Monday, August 19, 2013

Cervical Checks and why I'll forever DENY, DENY, DENY.

*DISCLAIMER: This post is made up of both my opinions and research. The research and reading I did while writing this is cited. Do NOT take this post as medical advice as I am not a doctor and don't claim to be. However, I hope that reading this does make you aware that you have options, and that it's best to do your own research into your options and the consequences of each choice. Remember: if you don't know your options, then you have no options.

A conversation in one of the internet forums I belong to recently turned to routine cervical checks and what I think of them. My exact answer was:

"I'd rather go through my Pitocin augmented, pain med free 46 hour labor again rather than EVER getting another cervical check"

I remember being in labor, thinking I was going to die during the cervical checks. Literally. I was making my peace because I was certain the pain of those checks was going to throw me into shock and my heart was going to suddenly stop beating. The labor was nothing compared to those checks.

Needless to say, I'm not really a fan. But I was in labor, I was scared, and I didn't think I had a choice. BUT I DID. I just didn't know it. Now I do know about my choices, and I can assure you my next pregnancy and labor/delivery will go much differently as a result.

Routine cervical checks (when a doctor does an internal measure of how dilated and/or effaced your cervix is) usually start happening at about the 36 week mark in pregnancy, though they may start as early as 34. The reason your OB gives you that fancy gown to change into at your appointments is to make these tests possible. They check you, give you a number, and possibly make judgements or plans surrounding your birth based on what they find.

Now here's the thing....these figures tell the doctor NOTHING. Some women are dilated to 3cm for weeks and it has no bearing whatsoever on when they'll go into labor or how long the labor will take. Other women are completely shut until the moment they're in labor, and have 5 hours between their water breaking and seeing their baby emerge.Cervical checks are absolutely pointless if you are not in labor.

What about during labor? Well, you might want to know. Your doctor might want to know. But again, your "number" at any given point of labor has no effect on, nor can it predict, how much longer it'll be before you can push. In fact, here's three things I learned about cervical checks during my labor (besides how astronomically they hurt me): 

*Firstly, different people have different sized hands and  checking for dilation is not an incredibly scientific process. Two different people might check you within minutes of each other and get two completely different measurements. 
*Secondly, knowing that number may just discourage you. Imagine being at full on transition strength contractions for 6 hours on Pitocin, only to be checked and have a nurse tell you that you opened up another half centimeter in those whole 6 hours. Talk about taking the wind out of your sails.
*Lastly, checks during labor take the laboring mother out of the flow. It's an interruption that takes you out of whatever space you put your mind in to get yourself through the next contraction, or whatever your focus object is, or the anticipation of meeting your child that helps you get through the pain. Whatever your "happy place" is, you have to snap out of it every time anyone even talks to you, let alone tells you to lie down for one of those checks.

Another thing I didn't know? Cervical checks can lead to infection, especially if your water is already broken. If only I had known that, I would have denied each and every one of those checks right off the bat. You live and you learn, right?

So what am I going to do next time instead? Keep my pants on! Unless the prenatal appointment includes the GBS test, there's nothing that's going to happen at that office that can't happen while I stay in my own clothes. As far as during labor, there are other ways that a medical professional can tell how close you are to being ready to push. If anything, I suppose one could opt for minimal checks and perhaps choose to not be told the "progress" so as to not get discouraged. Plus, minimal to no checks mean less chance for a doctor to pull the "failure to progress" card. 

What is your experience with cervical checks? Perhaps they didn't hurt you and I was just lucky ;) perhaps the number encouraged you to keep going when the going got tough...I'd love to hear all opinions and perspectives on this!

Additional Information:
*Stages of Labour and Conclusion
*The Assessment of Progress

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