Why I’m saying NO to Vaginal Examinations (VE’s) during the next birth:
With my past birth experiences, I began researching about VE’s. Because.....
With research, you have KNOWLEDGE....
With knowledge, you have OPTIONS....
With options, you have a CHOICE....
That is exactly what my blog page is about, sharing knowledge to help others make an informed choice 💜
Having had three very different births,my last with Bonnie in 2016 was probably my most traumatic.
In brief, my cervix had dilated to 4cm and thereafter my labour did not progress. After 11 hours I was given Pitocin to speed things up. Which then intensified labour pains, I was then given an epidural which slowed babies heartbeat down and she got distressed. Which then led to me having an emergency caesarean.
Thankfully Bonnie arrived safely into the world 💜 But the experience has left me questioning the birth and determined to have a more mindful labour (and hopefully birth) at home this time round.
Some women can be 3-4 cm dilated for weeks without going into proper labour, and others can open up in a matter of hours.
With our second baby, I spent most of my labour at home, before giving birth to our daughter soon after arriving at hospital. So nobody knew how far dilated my cervix was because I hadn’t had any VE’s.
I absolutely dreaded the thought of vaginal examinations, more than the pain of giving birth. Through my experience, research and hearing others that have refused vaginal examinations, I now know that I have a choice and that I will be including this decision to decline any VE’s on my birth plan.
“What often isn’t told to mothers is that there is actually an increased risk of infection each time a vaginal examination is performed and the person doing the performing may affect how relaxed or safe the woman feels. Often the language used is so breezy ‘I’m just going to have a little feel’… that it can seem like a woman has no choice but to say yes, and that to not have one would leave everyone mystified as to baby’s progress or position.”
“Besides the fact you may get an entirely inaccurate picture based on a VE, it can put women up against the clock and there will be pressure during labour to progress according to ‘The Friedman curve’ which is the progress chart of a fictitious person who does not have your exact body or your exact baby. Variety is women’s dilation is absolutely normal and not necessarily indicative of any problem – just that women’s bodies all dilate differently.”
“If you refuse VE’s (which is absolutely your right if you wish) your dilation can instead be assessed in other ways. One way is for midwives to pay attention to the purple line that grows up the crease of your bum starting from the anus and going upwards to the top dimple of your bum crack, which is handy huh?”
“Skilled midwives should also be able to tell how dilated a woman is by feeling by how warm her legs are. (Providing she is on dry land and not in the birth pool and she does not have a temperature). This method is called Mexican Hot Legs. If the leg is warm but only the feet and ankles are cold, a woman’s cervix is generally about 3cm dilated, if she is cold up to a little higher up the leg to mid-calf area, around 5cm, and if the entire leg up to her knees is cold she will be fully dilated and ready to push very soon. The reason for this is that blood flow gradually decreases to the extremities as labour progresses because it is needed higher up in the body.”
“Simply looking at women closely and reading her breathing and behaviour, the pitch of her voice, and how she is moving around should also be clue enough to any skilled midwife as to how far a woman is dilating.
With these simple, non-invasive methods, you have to wonder why hospitals continue the tradition of midwives performing VE’s so routinely and frequently, given their unreliability and the increased risks of infection.
If you prefer to be monitored and measured in other ways, just say no to VE’s.”
Ref:
http://www.birthyouinlove.com/tools-for-birthing/paulaclearyguestblog/
In answer to me researching why my labour did not progress, I have armed myself with this knowledge:
WHAT EFFECTS DILATION:
Effective cervical dilation is dependent on the hormone oxytocin, which stimulates efficient uterine contractions. The uterus draws upwards, which in turn causes the cervix to thin and dilate. It is during this stage of labour women most need to be undisturbed, to promote oxytocin levels to increase as labour progresses. If a woman is exposed to bright lights, noise cold, or has no privacy, her body may start to produce adrenaline.
Adrenaline is released by the body in the ‘fight or flight’ response to a perceived danger or threat. During labour, mammals need to be able to move to safety if threatened. Humans are no different, even though we rarely give birth in the wild, the part of our brain that regulates hormone production and threat analysis is unable to distinguish between a real and an imagined danger. As your body makes more adrenaline, you make less oxytocin and contractions begin to slow down, become irregular, or even stop. World renowned midwife, Ina May Gaskin, often discussed reversal of cervical dilation occurring when women go to hospital after labouring well at home for hours. They may encounter staff they don’t like or be under pressure to have procedures or interventions they don’t want. Contractions often slow or stall because of rising adrenaline levels, and a vaginal examination shows ‘only’ two centimetres – the woman is sent home or may have her labour augmented (given medications to stimulate contractions).
BUT WHY DIDN’T MY CERVIX FULLY DILATE:
There are some factors that can affect your body’s ability to dilate. In most of these situations there is a way to work through them, rather than consider your body as faulty.
Adrenaline and stress hormones. Read my previous post about OXYTOCIN:https://steemit.com/birth/@allthingsbaby/will-the-real-oxytocin-please-stand-up Malpositioning of your baby: this can affect where your baby’s head is presenting Practice optimal fetal positioning during pregnancy and choose upright positions during labour.
When these situations are unable to be overcome, making an informed decision with the support of your care provider will help you give birth safely. -
So before you agree to ANY procedure… remember the maxim at the heart of medical care ‘Nil nocere’ (First do no harm) and always ask:
Is this really necessary?
What is the evidence that my baby will be in genuine trouble if I decline xyz?
What are the full range of alternatives?
What is the evidence for this suggested course of action?
Is this standard policy or an individualised recommendation?
What happens if I do nothing?
What happens if we wait… half an hour… an hour…. a few hours…. another day… a few days…
Thanks for reading and I hope this post helps 🙏
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