Why do they check your cervix in late pregnancy?

[staceyobu]

I don't get it. I'm at a 3 now at 36-37 weeks. But, from everything I can tell, this means nothing. I know of people who walk around for weeks at a 5. I've tried to see if I can find some study that says people dilated x amount go into labor in x time frame, but I can't find anything. The ob's plan is to check me every week from now till I go into labor. Everyone I know gets checked every week for weeks before labor. Why? Why do they do this? It seems like worthless discomfort to me, but maybe I'm missing something?

[JVA]

They're looking to see what the change may be from week to week- both in the diameter of the opening as well as efacement (sp?)- the thinning of the cervix....gives them an idea of the progress.Checking it can be uncomfortable but wait till they might strip your membranes- that can get things going - as in labor. They usually wait until you're really close or passed your due date to do that.

[stripe]

I had both midwives and an ob (different pregnancies) offer to check me, as if I or others might be interested (not exactly sure why, maybe anticipation), but I never felt pressured to be checked weekly. I am not sure about my friends, but I know several who went to the same doctor and midwives. They admitted some women dilate quickly and others walk around at a 3+ for weeks. Anything about a schedule is probably part of trying to push labor induction, in my opinion, which I am not a fan of unless it's medically indicated. I certainly am as puzzled as you.

 

I find not changing into the gown is pretty effective as a cervical check avoidance mechanism. Keep your pants on!

[ktgrok]

Because they are dumb. Seriously. There is ZERO benefit. It is just for curiosity, not an actual medical reason. And it risks infection. The only kind of reason they have is to see if you are ready for induction, lol. Seriously, how dilated you are means NOTHING. You can walk around 5 centimeters for WEEKS or be not dilated at all and go into labor that day. I know women that have done both. I personally was 3 centimeters dilated for a month before I gave birth.

[brett_ashley]

there's no reason except curiosity IMO. I always decline (unless actually in labor)--the risk of infection is real.

[Leanna Tomlinson]

I will say that KNOWING I was 5cm made me pay attention to some painless but rhythmic Braxton-Hicks, which ended up being my actual labor....... taking only 1.5 hours.

 

If I hadn't known I was 5cm, I would have dismissed the pressure I felt as normal for late pregnancy. We could have easily ended up with an unplanned home birth. I literally didn't really think I was in labor until the last 15 minutes. My scared husband, who knew I was already 5cm, made me go to the hospital for what I was calling a "false alarm".

 

I think there can be a benefit if you have a history of fast labors.

[kalanamak]

there's no reason except curiosity IMO. I always decline (unless actually in labor)--the risk of infection is real.

 

Doctors are curious about that? Why not look in your ear every time? Surely doctor's curiosity would, statistically, be spread over various parts of the body.

 

Doctors are tired. They do very little out of mere curiosity.

 

I checked my own when I was fairly far along. (What few times I have examined pregnant women, it has been during an ER check for possible labor.) It felt squishy like a jelly fish, and I wanted to know if this was normal. I called the office and the nurse expressed alarm that I'd examined myself. I said, "I am not convinced a gloved finger gently pressing a couple of times is that alarming after nightly action from a husbandly member wearing no rubber glove at all." As expected, no reply to that. I was assured the jellyfish was normal.

[VeganCupcake]

I don't think there is any real benefit other than attempting to make a prediction--which very rarely ends up being of any use. I think it's just tradition and it seems like it might be useful, so it continues to be done.

 

But in reality, I think it's very good at making a woman feel like there is something wrong with her because she's not at all dilated before her due date, especially in a first pregnancy; or making her think she'll go into labor at any second because she's a 3 or something.

 

I have never had mine checked until I was well into active labor. My midwife will check if I ask, but I don't care unless I'm about to give birth.

[Melissa in Australia]

the only time I have had my cervix checked was when I was in hospital to have my labour induced. They then checked my cervix at about the same time they broke my waters.

 

the more I read o these boards the more amazed I am, the doctors in America sound like real perverts, they seem to be checking there all the time for everything

[LostSurprise]

I was 7cm dilated with my first child with no noticable labor (I know, nice). They sent me to the hospital so I didn't have a cord prolapse or something. I have quick labors though. I generally had 30-45m between the start of labor and birth.

 

I have fully dilated in 1 ten minute monster contraction before. That's right, full dilation and then pushing.

 

Of course I'm kind of weird. In general most people don't need it and you can refuse it.

[Dianne-TX]

I will say that KNOWING I was 5cm made me pay attention to some painless but rhythmic Braxton-Hicks, which ended up being my actual labor....... taking only 1.5 hours.

 

If I hadn't known I was 5cm, I would have dismissed the pressure I felt as normal for late pregnancy. We could have easily ended up with an unplanned home birth. I literally didn't really think I was in labor until the last 15 minutes. My scared husband, who knew I was already 5cm, made me go to the hospital for what I was calling a "false alarm".

 

I think there can be a benefit if you have a history of fast labors.

 

:iagree:

[Tarreymere]

There is no good reason. In fact, it certainly can introduce harmful bacteria into the vaginal canal.

 

Doctors do it as part of the 'smoke and mirrors effect', as we called it. It makes it look as though the doctor were doing something important or necessary for the health of the woman and her child, in part maybe to justify how very much the client, um I meant 'patient', needed them. It has been a traditional part of maternity care for so long that now most women even demand this kind of check in the last weeks and get upset if one doesn't perform it.

 

Don't try to tell me that the doctor needs to do this check at a routine ob appointment to determine if a woman is in labor, because that is just ridiculous. Labor is defined as cervical change over time (most places like to see at least a centimeter change over an hour or maybe two for admission, unless the beds are empty and they are trolling for potentials to admit and string along until they can get the pitocin started and bring on labor for real), and a one time 'spot check' during a routine visit doesn't cut it.

 

Ask me about what other stupid, 'smoke and mirrors' type tricks or unnecessary interventions are common in ob.

[meggie]

There is no good reason. In fact, it certainly can introduce harmful bacteria into the vaginal canal.

 

Doctors do it as part of the 'smoke and mirrors effect', as we called it. It makes it look as though the doctor were doing something important or necessary for the health of the woman and her child, in part maybe to justify how very much the client, um I meant 'patient', needed them. It has been a traditional part of maternity care for so long that now most women even demand this kind of check in the last weeks and get upset if one doesn't perform it.

 

Don't try to tell me that the doctor needs to do this check at a routine ob appointment to determine if a woman is in labor, because that is just ridiculous. Labor is defined as cervical change over time (most places like to see at least a centimeter change over an hour or maybe two for admission, unless the beds are empty and they are trolling for potentials to admit and string along until they can get the pitocin started and bring on labor for real), and a one time 'spot check' during a routine visit doesn't cut it.

 

Ask me about what other stupid, 'smoke and mirrors' type tricks or unnecessary interventions are common in ob.

 

Rainefox, what other stupid "smoke and mirrors" type tricks or unnecessary interventions are common in ob?

 

:D

 

(You don't really have to answer that. I'm not a pot stirrer, just a sassmaster.)

[enviromommy]

Doctors are curious about that? Why not look in your ear every time? Surely doctor's curiosity would, statistically, be spread over various parts of the body.

 

This is totally off topic and maybe it's rude for me to inject something off topic since I hardly ever post, but I'm :lol: over this answer because it reminds me of when I was a little girl and my parents brought me to the pediatrician because I had cut my finger on an olive can and they wanted to know if I needed stitches. The doctor started looking in my ears and mom mom said, "But it's her finger that's the problem." The doctor shrugged and said, "I like to look at ears."

 

To the OP: dilation doesn't mean much, but according to my OB, effacement does mean something. When I came to her 2 cm dilated but not effaced, she said it meant nothing. When I came in 2 cm dilated but 80% effaced, she said she was thinking of canceling her dinner plans.

[Lisa in the UP of MI]

I've never been checked until I went to the hospital in labor. With our newest little one I was checked once to make sure I was complete (just got to the hospital) and he was born immediately after.

[celticmom]

There is no good reason. In fact, it certainly can introduce harmful bacteria into the vaginal canal.

 

Doctors do it as part of the 'smoke and mirrors effect', as we called it. It makes it look as though the doctor were doing something important or necessary for the health of the woman and her child, in part maybe to justify how very much the client, um I meant 'patient', needed them. It has been a traditional part of maternity care for so long that now most women even demand this kind of check in the last weeks and get upset if one doesn't perform it.

 

Don't try to tell me that the doctor needs to do this check at a routine ob appointment to determine if a woman is in labor, because that is just ridiculous. Labor is defined as cervical change over time (most places like to see at least a centimeter change over an hour or maybe two for admission, unless the beds are empty and they are trolling for potentials to admit and string along until they can get the pitocin started and bring on labor for real), and a one time 'spot check' during a routine visit doesn't cut it.

 

Ask me about what other stupid, 'smoke and mirrors' type tricks or unnecessary interventions are common in ob.

 

:iagree:

[chepyl]

My doctors used it as a baseline. I had been at a 2 for two weeks. I had been having real labor contractions less than five minutes apart for a little over an hour, I went to the hospital and they monitored the co.tractions and checked....after several hours of regular contractions nothing had changed still a two. They sent me home when i still made no progress with walking off and on over an hour.

 

Next day, doctor checked and still at a two after 24 hours.of labor. He gave me a choice and I chose to go home. Another 24 hours...still a two. I was exhausted and agreed to let them break my water. I think they knew something was wrong but were trying to avoid a c-section. I had a slowing labor after that, but eventually got to a ten, pushed once, baby's heart rate stopped until I stopped pushing. I was in the OR and my son was out in minutes. The cord was wrapped so tight around his neck and body that Jr could not move down. When I tried to push it put him in extreme distress. Because they knew how long I had been a two, they were ready for a problem. I only wish I would have requested an ultrasound when nothing was happening, but it was my first baby and I was young. I know better now.

 

I totally understand why it is done.

[staceyobu]

Rainefox, what other stupid "smoke and mirrors" type tricks or unnecessary interventions are common in ob?

 

:D

 

(You don't really have to answer that. I'm not a pot stirrer, just a sassmaster.)

 

I agree... she should elaborate!

[Joanne]

I lost my mucous plug more than a week before my oldest was born. I was dilated to a "stretchy 3" before my dd was born. My my third, I didn't even know his sex and had no idea how dilated I was. I knew how *tired* I was, though. THAT was useful information I could do something about.

[weddell]

My first baby was delivered by a family practice dr and my second by a midwife. Neither checked as part of a routine visit late in pregnancy. My first was born at 38 weeks and I wasn't checked until I was in labor. My second, my midwife checked at my 40 week appointment but not before. My providers were both pretty laid back and didn't do things they didn't think we're necessary.

[Cricket]

I'm not sure why they check. With my older two, I used OBs. They insisted on checking every week towards the end. With my younger two, I had home births with a midwife. No routine checks. She offered to check when I went past my due date with the first home birth. I ended up going two weeks past my due date. I don't think she ever checked with the second one.

 

Maybe it is more a malpractice thing? Like if a woman goes into labor and gives birth on the side of the road she can sue the doctor for not knowing she was on the verge of labor. :confused:

[kitten18]

Doctors are curious about that? Why not look in your ear every time? Surely doctor's curiosity would, statistically, be spread over various parts of the body.

 

Doctors are tired. They do very little out of mere curiosity.

 

 

:lol: but I do agree with you.

[Sara in AZ]

With my second pregnancy we made the decision to induce based in part on the fact that I was already dilated to about a 4-5 and 70% effaced. It was evidence that my body was already on it's way and more likely to play along, (which it did, just breaking of water, no pit.) This was at four weeks before my due date and necessary for the safety of the baby.

 

A few days before my third was born, I had a particularly traumatic experience at OB triage (where my membrains were stripped with out my consent.) And I went from being a stretchy three to completely closed up. Turns out you can undilate.

 

My fourth was a water birth at home. It happened so quickly that the midwife didn't even make it to the birth. Her assitant arrived after the head was out, just in time to catch the baby. I LOVE being able to say that I, and my baby, experienced an entire labor without knowing how dilated I was. Apparently enough. I especially love being able to tell this to my mother who was pestering me about it every day for weeks before the birth. :tongue_smilie:

[Amber in AUS]

Have not read all the responses.

 

My OB only checked me on my due date (which i only passed with 1 baby) and at that time i was 3cm. He was looking to see if things were getting ready. If i was shut tight then his plan might have been different.

[BoZeeCo's Mom]

I've had home births, so maybe I don't know, but the only time they looked down there during the whole course of my pregnancy was when the baby's head is coming out. You can be x centimeters for a couple of weeks before you actually give birth! You're not in labor till you're in labor. But maybe they check at the dr.s so they can start talking about interventions?

[Sara R]

My doctors used it as a baseline.

 

Same with me, but with a homebirth midwife. She checked me before she went out of town at 38 weeks for a midwife conference. I was a 2. I didn't go into labor until 41w5d, and after 10 hours of painful labor contractions I was still at a 2. This didn't bode well, and indeed I did end up transferring to the hospital and eventually required a c-section for failure to progress/CPD/fetal distress/infection starting.

 

That baby actually went up at the end of pregnancy, according to the station the midwife measured in the exams. Apparently as his head grew, he no longer fit in the pelvis and went up. I had my OB check for this in the next pregnancy. I figured this was a pretty good sign that the VBAC thing wouldn't work, so I opted for an elective repeat section.

 

It was useful information in my case. It would also be useful for a person at risk of precipitous labor. A friend was very dilated with her 4th baby. Her husband worked an hour away from home and she was concerned that he might miss the birth and she wouldn't be able to arrange for child care. Her other labors had been very fast. She induced, her body cooperated, her husband was there and her other children were well taken care of, and all was well.

[lewelma]

Sarah R, you are my twin.

 

Same with me, but with a homebirth midwife. I didn't go into labor until 41w5d, and after 10 hours of painful labor contractions I was still at a 2. This didn't bode well, and indeed I did end up transferring to the hospital and eventually required a c-section for failure to progress/CPD/fetal distress/infection starting.

41+6 for me. After 40 hours labor, 8 of which was transition labor, my midwife checked me for the first time, and I was at 4 cm.:tongue_smilie: I quickly transferred to the hospital. After 15 hours of syntocin, I had a c-section.

 

That baby actually went up at the end of pregnancy, according to the station the midwife measured in the exams.

For the second, I was in the birthing rooms at the hospital. The first time they checked I was at 8cm and 2 hours later I was at 4 cm and went with a c-section.

 

No one ever checked me before I went into labor, and I am not sure how it would have helped at all.

 

Ruth in NZ

[Bonkers247]

I was checked with all my babies because there were inductions planned for each of them. Whether or not I was dilating made a difference in how my doctors wanted to proceed.

[kalanamak]

The doctor shrugged and said, "I like to look at ears."

 

Now this is something you get conditioned to do, because after the first two times you find an ear packed with wax, clean it out, and the patient is delighted to find out they weren't losing their hearing (something that had happened so slowly they hadn't mentioned it), you become "trained" to check ears. So infrequently in life does one perform such a simple act and get such a look of gratitude, it "trains" one to do it.

 

I'm not an OB, and I'm not chummy with one so I can't ask (and OBs were the most pressured and grumpy doc (aside from vascular surgeons) when I was a med student, and no one let a student get near a patient's cervix in the private hospital I did my rotation, so I honestly don't know why docs do this "smoke and mirror" trick). I will note that part of a doc's job is to look first for "deadly serious things a doc can do something about" first. Next is deadly serious things you can't significantly change the outcome to by acting, next not deadly serious things but unpleasant ones you can intervene on and lastly the minor things docs can't have much of an impact on. If I doc has "seen" something that prevented a bad outcome, s/he would be conditioned in a Skinnerian way to check.

 

Lawsuits ABOUND in OB.

 

Insurance companies check your charts to see if you are providing standard care.

 

In my state, if a patient has a bad outcome and a doc hasn't dotted an i, the state board audits you, disciplines you, and makes you pay for your own monitoring. I read these bulletins monthly: Dr. X of such and such a place denied wrongdoing but censured by this board. Dr. X will document 20 hours of reading on this topic, will have 40 charts randomly audited over the next year, and will be assigned Dr. Y as a peer-to-peer consultant on issues of this sort until this board decides otherwise. --This is a sobering message I read several of a month.

 

Not all woman are as in tune with their bodies and health as our board members.

 

I can think of a lot of motivations to do this, just knowing the medical world.

 

If you don't want it, say no, but except a little backpush, so the doc can document that they "strongly recommended" and "patient declined", which gives them a crutch in front of the medical board. And remember, OBs are a tense lot because they have two patients. Sometimes their needs conflict. I know I ran screaming from OB for that very reason.

[dirty ethel rackham]

Because they are under some outdated notion that knowing the condition of your cervix will give them useful information about when you will go into labor. It doesn't. But, it does raise the risk of infection and the risk of unneeded interventions and interventions done without consent, such as membrane sweeping. Yes, tons of doctors do membrane sweeping without consent, let alone informed consent.

 

With my first baby, I didn't know very much and did whatever the doctor told me. At my 39 week visit, they told me that I was fully effaced and was dilated to 2. As I made the following week's appointment, they said I wouldn't need it anyway as I was sure to go into labor that weekend. 3 weeks later, still pregnant, I went in to be checked and they swept my membranes and only told me about it after I asked why that exam hurt so much. I was an emotional wreck those 3 weeks expecting to go into labor any minute. People stopped calling me "not wanting to bother me."

 

I can't remember who said this but one quote I heard is "If the cervix was meant to be measured, it would be on the outside."

 

With my last baby, I didn't have any cervical checks beyond confirming pregnancy. None in my final weeks and none during labor. Granted, my labor was less than 2 hours, but, at no time did she feel the need to check me. Outward signs are often a better indication of where a woman is in labor than what the cervix says. I was at a birth where a mom showed all the signs of transition, only to be told that she couldn't be - her cervix was only 5. Ten minutes later, she was holding her baby.