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Vaginal exams: Forcing finger through cervix?



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  #1  
Old Oct 20, 2004, 11:55 PM
Registered User
Join Date: Jul 2002
Vaginal exams: Forcing finger through cervix?

I'm a lowly apprentice midwife at this point and haven't yet learned vaginal exams. I'm in no hurry either, lol.

The first time I was pregnant, my midwives explained the difference between one and two centimeters dilation. Correct me if I'm not remembering this right. One centimeter is "fingertip" dilated, as in just the little fleshy pad on the tip of the finger can go into the cervix. With two centimeters, the finger can be inserted into the cervix up to the first joint and baby's head can be felt at the inner os.

So, yesterday I landed in the ER at 37 weeks after an awful stomach bug left me dehydrated and contracting. We have two hospitals here, one with the ER and one for women and children where the babies are born. My hemotologist wanted me to go to the one with the ER first, in case the stomach bug was a reaction to the blood transfusion I had two weeks ago. At that hospital, they gave me fluids, checked my cervix, and monitored baby and me for 20 minutes before shipping me over to the Women's hospital for more monitoring. The ER doc was very gentle with the pelvic and her finding was that I was one centimeter. (Okay by me...I'm hoping to go late, lol).

At the other hospital, the labor nurse didn't want to trust the finding of the ER doc and insisted on checking my cervix again. Since the first exam had been so gentle and the cervix had been easily reached, I assumed this exam would be the same. Oh my goodness, it wasn't! I felt like this nurse was trying to check my tonsils! My husband said he nearly fell out of his chair when he saw her go in hard, then rear back a bit and lunge in again, literally pushing my whole body back on the bed. I've never had a more painful exam, and I've even been manually dilated during one of my labors!!!!!

After she was finished, she said that this cervix wasn't going to be producing a baby anytime soon and said, "I had a really hard time reaching the inner os." I was speechless! I couldn't imagine why she thought it was important to even TRY to reach the inner os, considering I was only dilated one centimeter.

So, I guess I'm wondering...do I have my facts straight? And do you all examine women this way? Is it standard to try and force a finger into a cervix that is only open enough to allow the small pad of your finger in????

Thanks in advance.

Sarah

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  #2  
Old Oct 21, 2004, 12:30 AM
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Join Date: Jan 2004

Ouch!

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  #3  
Old Oct 21, 2004, 08:46 AM
Registered User
Join Date: Sep 2000

From what you've told us, the second exam being so, shall we say "rigorous", was not necessary. For crying out loud, you were 37 weeks, so who cares if your inner os is dilated or not? If you went into labor, you went into labor. If you had been IN labor, I could see maybe she wanted to check for position of the baby (vertex vs breech), which is how I have to do it, since I suck at Leopold's! But in your situation, it seems like overkill.

Linda

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  #4  
Old Oct 21, 2004, 08:52 AM
SmilingBluEyes's Avatar
SmilingBluEyes (Female)
Temper-MENTAL Redhead
Join Date: Apr 2002

It was unnecessary. I am sorry you went through this. I am NOT one for gratutious vaginal exams myself. They are all uncomfortable and in some cases, can hurt rather, than help, in diagnosing progress in laboring women. There are many other ways to assess how things are going besides doing vaginal exams, IMO.

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  #5  
Old Oct 21, 2004, 06:10 PM
Fiona59 (Female)
Registered User
Join Date: Oct 2004

Ouch!!!


I recall feeling the model vagina with a 10 cm cerevix and thinking don't want to ever do that again!

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  #6  
Old Oct 21, 2004, 09:30 PM
Registered User
Join Date: Sep 2003

I am so sorry you went through such a horrible and violent "exam." I makes sick that a (male or female) nurse would act in that manner. I hope everything goes well for you and your baby! Minerva


Last edited by MinervaB : Oct 22, 2004 at 02:59 PM.
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  #7  
Old Oct 21, 2004, 10:00 PM
kmrmom42 (Female)
MSN ICCE IBCLC
Join Date: Sep 2003

I would guess that you probably already know the answer to your question since you have already had 4 children and you work with a midwife. This is not a typical exam and from what you say the nurse was unnecessarily aggressive. I pride myself on trying to ensure that my exams are more gentle than the generally rough docs I work with. I am pleased when a patient says "that was much better than when the doctor does it!" Seems like that nurse could use a little empathy.

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  #8  
Old Oct 21, 2004, 10:19 PM
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Join Date: Jun 2004

Originally Posted by MinervaB
I am so sorry you went through such a horrible and violent "exam." I makes sick that a female nurse would act in that manner. I hope everything goes well for you and your baby! Minerva
ANY nurse, male or female! (Just being equal opportunity)

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  #9  
Old Oct 22, 2004, 02:30 PM
SmilingBluEyes's Avatar
SmilingBluEyes (Female)
Temper-MENTAL Redhead
Join Date: Apr 2002

Originally Posted by hypnotic_nurse
ANY nurse, male or female! (Just being equal opportunity)

Thank you. My experience has been, men can be just as gentle, or even more so, than some female nurses. I think it best to leave gender out of the issue.

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  #10  
Old Oct 22, 2004, 02:58 PM
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Join Date: Sep 2003

Originally Posted by SmilingBluEyes
Thank you. My experience has been, men can be just as gentle, or even more so, than some female nurses. I think it best to leave gender out of the issue.

Jeez, I get it! I wasn't even thinking when I put "female" down, I guess I would have written male nurse if it had been a man who did the exam. I'm sorry I have ofended everyone with my blatently sexist comments.

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