I will start this post by saying that I have been working very hard to tone down my, well, tone. Especially on here. I attended a women's retreat with a very dear friend of mine, and God did awesome things in me...and in turn, my family. It's been a long time, and He still gathered me back into His arms. God is such a gracious God.
Anyway...some of what I'm saying may sound a bit graphic...but think of it in terms of anatomy, purely.
It occured to me today, after reading a post from a woman in one of my birthy groups, just how intimate the question, "How dilated and effaced are you?" really is.
Think about it. The person is asking you if another person has had you spread open your legs, and insert a hand into your vagina, and felt your cervix. They're asking how open your cervcal Os is, and if it's thinned any.
And we don't see any problem with this initially, because we're groomed to believe that it's just what happens during pregnancy and labor...not what it is. A violation. I truly wonder what the reaction would be if we countered that question with, "How hard and long was your husband's penis at the time that you two conceived your baby?". Is that really any more personal than the question asked above?
The penis is not checked at the time of conception to make sure that it is hard enough for insertion, or that it is long enough and the sperm will make it to the cervical Os, correct? Why do we need to know, to feel with an outsider's hand, what the cervix is doing to make sure that a birth can happen?
Yes, I know, I know. If any midwives are reading this, I'm sure I know what the reaction is. YES...sometimes a cervical exam can be a VERY useful tool IN LABOR. There is zero excuse, IMO, for checking a woman's cervix before labor. And in labor? It really would have to be an exceptional reason. Checking because the labor has been going on for a few hours? Not a good reason. Checking because you want to see if mom's made any progress from the last time you checked? Not a good reason. Yes, I personally have had moms want to know what their cervix is doing, but those have only been the moms who have brought massive fears into the birth ( both being VBAC women ). I didn't want to check. Checking the cervix doesn't change what the body is doing. It doesn't change when the baby will be born.
And before anyone gets their panties in a bunch...this is not a blanket statement that ANY and ALL vaginal exams during labor are evil...just that they're overdone. I don't care if you're an OB, a hospital nurse, a hospital midwife, or a home birth midwife. I have seen home birth midwives be even more invasive than some OBs. We need to figure out WHY this is being done to women...and why women are accepting it without question.
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(This is coming from a mother of five who had non-induced, med-free Bradley-style births in a hospital, one w/ a midwife, four with an MD.)
I think it's perhaps to eliminate surprise as much as possible, and to prepare oneself emotionally. A mom may be laboring hard and find out she's only dilated to 2. She might hardly be feeling ctx and be dilated to 8. I know that mothers (myself included) can progress from 5 to 10 in a matter of minutes, so to some extent, it doesn't matter how much a mother's cervix is dilated. Labor is going to happen the way God intended, and checking isn't going to change that. But, it can give direction to those who are assisting the mother, as in offering the hope of, "You can do it!! You're now fully effaced, dilated to 10! The baby's going to be here so soon! Hold on!!" Or, to offer some constructive advice if the mom is panicking, but dilated only to two, about different steps she can take to help the labor progress ("Take a walk!" or, "Why don't we try the birthing ball?").
I know for myself, I was happy to be checked when it was good news, and not so happy when it was "bad" news, like I hadn't progressed in two hours. And... you just never know unless you're checked.
That said, I do agree that there is often FAR too much checking, and if the mom is simply left by herself and her coach for 97% of the L&D, she'd do better, and there would be less medical interference that became deemed "necessary." After this past birth, my fifth, I've started watching shows like A Baby Story and Birth Day and I have been HORRIFIED at how the mothers just nod their head and say, "OK," to doctors who say things like, "Well, you haven't dilated for the last four hours, I think we need to do a c-section." Too many doctors grow impatient with the process MUCH too quickly, and it leads to awful decisions like putting the mom on pitocin, doing an unnecessary c-section, etc.
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