need info re: internal

[veve]

ok .... I have an OB appointment tomorrow... and he told me last week that he wants to do an 'internal' at my next appointment... :eek:

I am trying to stay relaxed... as my BP was up at the last appointment... but this is weighing on my mind!!!!

a few questions
1) what does that involve???? - I'm not really looking forward to it!!!
2) can it 'bring on' labour??? as one of my friends said??
3) why would he need to do this?? none of my friends have had one done... I know my baby is 'big' by his standards.... and that I am still carrying high for 38 weeks.... ?>???!!

all help will be appreciated!!!!! :)

xxx

[~MUMMY~]

when i had a suprise internal once at an appointment ... it was to see if the cervix was soft or had opend at all .... it involved a doctor just feeling with 2 fingers the inside to see if it has "rippend" as she liked to say....lol


dont mean to scare you but...

i was 17 and i thought it was the most horrable thing ever....

and they say it can bring on a labour but i highly doubt it will do anything unless your already nearly there ! meaning your cervix is opening and soft.

ohhh and it might hurt a little afterwards depending how much they need to push there fingers in ...well it hurt me because she couldnt even find it it was that far back!!!

but nothing to bad.. besides you better get use to it... they did many many many more for my induction and while i was in labour !

ohh and they only use a glove and some lub... wich was really sticky and yuck...LOL

but as i said you get over it ... it really isnt that bad...

[dee dee]

Hi Jenny,

During the course of my pregnancy I had quite a few internals, lucky me :(
They can be a bit uncomfortable, and like MUMMY said it depends how hard they have to press. I had a very unripe, closed cervix even to the day that I was induced at 10 days overdue so perhaps that is why I found mine so uncomfortable.

All the internals that I had did not bring on a labour (even an induction didn't bring on a labour!!) But afterwards I did feel a little crampy.

I don't want to make you even more anxious but as I said I found them uncomfortable and a little painful. Looking back in hindsight it probably wouldn't have been as bad if I had relaxed, but given the circumstances it is a bit difficult to do IYKWIM :o

But everyone is different, and you might find that the whole experience wasn't anything to worry about at all.

Hope this helped.
Good luck,

dee dee

[tickle]

Hi,
I never had any internals, besides two when I was in labor. I found them painful, but was that because I was in labor?? Maybe someone knows the answer to that.
If you are really worried about it, ask why he wants to do it. If it is just to see how close you are to having the baby, if you don't want one, say so. If it is not for an important medical reason, you shouldn't have to have one if you don't want to. ;)

[DoulaFelicity]

It sounds like you're not altogether pleased at the prospect of this procedure being carried out. The choice to consent to having someone's fingers inserted into your vagina is entirely yours; not your Ob's. He may "want" to do an internal examination, but that doesn't mean you need one, or that you are obliged to allow him to do one.

He should explain to you, in full detail, his reasons for wanting to perform an internal examination. He should ask you if you have any questions, answer them openly, and then ask you if you would like him to perform the procedure. Anything less than this is not informed consent.

Barring a clear and evident medical emergency requiring the cervix to be examined, there is no need for you to undergo an invasive and uncomfortable internal examination. In fact, it can increase the risk of any infection (pushing all manner of germs into our most sensitive parts and inside the cervix). Some information on internals:-

http://www.pregnancy.org/article.php?sid=1528

An internal examination involves your care provider inserting one, two or sometimes three fingers into your vagina, and up towards the cervix, to gently deduce how effaced/dilated your cervix is. This is not to be confused with a stretch and sweep, in which the procedure goes one step further by gently sweeping a finger or two around the inside of the softened cervix, to try and "stretch" the opening wider, and "sweep" the membranes away from the wall - to induce labour. Your Ob should also ask your permission to perform a stretch and sweep if this is actually his intent, and discuss this in full with you. There is also a risk of the waters being "accidentally" broken during the procedure; this should also be openly discussed.

It's your body, your baby, and your birth. You have a right to decline any procedures you don't want, and be fully informed so that you can choose those that you do.

If you do make an informed decision to consent to the procedure, focus on your breathing and relaxation. Visualise loose vagina, loose belly, loose legs. If you can resist the urge to tense and be frightened, you will get through the procedure with minimal discomfort. The fear/pain cycle works here as well as in birth.

Also remember that the only way to know the actual size of your baby is to place it on the scales once he or she is born. No machine or person can accurately predict the size of your baby - ultrasound has a margin of error of at least 2 pounds, and even the most experienced medical professional can only place a guess. It would be a very, very rare event where your body created a babe too big for you to birth.

Sending relaxing thoughts your way, and best wishes for the remainder of your pregnancy. :)

[veve]

thanks guys :)

I have had many internal ultrasounds before (have had surgery on an ovary) - I just wasn't sure exactly what an OB internal involved... and although I remember him saying something about my cervix... my brain was numbed (from the word internal!!) - and I couldn't remember much!!!

thanks too... Doulafelicity - I will remember to check if it is a 'stretch and sweep'- because I really do just want bubs to arrive when he/she is ready!!!


'An internal examination involves your care provider inserting one, two or sometimes three fingers into your vagina, and up towards the cervix, to gently deduce how effaced/dilated your cervix is' - Hang on... I assumed that there would have been no change to my cervix considering that I am not in labour... and haven't had a 'show' yet???

awww man - pregnany is such a HUGE learning curve!!! :)
xxxx

[jaydensmum]

I know the exact feeling that you're having. I had the same questions when i got it done to me the first time. What they do in an internal and sorry if this is TMI, they basically place 1-2 fingers inside and feel for your cervix. It is a bit uncomfortable but it doesnt last long. It actually feels a bit like a pap smear. Why they are probably trying to do it is to see what condition your cervix is. What i mean by that is whether its high, low, open, closed, soft or hard. They gave me an internal at 35 weeks because i was having contractions. They were worried at that stage because it can induce labour. It doesnt always happen, but it may. The reason why is because there is membranes just inside the cervix and if they move them around by accident it can fool the body by telling it that its in labour. Mind you though i had the sweeping of membranes at 40 weeks and nothing happened. Try not to worry too much. The doctors know what they are doing and try and trust that they will do a fanastic job. I hope this has helped ease you mind a bit.

jaydensmum

[tickle]

OK, I don't want to cause a debate here. But I was just wondering whether OB's maybe do more internals because they are more keen to see whether there is more of a chance you will go into labor sooner or later. Does this make sense??

Most peope I know that see their GP or middie don't have one until they are in labor. I might have completely the wrong end of the stick here, so someone correct me if I'm wrong. Just wondering if it is a possibility?? :rolleyes:

[jaydensmum]

I have no idea if they do internals for that reason. I had 5 internals before i was actually in labour. I had 2 internals at 35 weeks. They put off doing an internal until it was actually necessary. I was having contractions at 5 min intervals and they needed to see if i was dilating. To answer your question they might do them to see when you'll go into labour but again im not sure.

jaydensmum

[veve]

OK, I don't want to cause a debate here. But I was just wondering whether OB's maybe do more internals because they are more keen to see whether there is more of a chance you will go into labor sooner or later. Does this make sense??

I dont know if I can answer this question (I dont want a debate either :D) - but two friends who went through the same OB didn't have any internals (I rang THEM before posting here!!!!)

I'm just lucky I guess!!!!

xxxx

[tickle]

I guess it just depends on who you see, hey. :)
Interesting topic though.

[DoulaFelicity]

Hang on... I assumed that there would have been no change to my cervix considering that I am not in labour... and haven't had a 'show' yet???

Not so, veve. :) Labour isn't a sudden event that "begins" at a certain point with a certain event. It's a gradual, subtle process of hormonal interplay that builds to a point where we start to notice the more recognisable outer signals. Your cervix is readying itself many weeks before you will actually go into labour; your wonderful uterus is "practicing" for months before established labour begins (with Braxton Hicks contractions). Your body is constantly changing and ripening towards birth.

Often, by the time an internal examination is done (if the pregnant Mama opts for one), the cervix is already a few centimetres dilated, and very soft. Even so, established labour may not follow for a few weeks. Our bodies are constantly working hard; we don't need a reading of centimetres or station to tell us this. Your baby will be birthed whether someone puts their finger in your cervix or not. :)

As to the reasons why some birthing women have no examinations and others have many, it really comes down to your own birthing philosophy, and the philosophy of the care provider you choose. An actively medically managed pregnancy and birth will more than likely entail a few internal examinations; a midwifery model will entail less (if any). Regardless of the model of care you are in, the choice to be examined internally is yours, so there is no reason why any women should have more internals than others, unless that is their personal informed choice.

I had no internal examinations during my pregnancy; this was my wish, but they were not offered to me anyway (why would they be?). During my labour, I had two; both requested by me. None were offered to me or pushed upon me, and they were not done as a "routine" intervention.

If you are in labour, you are in labour. :) This remains true whether someone measures your cervical dilatation with their finger and tells you a numerical figure, or not.

If anyone wants some detailed information on internal examinations (with relevant websites and references), please feel free to PM me. I have lots of it; a little too lengthy to post here! :p

[jaydensmum]

Yeah it is an interesting topic! :D

jaydensmum