Vaginal exams. “Yea!” Or “Nay!”? Your provider will certainly want you to have some vaginal exams to check your progress. But do you really NEED them?....
"You're 2 centimeters" I was told by the nurse after hours of difficult labor and having already been sent home from the hospital once.
"Only 2 centimeters?!" I felt so discouraged, and the nurse could tell.
She said, "It's still progress. There are more things to take into consideration" and then left the room and left me feeling discouraged. What did she mean???
So let’s start by talking about what exactly that nurse meant. A vaginal exam is used to check cervical changes in labor. These changes include:
Dilation- Dilation is the opening of the cervix and is measured in centimeters (0-10) 0 being closed and 10 being completely dilated.
Effacement- As labor progresses, the cervix becomes thinner. Effacement is measured with a percentage. For example, if you are 50% effaced, your cervix has thinned halfway. When you are 100% effaced, your cervix is completely thinned.
Position- Did you know your cervix moves? It starts in a posterior position (pointing towards your back) and as it prepares for birth it moves to point towards your front (anterior position) A vaginal exam will determine whether your cervix is in a posterior, mid, or anterior position.
Ripening- As your body prepares for birth, the cervix becomes softer. To get an idea about what I am talking about- touch the tip of your nose. Now touch your lips. Your cervix starts out firm, much like the tip of your nose and as it ripens becomes soft, like your lips. A vaginal exam determines whether your cervix is firm, medium, or soft.
The position of your baby may also be determined during a vaginal exam. Your baby’s “station” refers to their position in relation to your pelvis, whether they are high or low. Your provider may also be able to feel the sutures of your baby’s skull to determine which direction they are facing.
Those are a lot of factors that contribute to the progress of labor! And then there are the factors outside of what is assessed during a vaginal exam contributing to labor progress. And they are all intertwined and work together towards the birth of your baby. But here’s the catch: Your progress at one moment in labor cannot predict how the rest of your labor will go.
A common phrase heard among birth professionals is >>> Your cervix is not a crystal ball<<<
This applies to vaginal exams at the end of your pregnancy as well. Cervical changes may begin in the weeks leading up to the birth of your baby.
Ultimately, labor is unpredictable! You could be stuck at 3 centimeters for what may feel like forever and then out of nowhere be fully dilated! Yes, really! Conversely, you could be dilating at a decent pace and then labor can stall.
Vaginal exams are also not completely risk-free. There is an increased risk of infection as well as a risk of premature rupture of membranes (breaking your water). It is especially important to limit the risk of infection once your water has broken.
So, with this information in mind and a discussion with your provider you can decide whether or not vaginal exams are right for you, or if you would just like to have them limited (Yes, you get to make that decision!)