Vaginal exams: Forcing finger through cervix?

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    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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  4. 15 Comments so far...

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    Ouch!
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    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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    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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    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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    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 edit by MinervaB on Oct 22, '04
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    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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    Quote from 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! :wink2: (Just being equal opportunity)
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    Quote from hypnotic_nurse
    ANY nurse, male or female! :wink2: (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.
  13. 0
    Quote from 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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