Refusing Checks?

phq2011 · June 2012

So my grandma was asking me about my birth plan and I mentioned I was planning on refusing vaginal exams until 40 weeks unless I suddenly become high risk and refusing cervical exams in labor, unless labor exceeds normal guidelines or other medical reasons. I tried to explain my reasons including reducing risk of infection and that I was trying to reduce tension during labor so I could focus. (We are planning on using the Bradley Method) She told me I was too opinionated and trying to tell the doctors and nurses how to do their jobs. So what I want to know from those who've been there is: Is it really a big deal and am I actually interfering with what the doctor needs to be doing?

ittybitty8809 · June 2012

I am using the Bradley Method as well and think I am going to refuse vaginal exams as well unless I want to know how I'm progressing. I don't know how the doctors and nurses will take it, but to work in OB, they would have to know that women have all sorts of different plans for giving birth. I'm also a nurse, though I don't work in OB, but as a patient, you have the right to refuse any intervention or treatment. I don't want to be hooked up to an external monitor unless periodic heartrate checks by a nurse continue to show dips. Being hooked up will limit my ability to move around and get myself comfortable and labor how I want to labor. Vaginal checks are also uncomfortable and I think could break my focus, as you mentioned. And anyone who has had a home birth or even the millions of births that happen to women when they are by themselves or at home before hospitals never had vaginal checks. It just gives you an idea of where you are in the process, but when you are ready to push, your body will tell you, so I'm planning to wait until I feel ready to push to be checked. I say do what you want to do. This is your birth and while you may/will meet people who disagree with you, the only way to get the birth you want is to advocate for yourself.

Celyn · June 2012

It's not a big deal. The only time it's a big deal, imo, is when they are wanting to augment. For example, recently I was at a birth at which they wanted to give the mom cytotec to ripen her cervix, because they didn't think she was in active labor yet. She hadn't been checked in 48 hours due to ROM. She asked to be checked before making that decision. Turned out she was complete already

theladyjess · June 2012

I refused routine checks and my OB was fine with it. At the hospital I had planned on limited checks, however, I discovered that the checks actually felt good because of the counter pressure. LO was pressing on my cervix so much that I almost welcomed the checks (I did not welcome hearing that I wasn't as far along as I was hoping).

As you probably know, cervical checks before you're in labor don't really tell you anything. They don't predict when you'll go into labor and can often create unnecessary stress and just give you one more thing to fixate on.

Jcrab · June 2012

Totally reasonable to me. I didn't have any checks with my HBAC, the MW arrived after j had already started pushing! Everyone asks how I knew it was time and it seems funny to me - my body just knew it was time to push like every cave woman before me. GL!

KateLouise · June 2012

My midwives never did any checks during pregnancy.

DD1 - I had one check when I arrived at the hospital, and then another when I said I felt an urge to push.

DD2 - I had a check when I arrived at the hospital. I was only 3cms. I went home. Had baby on the bathroom floor. In hindsight I've learnt to pay a lot more attention to my emotional and physical signs than the clock or exams.

I knew it was too soon to go to the hospital based on how I felt but MW wanted me to go in so she could check me.

On the way home from hospital I knew things were getting serious and that we should turn the car around, but MW had told me I was only 3cm and although I was welcome to call her anytime I probably wouldn't have a baby for at least a few more hours,

fmw0526 · June 2012

That is TOTALLY fine. There is really no reason to check. You're in labor, the baby will come out when you're ready to push. There is no denying that feeling of being ready to push. You WILL know, you do not need someone to say "ok, you're a 10, now you're ready!"

Just let labor take its course :-)

The only time they may check is if you are birthing in a hospital they will check before admitting you. If you are only a "1 or a 2" they may tell you to go back home for a while

caralck · June 2012

Perfectly fine to do that. Only reason why it would be needed in labor is if you're being augmented/induced since they will need to know if the meds need to be adjusted. I haven't had any checks yet but next week (40 wks) I will because I want my doctor to tell me where we're at and try some membrane stripping to get the show on the road. While in labor, I'm hoping to stay at home as long as possible and my doctor suggest I try to check my own cervix to gauge when to go in. Only reason I'll go sooner is if my bag breaks and it's not clear fluid.

Watergirl's World · June 2012

Refusing checks is not a big deal. You are not interfering with the doctors and nurses. It's not THEIR job to have the baby. It's yours. By constant checks, they are interfering with YOU. An OB, is a trained surgeon, and nurses are for taking blood work and monitoring machines. You are in charge of your body and baby, and you both know what your capable of.

That being said, a lot of OB can check your progress during birth without penetrating with any instruments. And if they are a good OB, they can tell,just by looking at you, feeling your stomach, and watching your contractions.

YOU are not "too opinionated". YOU are emancipated from letting others tell you what is best.

cbj09 · June 2012

I think you're fine. I would definitely talk to your doctor about it to see how comfortable they are with it too. I'm going to let it slide and let them do checks (my midwife doesn't do many, and I'll allow the one in triage so they can determine whether or not to admit me)... but if I get to the point where it is just stressing me out, I may ask them not to tell me. That could be an option for you too if your doctor would rather that...

... but again, you're fine. Doctor's ruled the world when your grandmother was giving birth. There was no questioning what they said. So take what she says with a grain of salt.

dosafyre · June 2012

I only had a couple checks at the hospital, mostly near pushing time...and refused all others. It's totally fine, and the later checks are far more informative.

alanap · June 2012

I can imagine my own grandmother saying the same thing. I think it is just a difference in generational views of medical practice. My grandma trusts doctors, I don't.

I want to be in control of my pregnancy/labor process and if I don't want the doctor to do something, then I am going to speak up.

No big deal!

sschwege · June 2012

Jcrab:
Totally reasonable to me. I didn't have any checks with my HBAC, the MW arrived after j had already started pushing! Everyone asks how I knew it was time and it seems funny to me - my body just knew it was time to push like every cave woman before me. GL!

I think that's so funny too! I had someone ask me, "So if they weren't monitoring your contractions, and they weren't telling you to push, how did you know?" Simple, your body tells you

iris427 · June 2012

Jcrab:
Totally reasonable to me. I didn't have any checks with my HBAC, the MW arrived after j had already started pushing! Everyone asks how I knew it was time and it seems funny to me - my body just knew it was time to push like every cave woman before me. GL!

This is just how my HBAC went too. OP, perfectly reasonable not to get routine cervical checks. They don't tell you anything useful. Why have someone stick their hand up you for no reason? I only had them done at 40+ weeks with my first and had none at all with my second. My babies still managed to come out somehow.

Daniellekrista · July 2012

Celyn:
It's not a big deal. The only time it's a big deal, imo, is when they are wanting to augment. For example, recently I was at a birth at which they wanted to give the mom cytotec to ripen her cervix, because they didn't think she was in active labor yet. She hadn't been checked in 48 hours due to ROM. She asked to be checked before making that decision. Turned out she was complete already

Good thing she got a second opinion. Cytotec is not very safe.

Genevieve14 · July 2012

I declined the routine checks with DD. The midwives offered at every appointment and every time I very politely questioned if they thought it was useful. All of them said no. You can walk around for a week at 4cm dilated and you can show no signs of progress and go into labor hours later. The only time I kind of wished I knew was when I actually was in labor and called the hospital - they asked what my last status was (I think with the attitude that if I'd already progressed at all, I should get to the hospital faster). That said, I've heard from friends that the checks are uncomfortable, uninformative, and one friend even had her water accidentally broken. I think I'll probably avoid them this time around too.

JuneBug0611 · July 2012

My midwife practice doesn't do routine cervical checks until you are in labor. When I was in labor, they did a check when I was admitted and another one when I told them I felt like it was time to push (they wanted to verify my progress because I'd only been admitted a couple of hours earlier and was only 3cm then, but sure enough, when I felt like I wanted to push, I was 9 cm).

I think it's fine to refuse the checks, though I didn't have a problem with them performing the two they did. It was nice to get confirmation of what I was feeling (at the first one, that I had progressed enough that it made sense for me to check in to the hospital, and at the second one, that I had progressed enough that it was ok to start pushing).

honkytonk_kid · July 2012

Watergirl's World:
and nurses are for taking blood work and monitoring machines.

No...just no. Sounds like you've had bad experiences with nurses, but this is just not true. A good, pro-natural childbirth nurse can be invaluable (too bad they are not all this way...). You could train any moron off the streets to take blood or watch a monitor. I know nurses who can walk into a room, look at a laboring mom for 2 seconds and tell you correctly how far along she is, why she's in the position she's in, and what position she might try to speed things up. Don't let your bad experiences make you think all nurses are useless.

OP, your grandma is from an era where this line of thinking was common. She likely does not even remember giving birth (twilight sleep). You absolutely don't need as many checks as seem to be standard. I would/will probably decline until 40 weeks, then have one on admission and one when I feel like pushing. I would probably want one if my labor seems to be stalling, but there's really no need for this one every week starting at 36 weeks and one every hour in labor mess. Less= better in this case, IMO. Checks don't tell you anything about when you will go into labor, and during labor more checks= more risk for infection.

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