06/28/2020
Reposted from Earthley
Most women are subject to routine pelvic exams during pregnancy...early, late, and during labor. But did you know these are often NOT necessary?
Early in pregnancy, cervical exams are used to "confirm" pregnancy. A simple, non-invasive urine test can do the same thing.
Late in pregnancy, cervical exams are used to "predict" labor. While a pelvic exam *may* benefit a woman who is pre-term and having signs of impending labor (via the "Bishop score"), there is no benefit to women who are full-term and simply wondering how many more days it will be!
During labor, there is also little benefit. Most providers use cervical exams for their own knowledge, so that they can try to predict when they'll be needed for delivery. It doesn't impact the progress of labor or improve the outcomes for mom or baby.
Pelvic exams can also introduce foreign bacteria and increase the risk of infection to both mother and baby. Some women find the exams extremely uncomfortable mentally and physically, especially if they are performed frequently or by different providers. They also immediately shift the vaginal flora, which can impact the baby's gut development (but no studies have been done to see what the long-term impact might be).
One situation in pregnancy where an exam may be advised is if a woman has had a previous second-trimester loss, or is having symptoms of very pre-term labor. Cervical shortening is highly predictive of early labor, and women can get progesterone supplements to help sustain the pregnancy until they are full-term. However, "repeated" exams do not improve outcomes with pre-term labor. (An ultrasound may also work to detect a shortening cervix.)
If you don't want a pelvic exam, you have the right to say NO (until or unless you change your mind or something goes wrong). You can also learn how to check yourself for dilation during labor, if you want to know. Whether or not you have an exam, baby *will* be born. :)
Sources:
https://www.ncbi.nlm.nih.gov/pubmed/20159393
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5503468/
https://www.ncbi.nlm.nih.gov/pubmed/23857468
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3560273/
https://www.ncbi.nlm.nih.gov/pubmed/20556763
https://www.ncbi.nlm.nih.gov/pubmed/10076131
https://www.ncbi.nlm.nih.gov/pubmed/28475099
https://www.ncbi.nlm.nih.gov/pubmed/21551402
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3647734/