Knowing how many centimetres ‘you are’ in labour has become something we are obsessed with to such an extent that vaginal examinations (VE’s) have become routine.
On the plus side, midwives might be able to tell cervical dilation, effacement, consistency, application (of the baby’s head against the cervix) and what position the baby is in from a VE – though all of these things will be an educated guess. The negative is that even if your midwife has confidently diagnosed all these things, knowing any of them will not give any concrete information about how labour is progressing or when your baby will be born. In fact, the very act of examining someone internally, which usually involves them lying on their back – feet together, knees wide (smear test position) is likely to interfere with both the hormones of labour and the mechanics. The hormone that’s essential in labour is oxytocin, the ‘love hormone’, which needs privacy, darkness, trust, security and relaxation to flow. And for the mechanics of labour to work, you need to be upright and mobile, rocking and swaying as your body dictates. So having someone you might have only just met put their fingers into your vagina might not be all that helpful…
Sometimes people seem surprised to know that you do not actually need any vaginal examinations throughout the course of your labour… but it’s really important to remember that it’s your body, your baby, your birth and no one has the right to put their fingers anywhere on - or especially inside - your body without your express permission! In fact, you have as much right to put your fingers into your midwife’s vagina as she does to you.
So if you are not keen on the idea of internal examinations, say so. Put it in your birth plan. Be ready to decline when you’re asked again, during labour and make sure your birth partner knows your wishes. Any midwife worth her salt will be able to tell how advanced your labour is just by spending a little time with you.
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