Vaginal examination in pregnancy

“There are clearly few reasons to do vaginal exams during pregnancy, yet we still live among those who insist on doing them beginning at 37 of 38 weeks’ gestation. At this point, most women are not at all dilated – they are not supposed to be! Yet when they are told that “nothing is happening” they feel discouraged and wonder if it ever will. (Note: Plenty is happening, just not dilation yet … do we think cervixes don’t know what to do? If so, how have billions of humans since the beginning of time been born?) Those who are told that they are “a fingertip” or even two or three centimeters dilated go home excited, too revved up to sleep, impatiently waiting for the “real deal” to begin or frantically getting things checked off their to-do list for when it does. Doing too many vaginal exams to “see” what is going on may increase the risk for infection, aggravate the cervix and trick the body into thinking it is supposed to be starting up. Think of a car sitting out all night in the bitter cold that is doing its best to get the engine to turn over – it just ain’t gonna happen until it thaws.”

– Nancy Wainer

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Wainer N (2019). Leaving the Farmhouse. Musings on the first stage of labor. Midwifery Today 129: 8-13.
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