Natural Birth

Question about Internal Exams

I posted this on my month board as well, but I wanted to get your insite as well...

As I am nearing the 3rd trimester,I have been thinking a lot about my upcoming appointments. I believe internal exams are normally started at 37 weeks at my hospital. As a FTM I was excited to see if I had progressed at all so I was all for the internals. This time around, I fully intend on declining them since they dont predict labor.

So my question is.... why do they bother to do internals if they don't tell them anything? What am I missing?

Mom to Carter, Kendall, Kiersten and Baby O #4





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Re: Question about Internal Exams

  • I've always wondered that myself!  When I was pregnant with DD I asked my MWs when they started doing internal exams and the response was, "All I care about is if you are fully dilated and it's hard to imagine you would be walking around like that!"  Good enough for me!

    I guess the only thing I can think of is maybe it would be an indication of whether you are indeed in labor.  For example if you had an appointment yesterday and you were totally closed and you showed up at the hospital the next day with mild contractions and you were at 2cm.  Maybe that would be a way of saying, yes, you are indeed in labor we will admit you.  I have no clue though!  

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  • I have wondered, too. I didn't have them with either of my pregnancies, not because I refused them, but because my care providers didn't offer them. I mentioned it to my doc with my first pregnancy and he shrugged and said I could get one if I really wanted, but they didn't do them routinely at their practice. He said, "at this point you are either dilated or you're not. Both would be normal, and doesn't tell us anything." I wasn't about to argue.
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  • I plan to decline until I hit 41weeks.
    Mom to Carter, Kendall, Kiersten and Baby O #4





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  • I decline them until 40 weeks personally.

    However, my girlfriend went in for a regular appointment at 36/37 weekd and they did an internal and she was 5cm!!  She had no idea.  They sent her right to the hospital.  I envy that labor, lol.

    So maybe that is why?  Maybe they just like to get an idea of the baby's station or something?

     



    Natural M/c 12/13/08 at 8w5d 

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  • imagejinnymb:

    I decline them until 40 weeks personally.

    However, my girlfriend went in for a regular appointment at 36/37 weekd and they did an internal and she was 5cm!!  She had no idea.  They sent her right to the hospital.  I envy that labor, lol.

    So maybe that is why?  Maybe they just like to get an idea of the baby's station or something?

     

    Why did they send her to the hospital right away?

    Mom to Carter, Kendall, Kiersten and Baby O #4





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  • imagemrsodonnell12:
    imagejinnymb:

    I decline them until 40 weeks personally.

    However, my girlfriend went in for a regular appointment at 36/37 weekd and they did an internal and she was 5cm!!  She had no idea.  They sent her right to the hospital.  I envy that labor, lol.

    So maybe that is why?  Maybe they just like to get an idea of the baby's station or something?

     


    Why did they send her to the hospital right away?

     

    I would imagine it's because at 5cm dilated without her knowing, if she were to spontaneously go into active labor, she would need to BE in the hospital ASAP. It's a safety measure. 

     

    ETA: formatting error. stupid mobile app.

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  • Most OBs do them to see if your bishop score is favoring induction. I had my MW do one last Friday and the next time I will ask for one is if I think I'm in labor or 40 weeks which ever comes first. For me I wanted to know where I started from so I could better judge if I was making progress with the random contractions I have been having.

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  • imageMommyLuvsMe1210:
    imagemrsodonnell12:
    imagejinnymb:

    I decline them until 40 weeks personally.

    However, my girlfriend went in for a regular appointment at 36/37 weekd and they did an internal and she was 5cm!!  She had no idea.  They sent her right to the hospital.  I envy that labor, lol.

    So maybe that is why?  Maybe they just like to get an idea of the baby's station or something?

     


    Why did they send her to the hospital right away?

     

    I would imagine it's because at 5cm dilated without her knowing, if she were to spontaneously go into active labor, she would need to BE in the hospital ASAP. It's a safety measure. 

     

    ETA: formatting error. stupid mobile app.

    Yeah she did have the baby that night.  She went into active labor maybe a couple of hours later.  I guess if she hadn't had the appointment they wouldn't have known and she would have just rushed to the hospital and been surprised to know she was almost there, ahha. 



    Natural M/c 12/13/08 at 8w5d 

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  • For me, each week I was more and more dilated.  So my timing between contractions was lessening.   It started at 5, then 7, then 10.....  FWIW, I was 5 cm, and my OB sent me home.  I didn't go into labor.   
  • imageMommyLuvsMe1210:
    imagemrsodonnell12:
    imagejinnymb:

    I decline them until 40 weeks personally.

    However, my girlfriend went in for a regular appointment at 36/37 weekd and they did an internal and she was 5cm!!  She had no idea.  They sent her right to the hospital.  I envy that labor, lol.

    So maybe that is why?  Maybe they just like to get an idea of the baby's station or something?

     


    Why did they send her to the hospital right away?

     

    I would imagine it's because at 5cm dilated without her knowing, if she were to spontaneously go into active labor, she would need to BE in the hospital ASAP. It's a safety measure. 

     

    ETA: formatting error. stupid mobile app.

     I was 6cm for a couple days before going to the hospital.  Since I wasn't having any painful contractions and only "Braxton hicks" I wasn't sent to the hospital, but I was advised that if I went to the hospital I wouldn't be able to leave.  I ended up getting induced several days later which was a huge joke and had my baby 45 mins later.sorry to hijack..... I would agree about it being a safety measure because I only had two contractions before pushing.
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  • My mw did one at 36 weeks that she said wasn't really optional. She said it was to make sure the baby was head down and engaged. I wasn't happy about it but I didn't want to make a fuss about things so I consented. I bled like crazy and lost my plug the next day. I had the baby that week and I will always wonder if the internal had something to do with him coming early. I will decline all internals with the next pregnancy.
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  • With both my daughters I worked with two different MWs. Each MW only examined me once I was in labour.

    Once when I arrived at the hospital to see how far along I was, and then, with DD1, when I felt like I wanted to push, my MW wanted to make sure I was fully dilated.

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  • Well, dilation and effacement alone probably won't tell you much of anything but the Bishop Score actually takes into account a number of factors and can be predictive, particularly if you're talking about planning an induction.

    For instance, the day before I went into labor, I technically had no "progress" but my cervix had softened and moved into the anterior position. That raised my Bishop Score.

    That said, it's wise to decline internals, especially before 40 weeks, because in the real world, they're pretty useless. They're like every other intervention; they have value in certain circumstances but they're way overused.
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  • I think mostly they're done so the doctor has something to do. Honestly.

    I declined them and went into labour at 40 weeks, so there was no need for them. I would consent once we were talking induction, but not before.

  • I'm so glad you posted this question! I just asked pretty much the same thing- I agree it is unnecessary and only introduces bacteria and causes stress.
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  • With DS, I went in for my 39 week appt and OB checked me and I was 5cm already and I didn't know it. I'm glad he checked because I went to the hospital soon after that and was at 10cm only a couple hours after that.
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  • thanks ladies!!!
    Mom to Carter, Kendall, Kiersten and Baby O #4





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  • imageoliversmommy32912:
    My mw did one at 36 weeks that she said wasn't really optional. She said it was to make sure the baby was head down and engaged. I wasn't happy about it but I didn't want to make a fuss about things so I consented. I bled like crazy and lost my plug the next day. I had the baby that week and I will always wonder if the internal had something to do with him coming early. I will decline all internals with the next pregnancy.

    BFF had her baby at 35w, two days after an internal which caused bleeding. He had breathing issues & spent 2.5 weeks in the NICU. I firmly believe it was due to the internal.

    My MW doesn't do routine internals anyway, but I won't be getting any until I'm in active labor, at least. 

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