| Do you want or need them? |
| + How do say NO to them or any unwanted assessment or intervention. |
| There is a big movement happening right now of women saying no to cervical exams in pregnancy and labour. WHY? Because 90% of the time they are useless and cause more harm than good. You can go from 3 cm to 10 cm in the matter of minutes or it could take hours or even days. It does not adequately judge your progression or give you a timeline for when you’ll be in labour or crowning. Checks come with many more Cons than Pros: Cons: Infection Risk: Having anything inserted into you increases the risk of introducing bacteria into the birth canal, potentially leading to infection. This is even more of a concern if your waters have broken. Pain and Discomfort: Cervical checks can be uncomfortable or painful, especially if the cervix is not fully dilated. Checks may contribute to increased discomfort during labour and disrupt your normal physiology that supports labour. False Expectations: Cervical dilation is not always a precise indicator of when labor will occur or progress. Some women may become discouraged if dilation doesn’t correlate with their expectations, leading to emotional stress. I experienced this first hand in my first birth. Laboured ALL NIGHT to find there was little to no progression. It is heart breaking. Better to stay in the zone IMO. Interventions Based on Numbers: There’s a risk of unnecessary interventions if healthcare providers place too much emphasis on cervical dilation as the sole indicator of labor progress. It’s essential to consider other factors, such as your overall well-being and the baby’s status. Inaccuracy: Cervical checks may not always accurately reflect the progress of labor. The cervix can change rapidly, and dilation measurements may vary depending on the experience and technique of the healthcare provider. I was at a first timers birth and a resident told the momma she was 8cm just be rechecked by a nurse who could see by her demeanor she was not at transition yet or that close to delivery. She was then found to be only 3cm and it was devastating. Psychological Impact: For some women, frequent cervical checks can be emotionally distressing, especially if progress is slower than expected. This psychological impact may affect the overall birthing experience. And the Pros ? Progress Monitoring: A check for my one client showed her cervix had opened and labour was imminent despite not having any contractions. This allowed her to be admitted as she lived an hour away. Her baby told me “Go in and I will come” and she went in and had him with no labour leading up to it. Fetal stations: A cervical check can be used to assess the fetal station and position of their descent. THIS can be helpful if labour is not progressing. Asking ‘Where is baby?’ and ensuring good head engagement is what is needed. Informed Decision-Making: In theory checks can help you and your healthcare providers make more informed decisions about the course of labour and delivery, including the potential need for interventions or pain management but that is still on the assumption that checks are giving valid information about your timeline- which it does not. Patient Satisfaction: Some women feel reassured and satisfied by knowing the progress of labour. It may provide a sense of accomplishment and motivation during the challenging process. You may want to know and that is perfectly fine if you do! It is your body, your birth and your choice. In the summer of 2023, I took Birth Trauma Prevention and Advocacy training with R.N Emily Edwards. She took me through the ins and outs of understanding the hospital system from the inside and how to navigate the policies and protocols to get the birth YOU WANT all without hostility from the staff. Because guess what- any hostility or mocking of your birth plan, or failure to follow your wishes goes against their codes of ethics and your rights. They work for you, not the other way around. When they know that you know your rights and their code of ethics that they must legally abide by and that you are willing to hold them accountable for their actions if they overstep- they change their tune pretty fast. This can be hard it the moment when you arrive there in active labour. Which is why preparation and advocacy support is crucial. Did you know you can schedule a prenatal appointment with the hospital social worker to discuss your special needs in labour and concerns? They will have it all documented and have the staff prepared to support your birth and care expectations plan beforehand! I did not! I created these 2 documents to support this process and I’m sharing them with everyone freely because this level of autonomy and advocacy is important. If you are not in Saskatchewan or Canada they can serve as a template to find the matching information for your province or state. I have an Ontario version if anyone wants it. They are packed with information and will be helpful if you’re planning a hospital birth, have an unplanned transfer and even if you’re working with a Midwife at home or otherwise. Maternal Rights Guide -Saskatchewan Care Expectations Contract – Saskatchewan If you would like a .doc version of the care expectations to customize let me know and if you create it for another region please share it back to me! With my birth packages I include birth planning and helping you get clarity on what you do and don’t want and how to advocate for it. I am there holding and protecting that space for you, not from an adversarial place but one of compassion for the providers who have not been trained in or have even seen an undisturbed physiological birth. Not all doulas are created equal unfortunately many of the trainings out there teach doulas that advocacy is out of their scope. Prevention of birth trauma is in the hands of everyone in the birth space. The most trauma comes when the partner, doula or nurse does nothing to stop unwanted treatment. Being clear on what you want and having it documented and allowing your support people to advocate for you goes a long way to helping you stay in the ‘birth zone’, and that is where you need to be. Whatever birth you are looking to have, I’m here to help. |
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