Let’s talk vaginal exams! It’s a topic that comes up in every course I teach, last nights being no exception! I find it hugely frustrating that VEs are presented in a very biased way, without potential risks always explained, and yes they DO come with risks!
A recent study LAST YEAR retrospectively looking at over 22,000 women found that having more than 4 VEs in labour TRIPLES your risk of infection. TRIPLES! What does that mean in practice? It means antibiotics for you and baby, a prolonged stay in hospital, increased risk of further intervention, and increase in risk of morbidity to you and baby. On top of this research is the other impacts of VE’s on a labouring person. If you find it intrusive, uncomfortable or even triggering, a VE can impact the profession of labour, increasing the risk of intervention. It may cause a domino effect of needing things like artificial rupture of membranes or syntocinon to “speed up” labour, which can increase the chances of epidural, instrumental delivery or Caesarean birth. These are all very valid considerations.
All too often VEs are being presented as a non-negotiable, or women are being persuaded to “compromise” and consent to “just one” on arrival at hospital. This is not ok. Yes, if you understand and know the risks and benefits, then decide to consent because you’re happy to have one, then great. What isn’t ok is being told no and then being convinced otherwise. As with any intervention or procedure there are potential risks as well as benefits, and I find it frustrating that some antenatal classes or discussions with healthcare professionals neglect to cover the risks, focusing solely on their perceived benefits.
What I am not saying is that you should refuse vaginal exams at all costs. Some people desire to have them and know how many cm dilated they are, and that’s fine. What I AM advocating is making an INFORMED decision. It’s why I’m SO PASSIONATE about people taking courses like mine, to learn about the pros and cons of every aspect of birth. Facts that your midwife just doesn’t have time to cover in detail in a 20 minute antenatal appointment!