Monday, 22 June 2009

Assessing Cervical Dilation without Vaginal Exams

I personally have never felt uncomfortable about vaginal exams and was more than happy when I was in labour for the midwife, on her arrival at my house, to check how dilated I was (she was shocked to find me fully dilated because from her years of experience looking at me she had assessed I was about 5 cms dilated). For some women though the thought of having vaginal exams during labour is very intrusive and even uncomfortable. For others they don't know whether to be checked as they don't want to risk being discouraged if they are not far along (although with HypnoBirthing mums they are often a lot further along than both they or the midwife had realised).

However, midwives like to check how women are advancing with their labour. Sadly, although women are told that they can't plan birth (a topic of discussion for another day), in most cases, this is to check women are within their guidelines of how they should be progressing against the clock. (If there is a medical indication that it would be of benefit for you and the baby to have a vaginal exam obviously this is a different matter).

There are many midwives however that believe both can have what they want.

Quoting from the article found at (section 4.3)

"There is a purple line which creeps up the so-called 'natal cleft' (or bum cleavage for the less scientific amongst us) that can be used as a measure of cervical dilatation. The purplish-red line begins at the anal margin at the start of labour and gradually creeps up, like mercury in a thermometer. When it reaches the nape of the buttocks the woman is fully dilated. "

Now whilst this purple line doesn't always show I guess if it is there and a midwife is open to following it, it can help avoid vaginal exams. If you find this interesting therefore you can print off section 4.3 and have a conversation with your midwife to find out if she and any of the other midwives that may attend your birth are aware of this and have ever used it. If they are and it is something that they are happy to consider put on your birth plan that if the purple line is visible you would like them to use this method to assess how you are progressing and place a copy of the article with it. It doesn't mean you won't have a vaginal exam just that you are open to exploring other way of assessing dilation.

How many vaginal exams you may have very much varies from midwife to midwife and a particular birthing locations procedures so it is important to know that, without special circumstances indicating the benefits of a vaginal exam, you don't have to agree to them if you don't want them.

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