checks do increase until an intervention is working. The best ways to avoid lots of checks are to labor at home as long as possible, not be in the bed, and wait until the pushing urge is undeniable.

I know most people say having to push feels like you need to poop and while that is true there is more to it then that. The initial push feeling is kind of like the pressure you have from being constipated. It only comes with contractions and while it is there it is more annoying then anything and if you can breath it away do so. That pressure will get more and more intense and be present without contractions as well. There will come a point where it feels like you are going to poop your pants kind of and you can't breath it away if your life depended on it. That is the real pushing urge and when it is time to be checked. It will save you a few checks and almost always shortens your pushing time.

I just went with it. I started feeling pushy and so I pushed. I have no idea if I was fully dilated yet because my doctor never checked me--he didn't think it was necessary. Actually my husband and I were home alone when the urge to push hit me so there was no one around to check me!

At first the urge to push was just to do some light, short pushes and then the urge got gradually more intense and the pushes got longer and stronger. So it's possible I wasn't fully dilated yet when I started pushing but I think most women are unlikely to do any damage by pushing when it feels right, if they don't have an epidural. Pushing felt good and I'm glad I didn't stress myself out trying to breathe it away initially or because I hadn't been given "permission" to push yet. It's apparently what I needed to do to get my baby out vaginally.

MustanGTbaby13 · June 2011

My MWs are totally okay with waiting for the urge to push before they check...especially if my membranes have ruptured.

I did mention in my birth plan that if I start wavering on my resolve, or I start saying I can't do it, that I would like to be checked to see if I am in transition and for them to remind me that I am about to have a baby before giving me meds.

abell77 · June 2011

Yep, I would include it in the birth plan and just refuse the checks until you're ready. Just remember, it's your body, your baby, your birth.

kattyleigh · June 2011

I was checked upon admittance and the nurse asked me if I wanted to know, or if I wanted to just keep laboring away. I was at 8 cm. I was only checked again one more time by my OB when it felt like it was time to push.

DoulaSamma · June 2011

iris427:
Pushing felt good and I'm glad I didn't stress myself out trying to breathe it away initially or because I hadn't been given "permission" to push yet. It's apparently what I needed to do to get my baby out vaginally.

If pushing feels then of course do it, but if breathing and pushing feel the same then why waste your energy pushing when you can breath and your body will push the baby down?? I have been at deliveries where mom has been 10 and had pressure for over an hour, but not had that telltale "I need to push", so they just breath till pushing feels better then breathing.

You also just need to know how your nurse and care provider operate. Some will be very forceful about pushing the second you're ten. Some will try to make you "push past" a cervical lip and have their hands all up in you till that happens. And some are fine with little pushes before 10, waiting till you have the urge or not checking at all.

TheQuietGrrrl · June 2011

One thing, especially in the hospital setting I didn't completely appreciate. Internal checks are pretty qualitative and have a lot of components to check. Which means everyone wants THEIR own assessment, and don't want to rely on anyone else's. Or each individual may be looking for and assessing different things.

I ended up with a total of 5. Without "team based care" it could have been maybe 2-3. One at the OB triage (where the decision was made to admit or not, this was OK with me). One upon arrival at L+D on another floor by L+D nurse (her "baseline"). One each from L+D nurse (time to call the OB) and OB (I'm the doc, I need my own assessment) when it was push time and once during squat pushing when LO's heart rate dipped and was sustained (to check for a possible cord prolapse). In the case of the OB/nurse, if I knew about that dynamic and really wanted the checks to a minimum, I would have just told the nurse to not bother and just go on the OB's assessment.

Nurse did ask, several times. All I had to say was 'no thanks, maybe later" and that was the end of that. No fussing or fighting at all. I guess LO was stable enough that there were no indications that warranted "we must know now"

I'd include in the birth plan something about minimizing the risk of infection, especially if water's been broken to keep checks to a bare minimum. If you're going into a hospital setting, then set the request in a medical context (help me minimize my risk to uterine infection), as opposed to "I don't want to know" or "I don't want YOU to know"

Oh yeah. Labored about 14 hours in the hospital (30 total). Bleh.

PinkGirlInCali · June 2011

I think it varies based on the situation. My ob sent me to triage for monitoring at my 36 weeks Appt because she said i was 2-3cm dilated but I hadn't felt any contractions. So when I got there they checked me every hour or so to see if I was still dilating to see if they needed to keep me. I was having a ton of contractions but still not feeling them. After I got to five cm and they decided to keep me they really only checked every few hours unless I asked them to check again.

cottonlily84 · June 2011

Thanks for all the GREAT advice! I will definitely include minimal checks in my birth plan and drill it into DH. I just think having a nurse come in every hour or so to make you lie down when you're trying to do your own thing is a real intrusion. The fact that several different people check you to get their own opinion perturbes me too! I'm honestly thinking now one check at admittance and I'm done...I plan on going in the hospital at the last moment possible.

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