Cervical Checks: are they helpful?

Women birthing with medical care providers such as doctors and registered midwives often have vaginal exams performed every 2-4 hours during a woman’s labour, depending on the care provider and birth location.

I could go on and on about cervical exams and how important I believe it is to be extremely cautious with both choosing if or when to have routine cervical exams and making decisions made based on them during birth.

I have seen many circumstances where routine cervical exams have drastically changed the course of a birth for healthy women.

For now, I will stick with a few quotes from what the Cochrane Collection. Cochrane is a widely respected database for “high-quality, relevant and up-to-date synthesised research evidence.”

So here’s what Cochrane has to say about routine cervical checks during birth:

‘If labours that are slow, but not abnormal, are mis-diagnosed as being abnormal, this can lead to unnecessary interventions such as drugs to try to speed labour on or caesarean section or forceps for giving birth. There are also concerns about introducing infection to the uterus and to the baby.”

“In addition, some women find the process of vaginal examinations uncomfortable or distressing, and so it is important that there is good evidence for its use. We looked for studies to see how effective routine vaginal examinations in labour are at reducing problems for mothers and babies.”

“We identified no convincing evidence to support, or reject, the use of routine vaginal examinations in labour, yet this is common practice throughout the world. More research is needed to find out if vaginal examinations are a useful measure of both normal and abnormal labour progress.”

You can read the full review here.

I like this quote from a study on the effectiveness of routine vaginal exams:

“It is surprising that there is such a widespread use of this intervention without good evidence of effectiveness, particularly considering the sensitivity of the procedure for the women receiving it, and the potential for adverse consequences in some settings.” (Downe et al, 2013)

I don’t know about you, but to me, it doesn’t sound like they are super confident that routine vaginal exams are all they are cracked up to be in terms of making useful predictions and decisions during birth.

Remember, there is no “have to” in childbirth. You get to decide what happens to your body during the birth of your child.