Refusing Vaginal Exams at Prenatal Appts?

mrsj0423 · May 2012

I am a FTM and will be 29 wks on Friday. We are planning a natural, intervention free hospital birth. I know that towards the end of pregnancy, most OB's will do vaginal exams at prenatal appt's to determine dilation/ effacement status. Part of our BP is to have no, or very minimal vaginal exams once we get to the hospital, since dilation is not an accurate indication of when the baby will be born and increases the risk of infection. Is there any good reason to allow our OB to perform these exams in the weeks prior to labor beginning? I believe at our OB's office, they begin the exams at the 36 or 37wk appt. Has anyone chosen to decline the exams? And if so, how did your OB react (just curious). TIA

FyreFlyeRush · May 2012

I had one at my 35w appt when they did my GBS swab because I was feeling squirming in my cervix. I plan on refusing from here on out, BUT will consent if I have other complications. IE, my blood pressure is an issue and I'd rather know of I'm ripened or not when (if) I have to be induced.

nosoup4u · May 2012

I declined all cervical checks at appointments for both of my pregnancies, and was never given a hard time. I was bullied into one when I was admitted during my first son's birth, though - I said no to one multiple times, and one of the MWs still insisted. It still pisses me off that she didn't respect my wishes.

But besides that, I've found that most providers have been very nice when I've refused procedures or tests. hth

SWBs Wifey · May 2012

I haven't seen an OB at all this pregnancy and I'm being seen at a birth center by awesome midwives. Today was my 36 week check up (Holy CRAP I'm going to have a baby soon!) and she asked if I'd like a check. I said no. That was it. It didn't mean anything with DS1, so I don't figure it will mean much this time either. My goal is not to be checked until I'm checking in at the center for delivery (they HAVE to check me when I check in, but that's THE only time they have to check... so I'm going with that)

sschwege · May 2012

No reason at all! My CNMs don't do them unless they have a reason to. In the words of one of my CNM, "All I care about is if you are fully dilated and chances are you wouldn't be walking around like that!" My office even has you do the GBS screening yourself, you just take it into the bathroom and that's it!

cyclek8bride · May 2012

My OB said he didn't do checks unless asked to before 38 weeks. I'm pretty sure it was still optional at that point but I was curious so I said okay. He then told me to make an appointment for the following week, but I would not likely need it. He was right.

I had to have a check when I arrived at the hospital and then had a few more. I was complete with a lip within 40mins of arriving at the hospital. I was not given the okay to push until the lip went away so I was check a few more times during that next hour and a half. The checks during labor were the most painful moments. They were quick about it though.

annabelle.27 · May 2012

I was never offered exams in either of my pregnancies; neither of my care providers felt they were beneficial I guess. I would have refused if offered, for the reasons you mentioned.

theladyjess · May 2012

I declined them and my OB was fine with it.

I did consent to having a check at 39w2d because we had just had a growth u/s and LO's weight was estimated to be 8lb 15oz. After talking with my dr she said she could check to see what my cervix was doing and offered to strip my membranes if things were favorable. I went for it but the membrane stripping didn't do anything. LO arrived a week later weighing 9lb 7oz.

pixieprincss · May 2012

With DS, when the nurse asked me to put on a gown for each of those late appt I asked her if that was necessary if I was declining internal exams. She said, no. Between me being in my clothes and her passing the word on to the dr it was never an issue. I also am pretty sure that I had discussed it with him at an earlier visit. My OB respected our wishes, but the few times I saw another one in the group I would catch flack. Being fully dressed in clothes really kept things in my court, though. For the GBS visit I did change, as I elected that test. I plan to this PG, also. But, I will say that my MW for this PG has a great protocol for GBS. There are things you can do preventively before the test if you want to take it, too--garlic, probiotics, etc.

judahsmommy1 · May 2012

theresat858:
I don't think you can refuse the GBS swab, but I think other than that your doctor shouldn't care too much... I don't plan to decline the exams if my OB offers them because I am curious even though I know it doesn't mean anything, but I don't think there is anything wrong with declining them.

You can refuse any medical procedure. They cannot require you to do anything. However, if you refuse the GBS swab they will want to do IV antibiotics as soon as you get there. So you're talking about refusing a test and then having to fight an intervention.

wannabigfam · May 2012

We never had an exam in the office. My midwife asked each time, but said that it was 100% unnecessary AND would not provide me w/ any useful information (because even if I was like 3 cm at 36 weeks, I could stay at 3 cm for weeks). I felt very supported in my decision to not be checked. First and only exam was when I arrived at the hospital 9.5 cm dilated.

JoyfulW&M · May 2012

I had them with my first pregnancy, but when I learned how much of a risk of infections etc I declined during my second, and will continue with all my future pregnancies. The only one I couldn't decline was the one when I reached the maternity center in labor, to make sure I was 4cm.

I didn't even have to have that one as I arrived with the urge to push and the head close enough to easily touch.

Anyway you can refuse anything. They aren't gonna strip you and strap you down. Even if you choose to get GBS test you can tell them NO cervix exams and enforce it. Refuse the little paper blanket so you can see what is going on so you know for certain they aren't sneaking in a check, which some have been known to do, though not a lot.

Anyway just tell them no, period. They do have to make sure you are at least 4cm's before they can admit you, but after that you can refuse.

mrsj0423 · May 2012

Thank you so much everyone for your insight!

flyer23 · May 2012

The GBS swab is not a vaginal exam. It's just a... swab.

I think my OB with DD offered to do a vaginal exam at around 36 or 37 weeks. I declined until 39 weeks. Then she insisted on doing them -- which was silly, but whatever, it wasn't worth fighting. I asked her not to tell me my "stats" until 41 weeks, when we were looking at induction anyway. I didn't want to get buoyed up by false hopes of going into labor soon, or disappointed at my lack of "progress" (that really means nothing at all).

With DS, my midwife didn't do a single vaginal exam. Not before labor, not during labor. She had never seen me with my pants off until it was time to push! And shocker! He still came out Smile I expect it'll be the same this time unless I have any specific complications that warrant an exam.

Smurphette · May 2012

I delivered in a hospital with an OB and the only exam I had in the office was the afternoon I delivered and was done at my request bc I was fairly certain I was in early labor. I wanted a point of reference for progress when I went to the hospital later (I labored at home/outside of the hospital for a while). No one ever said anything about me not wanting to be examined, they were very respectful of my wishes.