Posted by My OB said WHAT?!?.
Jun
2
Posted by My OB said WHAT?!?.
“…I’ll Get The Other Nurse. She Takes The Next Size Up Gloves…”
“You don’t seem to even be 1 cm… Hang on I’ll get the other nurse. She takes the next size up gloves – her fingers are really long.” -Nurse during a vaginal exam for a mother four hours into induction. She was told birth wouldn’t happen for 12 hours. Her baby was born 1 hour later.
There are 22 comments to this post.
Lindsey Carr-Ruck had this to say,
Jun 2, 2010 @ 4:13 pm (Quote)
I’ve heard of women going that fast. Is that the case here? If so, congrats to the mom. I bet that was a good lesson learned for the staff: never trust a pregnant/laboring woman.
If it’s not the case, then it was good for Nurse Nubs to get a second opinion. 
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I don’t see anything wrong with it either. My cervix is WAY posterior and difficult to reach until I am almost ready to deliver. I would be grateful for someone with longer fingers that didn’t have to go in up to their elbows (and cause me pain in the process) to reach.
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Lindsey Carr-Ruck Reply:
June 2nd, 2010 at 4:36 pm (Quote)
I agree. Calf-pulling gloves shouldn’t have to be used to check a cervix.
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Sarah Dorrance-Minch Reply:
June 2nd, 2010 at 4:49 pm (Quote)
Would I be a killjoy if I interjected that it should not, in fact, be absolutely necessary to know the exact dilation of the cervix to observe the progress of labour, and that all these vaginal “checks” are a great way to 1) temporarily reduce a labouring mother to a cervix, one that is suspected of being potentially faulty, at that; and 2) introduce bacteria into the vagina and thus the uterus – gloves or no gloves?
Even if it’s a hospital induction, do we really have to know what the cervix is doing? If Mom’s in labour, she’s in labour. When she hits transition, unless she’s got a really friendly cocktail of drugs in her, there are usually some definite signs, such as increasingly frequent, hard contractions that make her grunt, cry out, barf, or say, “I can’t do it, I need help.” When she’s pushing, she’s obviously pushing, dilation be damned (however much it is, it’s probably enough, although if the pushing seems to be causing her problems, that would be a good time to check for a cervical “lip” getting in the way or something). If the baby is out, well then.
Why do we have to constantly check to see if the cervix is opening “fast enough?”
My CPM does not do routine cervical checks. Admittedly, she also doesn’t do inductions, but gee whiz, the babies do come out, and she hasn’t lost one yet. And she has a LOT of experience.
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Sarah Dorrance-Minch Reply:
June 2nd, 2010 at 4:51 pm (Quote)
I should also add that I am deeply grateful for her not routinely checking cervixes. My cervix is so sensitive that it hurts when I have sex and it gets bumped. The times I laboured in a hospital and had cervical checks, I nearly screamed. It hurt that much. I’m pretty sure it did nothing to help my labour along.
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AMDR Reply:
June 2nd, 2010 at 4:57 pm (Quote)
I totally agree. My baby somehow manages to “get born” without a team a random strangers shoving their fingers into my cervix. Obviously this was not even a way to get reliable information in this situation.
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Lisa Reply:
June 2nd, 2010 at 6:07 pm (Quote)
I am not a fan of VEs either, but sometimes they are necessary. In my case they were.
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Susan Reply:
June 2nd, 2010 at 11:51 pm (Quote)
I agree. I had checks with my first (in hospital). I was checked at 3cm, and just over an hour later I was pushing. Had the mw paid attention to my other cues, she would have known I was in transition, no matter what my cervix said. I didn’t have any internal checks with my second (home birth), and the mws just paid attention to my other cues. When we phoned, the mw realised how far along labour was and was afraid she wouldn’t make it in time, so she had another one come ahead (she did make shortly before I started pushing).
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This was my story, a few points were left out…… I was induced then left in a waiting room to labor by myself (with terrible tightenings and only my husband and mother watching in horror as i tried to climb up the bed through each tightening) we were forgotten about by the hospital staff who after my mother complained one came in and stuck her hand up DURING a tightening then said she would need to get a second option from a nurse who took a bigger glove size… who again examined me during a tightening and told my husband and mother to go home, this was the only contact we had with staff until 10 mins before my daughter popped out and another shift started (a lovely nurse came in and realised i was crowning). My midwife was never called by the hospital as they were too busy (i called her and told her i was ready to push and lucky she only lived 5 mins away and arrived in time to catch the baby and get paid!) Afterwards she told me she had never seen what happened to me happen to anyone else. My second birth was the complete opposite I understand what an examination feels like now and is not best done while someone is having a contraction!
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GranolaRN Reply:
June 2nd, 2010 at 7:29 pm (Quote)
That makes so much more sense. My initial reaction to this post was “….and?” I couldn’t understand why it was so offensive.
With your explanation it makes sense. I’m sorry you were treated that way, it makes me sad. I’m glad your midwife made it and that you had a better nurse at least for your birth.
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CCindy Reply:
June 3rd, 2010 at 6:03 am (Quote)
I’m so sorry you went through that. I hope your husband and mother didn’t actually go home. I can’t imagine being alone while being induced. When my water broke and we decided to go with the pitocin I had at least one person in the room with me the whole time. Inductions/augmentation is not fun! Not a good time for the staff to forget about you!
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brige Reply:
June 3rd, 2010 at 11:07 am (Quote)
I thought that the nurse was implying that she would get the person with the bigger hands to “further stretch” her cervix, or that maybe the mum wasn’t being cooperative so as to punish her…
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Sarah Dorrance-Minch Reply:
June 3rd, 2010 at 12:38 pm (Quote)
They told your support people to GO HOME?!? Gee whiz, husbands/partners and other family members haven’t been ordered to stay out of the labour room since the sixties or maybe early seventies, I thought…
And as for the rest – what a horrible, horrible nurse you had. I am so sorry. Glad your next labour went better!
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So confused. Assuming the mom was ok with/wanted to have her cervix check I don’t see what the problem is. Doing cervical checks can be hard, and its not unheard of to feel something that seems like a cervix, but may not be. Getting someone with longer fingers who can reach better is a good thing!
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Well, I know how many partners I’ve had (3) but I have NO IDEA how many people have touched my cervix – and why is it that all of them are short people with tiny little hands? Posterior cervix or not, those tiny hands are horrid.
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More and more proof that vag exams are nearly always worthless!
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Jane Reply:
June 3rd, 2010 at 4:01 am (Quote)
My SIL’s OB practice did a VE on her at 38 weeks after which she bled bright red for two days, and they kept telling her it was “totally normal.” We decided they must have stripped her membranes without telling her about it.
I told her to refuse the next exam and that if they touched her anyhow, that would be sexual assault. She liked this idea: she’s a cop, as is my brother! So at the next appointment, the doctor walked in to find my SIL fully dressed and my brother, who’s a rock-solid guy, standing with his arms folded and his face grim. The doctor said, “You need to undress so I can do a vaginal exam” and my SIL and brother talked to the doctor until the doctor finally admitted that the vaginal exam gave no useful information.
My SIL said, “Then I’m not going to have one.”
It shouldn’t have been that much of a fight, but hey, even the doctor admitted the vaginal exam was pretty much worthless at that point in the pregnancy.
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s a doula and homebirth midwife, I have found that dilation means NOTHING!!!! So much attention is paid to dilation. In the grand scheme of things, dilation is like the dressing on a Caesar salad. Contractions are the bowl the salad is in. Just like you need the right sized bowl for the salad, you need the right contractions for labor. The baby’s position is like the cheese on the salad. Effacement is the lettuce. Effacement is the really important factor. You can go from 0cms to 10cms in minutes as long as the cervix is effaced. But if you aren’t 100% effaced you won’t dilate completely. This is why some women can walk around for weeks being 4-6 cms dilated, 80% effaced with a baby at 0 station. Because the contractions haven’t picked up to full labor and because that other 20% of effacement needs to happen so that the cervix can open up.
I have also found that the point-of-no-return is 90% effaced. At 90% effaced the cervix is very thin and the baby’s head puts direct pressure on the cervical pressure points and moms are in a strong active labor pattern. During an induction, Nothing is more frustrating than to have a cervical exam show a woman to be 2 cm dilated 70% effaced with a -2 baby (still high)….then four hours later when contractions have really picked up and a quick cervical exam is done, the mom is told, “oh you’re still only 2 cms…” but isn’t told that she’s 100% effaced and her baby is fully engaged. So here’s this poor woman thinking she hasn’t made any progress (when she has actually made a ton of progress), thinking that she’s going to split in two and die before they get an epidural in place, thinking that a c-section would have to feel better than this (because pitocin is terrible!), and thinking that her body is not working right.
And then ten minutes later when that same mother announces that she needs to push, the nurses will treat her like she’s crazy. Because too much attention is given to dilation….why???? Because it’s easier to measure dilation….it’s much more difficult to measure effacement.
Effacement is SUPER important!
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With my 3rd and final hospital birth (4th was at home) the exact situation the doula above described was my experience, minus an epidural.
I was checked at 6:15, was 7 cms, 70% effaced and my son was at -2. About 10 minutes later I announced I as ready to push, and the nurse had the nerve to tell me I couldn’t be because she “just checked me” and I was only at 7.
I raised myself up off of the bed and growled, “I need to push NOW.” She ripped the sheet back, and he was starting to crown.
TOLD YOU! Listen to moms, especially unmedicated moms. We know that of which we speak.
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Except for the next size up glove part, I have no issues with this. Nurse sounds like she knew she wasn’t getting a good read on the cervix. Did I miss something?
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