Vaginal Examinations in Labor
“I want to talk with you about vaginal exams during labor so you know exactly what they are for and what to expect. A vaginal exam helps us understand how your labor is progressing. During the exam, I use two gloved fingers to gently feel the cervix. I am checking how open it is, how thin it has become, and how far down the baby’s head has moved. I may also feel the baby’s position to help guide the plan for labor. The exam takes only a few seconds, and I will tell you everything I am doing as we go.
Most women feel pressure during the exam rather than pain, although it can feel more uncomfortable during strong contractions. You are welcome to take slow breaths, change your position, or ask for a moment to relax before we start. Exams are usually done only when they give us information that helps make decisions. This might be when you first arrive in labor, when your contractions become stronger or more regular, or when there is a question about how quickly things are moving. They do not need to be done on a strict schedule, and we avoid doing them too often because each exam can increase discomfort and, in certain situations, the risk of infection.
Consent is always part of the process. I will ask for your permission before each exam, and you can tell me if you want to wait, if you have concerns, or if something feels too uncomfortable. You are never expected to say yes automatically, and you can ask me why the exam is needed or what information we will gain from it. If you prefer fewer exams, we can talk together about what is safe and what still allows us to monitor you and your baby.
There are times when we may delay or avoid vaginal exams. If your water has been broken for a long time, if there is a known infection risk, or if the baby is tolerating labor well but there is no urgent need to check progress, we may decide that waiting is safer. We can use other signs to assess progress, such as how you are coping with contractions, how close together they are, changes in your breathing pattern, or the shape of your lower abdomen as the baby moves down. These clues often tell us a lot without needing to do an exam.
The most important thing is that you feel informed, respected, and comfortable. If you ever want to discuss your preferences, including limiting exams or setting boundaries, please tell me. We will make decisions together so you feel supported at every step of your labor.”