Protocol for being checked

jenalena · December 2011

I've heard from friends that their doctor was somewhat miffed when they declined to be checked late in pregnancy. Is there any merit to this? In the earlier thread, many mentioned that they will decline the checks since it's not valuable info. Is that true? Why would the doctors check if it doesn't really determine when you'll go into labor?

Kristine Schilling · December 2011

i am not really sure how to answer that question... why do they want to check right? I will ask at my visit this week if I remember. She was fine with waiting until at least 38wks for me unless I start getting regular contractions. But even then, I still dont get it.

If your not having regular contractions, BH or practice or whatever, chances are you are not dilating, so no need for DR to check right?

Also if Dilation and effacement doesnt tell you for sure when labor will occur, why get all uncomfortable on the table every week with Dr?

Maybe its just standard, old fashioned routine? I will ask!!

kaay16 · December 2011

I don't think it's necessary to be checked until you're in the hospital and in actual labor. I never got checked with my first until I was admitted. I got there and was 10 cm so that was the only time they checked me. My friend was checked at every appt after 36 weeks and was 4 cm for the longest time. She went late and had to be induced to get the ball going. It's so different for everyone but just because you are dilated doesn't mean labor is right around the corner which is why I think people decline to be checked. That was my thinking anyway and luckily my midwives were on the same page as me.

theladyjess · December 2011

I have no idea why dr's do cervical checks other than that's what they've been trained to do. My dr is leaving the decision up to me and I'm declining.

Yes, it's true that cervical checks don't determine when labor will start. You could be a couple of centimeters dialated and partially effaced and stay that way for weeks. You could be closed up tighter than a drum and give birth w/in the next day or two.

Some drs will sweep or strip the membranes while performing a routine cervical check and not tell their patient. The dr will take a finger and seperate the aminotic sack from the surface of the cervix. This procedure can induce labor. Maybe this is the reason your friends dr was upset they declined cervical checks.

Every time they do a cervical check they're introducing bacteria into the vagina and cervix. Once you start dialating this bacteria can begin to weaken the aminotic sack, thus possibly causing premature rupture of membranes (PROM) making labor begin. At least that's what I've learned in my Bradley childbirth class.

purpletulip · December 2011

Good question... I don't know why so many doctors do routine checks. It's pretty old school.
My doctors office limits checks. It's only done once you're past your due date, once you're admitted to the hospital, to see if you're ready to push, and if you request it.
Like someone else said, I've heard that some doctors will sweep your membranes without telling you, but I don't know if that's true!

BostonGayGal · December 2011

My midwives see no point in doing them since they rarely yield useful information. There is a risk of adding harmful bacteria. They do agree that effacement is more of an indicator than dilation.

However, I had been having contractions for about 12 hours this past weekend (fibroid problems) so my midwife asked whether I wanted to be checked at my appointment yesterday. She checked me and we learned that this last round of contractions did a number on my cervix. I am now 75-80% effaced, not at all dilated. I am still carrying very high.

She says it doesn't tell us much of anything HOWEVER, it just might mean that when I notice this baby drop it could be show time. That appointment was yesterday. Knowing this may drive me crazy as I rather frantically try to wrap up my cases, close up my law office, finish the nursery, etc, all the while pinning my knees together since I want this baby to stay in until all is well and ready!

emnoahmom · December 2011

My midwife would ask me if I cared to be checked starting around 2 weeks before dd. Last time I didn't really feel any contractions but I had begun to dilate.

trackchik6 · December 2011

Well my friend went to the doctor for her 38 week appt. She was not in labor at the time, but when they checked her she was 6 cm. dilated so she went to the hospital and had the baby then. If the doctor hadn't checked maybe she would not have been able to make it to the hospital on time.

Yesterday doctor said I was free to decline.

I wasn't dilated with DS at all until I went into labor. This time I will let them check because I have a long commute to work so maybe if I am dilated they'll tell me I shouldn't go in to work anymore

Luvvy1 · December 2011

For me, since I will most likely be induced, my doc wants to see if my body is starting to get ready or not which would make induction easier. I can't say I really care either way.

Angelrelic · December 2011

I just liked knowing, and yes the invariable frustration that came with no change week to week. Towards the end, it was more a check to see how favorable my cervix was which was useful information for being induced cause they could go straight to pitocin..

star173 · December 2011

So what if the doctor is "miffed", it's your vagina, your decision.

And no, it has NO merit. I was "high and closed" with DD on Tuesday- she was in my arms on Thursday. I was 3cm for 3 weeks with my son before I went into labor.

All that said, I totally do the checks starting at 36w- just because. However, I know and trust my doctor- some of them have been known to sweep your membranes without telling you.

Huahine · December 2011

BostonGayGal:
My midwives see no point in doing them since they rarely yield useful information. There is a risk of adding harmful bacteria. They do agree that effacement is more of an indicator than dilation.
However, I had been having contractions for about 12 hours this past weekend (fibroid problems) so my midwife asked whether I wanted to be checked at my appointment yesterday. She checked me and we learned that this last round of contractions did a number on my cervix. I am now 75-80% effaced, not at all dilated. I am still carrying very high.
She says it doesn't tell us much of anything HOWEVER, it just might mean that when I notice this baby drop it could be show time. That appointment was yesterday. Knowing this may drive me crazy as I rather frantically try to wrap up my cases, close up my law office, finish the nursery, etc, all the while pinning my knees together since I want this baby to stay in until all is well and ready!

I know we are seeing different midwives, but this pretty much sums up my visit today. She doesn't usually do internals, but because of my GD, she doesn't want me to go past my due date, so wanted to know how things were looking.

I'm 50% effaced, but closed up tight. She wants me to start taking EPO. But I really need to get this proxy filed, buy a new car and finish my Christmas shopping before I do anything else to bring this baby along.

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