Friday, October 29, 2010

Lovely Article: "Hey, Doc!"

Never would I have thought that I would ever write enthusiastically about an article with this title, but hey... you just don't know what life will bring. Surprises, to say the least!

Anyhow. One of my - many! - passions in the birth world is questioning, and encouraging the cessation, of procedures during pregnancy and birth that in the end prove to be either pointless or harmful. Slaying sacred cows, if you will. Examples? Well, things in the old days such as enemas and pubic hair shaving (which are actually still done in something like 5% of births, according to a midwife friend of mine), and also modern-day sacred cows such as continuous electronic fetal monitoring, premature cord clamping, routine IV insertion - and vaginal exams during pregnancy and birth.

I've already written my own article on the subject of routine vaginal exams:

The Sacred Cow of Modern Pregnancy Care: Routine Cervical Exams

And a midwife friend of mine also wrote up the subject on her blog:

Cervical Exams: Who Needs Them? 

If you check out those two articles, you'll have the gist! But I saw this lovely new article come out this past week, and I wanted to post it:

Hey, Doc! Keep Your Fingers Out of My Vagina!

From the article:

"One of the things a lot of women get used to during pregnancy and birth is tons of strangers sticking their fingers in their vagina for cervical checks. It's invasive, and often embarrassing, but we grin and bear it as a necessary evil.

"Thing is, it's not necessary. Not in the slightest, and believe it or not, something so simple as just checking your cervix can cause a whole slew of problems, from infection to induction and even potentially a c-section.

"And most of the time, this check means absolutely, positively NOTHING."

The main points of the article:

- Cervical checks do not predict how soon labor will start or how fast it will go.
- Cervical checks pose many well-known risks with no known benefits.
- Competent birth caregivers have many other ways (listed in the article) of knowing how near or how far-advanced a mama's labor is.

Also - did you know?

"The US Public Health Service recommends no routine cervical exams until 41 weeks of pregnancy, yet a lot of practices not only check you early in your pregnancy, but start checking at every single appointment in the third trimester."

A new tidbit of info for me. She continues:

"And why? To just see if you're dilating or effacing ... no other reason.

"A woman can walk around dilated to a four or five for over a month. A woman can also be completely closed and have a baby a few hours later. The dilation and effacement don't always determine labor. The only time it's an issue is if your cervix opens and needs to be closed until the baby is viable -- an issue completely unrelated to third trimester checks."

Good stuff. This is definitely a sacred cow that needs slaying.

As I've said before, I went to my midwife's office fully prepared to strip down for the usual pelvic exam. It didn't happen then... or the next week... or the next week. My midwife eventually explained the above - that there is no point to routine, i.e. non-indicated, cervical checks, and that she therefore does not do them. I got through two pregnancies/births with her with a total of one cervical check.

Thanks for posting!

1 comment:

  1. "As I've said before, I went to my midwife's office fully prepared to strip down for the usual pelvic exam. It didn't happen then... or the next week... or the next week. My midwife eventually explained the above - that there is no point to routine, i.e. non-indicated, cervical checks, and that she therefore does not do them. I got through two pregnancies/births with her with a total of one cervical check."

    That must have been liberating! I got through my last pregnancy and birth without any cervical checks, except for the ones I did myself and it was certainly wonderful. I don't like strangers peeking at my vagina for no reason. Love the title "Hey, Doc, keep your hands out of my vagina!"

    Olivia

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