Almost afraid to ask

[Carianne]

So next week I start going weekly instead of monthly and I am curious what does the internal exam entail? ie details and How bad is it? TIA


Baby boy EDD 8/17

[elliput]

You can refuse internal exams- the whole purpose of them is to give you and your doctor an idea of what your cervix is doing- ie dialation and effacement.

As to how bad they are- IME, not any worse than a yearly pap.

[shoxie]

Yes, with my first, I had maybe two (?) internals, but my ob was pretty good (for a regular ob) in not pushing for them constantly. With my second, I had a midwife and no internals. They don't really tell you all that much - some women will barely be dilated before active labor starts, while others walk around dilated a couple centimeters before going into labor a week or two later.

[jent]

If memory serves, they are very quick, not as big a deal as a pap (though my Dr is very quick with those too).

[DebbieJ]

they just check your cervix. I refused them until about 38 weeks. There is no real reason to do them sooner.

[SnuggleBuggles]

FYI- there is no reason to have an internal. If you don't want one, just say so. If you want just one to ease curiosity, go for it. Having one at every appointment has physical and emotional risks.

Physical- infection (not a huge likelihood, especially if your water is intact, but still a chance).
Accidental or on purpose without your consent membrane sweeping (separating the amniotic sac from the cervix a little- this can release prostaglandins and possibly push you into labor- best reserved for 39+ weeks at the earliest).
Discomfort- this will vary so much on your personal tolerance but even more importantly, your cervix. If your cervix is posterior (high and tipped back) it will be harder to reach and much more uncomfortable.

Emotional- disappointment and/ or a false sense of hope. The state of your cervix means *nothing* as to when the baby will be born. When you go into labor, how long your labor is...they are all far more complex than simply your cervix getting to some magic number. Some women walk around at 4+cm, 90+% effaced and baby low and engaged for weeks. They leave their appointments feeling like a ticking time bomb thinking they'll go into labor any moment now. As time drags on they feel like something must be wrong and get bummed out. Totally not a good feeling- the false hope or the disappointment. Same goes for the moms who find they are high and closed. They could beat that other mom into labor.

I was the mom, with ds1, that started having her cervix checked at 37 weeks and was 1-2cm, 70-80% and -1 but didn't go into labor till exactly 42 weeks. In those 5 weeks my cervix did not change. I was crushed by the end.

With ds2 I decided to have no internals at all. I finally had one the day I requested membrane sweeping (41w3d). I didn't ask for the stats but she gave them to me. I loved not knowing. It made things so much easier on me mentally and emotionally. I knew labor would happen when it was time. A head start on progress would be nice but it wouldn't be horrible not to have it. Oh, and none of my internals were painful. The only ones that hurt were a few in labor but that had more to do with the timing of them in relation to contractions plus the position I was in.

I know some moms can't stand not knowing, and you may be one of them. Or, you may think you don't have a choice or don't want to be a "difficult" patient. But, those are just some things to consider (the physical and emotional stuff).

The only time stats really matter is if you are facing a medically necessary induction so they can best choose the drug and/ or method to use for the induction.

This is a fantastic article that describes what they are looking for in an internal (dilation, effacement, position of the cervix...) and some other helpful things. Check it out:
http://pregnancy.about.com/cs/interventions/a/vaginalexam.htm

Oh, last thing, with ds2 I did my own GBS swab. That is becoming more popular. Be prepared for that possibility. They'll give you instructions. Totally easy and it just involved wiping a q-tip type thing down around your nether regions.

Beth

[pinay]

Wow, I must have an extremely low threshold for pain b/c my first (and only) internal was incredibly painful :( I refused them after that first experience and was induced anyway, so it didn't matter in the long run. If you're really curious as to your stats, you can always have the internal done the first time, see how you deal with it, and go from there.

[amldaley]

Wow, I must have an extremely low threshold for pain b/c my first (and only) internal was incredibly painful :( I refused them after that first experience and was induced anyway, so it didn't matter in the long run. If you're really curious as to your stats, you can always have the internal done the first time, see how you deal with it, and go from there.

Mine was bad too, so my Dr actually chose not to do more than the one. Bad, but very quick.

[lowrioh]

I think the level of discomfort depends on the position of the baby. My first internal wasn't bad at all but at the second the DDs head was REALLY low and it was VERY uncomfortable. I was going to refuse the next internal but the next time I saw the docs I was in labor.