Sep 052010
 

“If you can’t handle that, you’ll never be able to handle natural childbirth.” – OB to mother after an extremely painful cervical exam.

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 September 5, 2010  Cervical exam, OB, prenatal  Add comments

  40 Responses to “"If You Can't Handle That, You'll Never Be Able To Handle Natural Childbirth."”

  1. I got told exactly this after pelvic telemetry (stupid first time mom me believed them when my midwives said my lower severe scoliosis curve would maybe impede birth/the birth canal). It was said impatiently and with disdain – almost teasing. I went on to have four births with zero meds – one a twin footling breech extraction.

  2. Discounting for a moment that labor is a very unique type of pain because you have so many hormones in your system (and that women in general report widely varying degrees of pain in labor) commenting that something hurts when it’s not supposed to, or even commenting on something on the pain of something you know is going to hurt has nothing to do with the ability to stand or bear that or any other pain. This mentallity has always really ticked me off. I’m a chronic pain sufferer and bear a great deal of pain on a daily basis without constant complaint or comment but guess what, I’m still going to say ‘ow’ when I stub my toe!

    • Exactly! I used to have chronic knee pain, but that didn’t mean I wasn’t going to react to something else. And personally, I abhor pelvic exams and tense up, which doesn’t help, I know. Labour is completely different, though.

  3. Since the exam was over, the mother clearly DID handle the painful cervical exam.

    Sounds like a shame-the-mother response to the doctor’s inability to get the necessary information without hurting the patient. (Assuming the exam was necessary at all.)

  4. Personally, I think being hurt (even necessarily, assuming this exam was necessary) at the hands of another person is more painful than any pain my body can create by itself.
    And labor has a baby coming at the end of it.
    Why do docs discount the effects of psychological distress on physical pain?

    • There are different kinds of pain. Being cut, for example, hurts differently than being burned or being crampy.

      Labor pains are, essentially, cramps. They’re pressure, and they do hurt, but they’re a squeezing/flexing kind of pain.

      When a doctor jams his hand in the hoo-hah, s/he is forcing, stretching and causing little rifts in the tissue. There aren’t birth hormones that have primed the cervix to open, and naturally the cervix wants to keep stuff OUT, whereas during birth the cervix wants to open to get the baby through. For anything bigger than sperm, it’s supposed to be a one-way door.

      If the doctor doesn’t know pain can feel different when different things happen to the body, then the doctor must have dozed through anatomy class.

  5. When my midwife swept my membranes with #4 (Glad she did too because i had been having almost 2 weeks of prodromal labour and she discovered in doing it that he was trying to come forehead first!) Anyways, when she did the sweep I said when she was done “That’s it? What’s the big deal with having membranes swept? That didn’t hurt at all, a little uncomfortable maybe but definitely not painful.”

    Her response was “If it hurts then whoever is doing it is not doing it properly and should get more training.” :)

    Which means I agree with Jane (gee, big surprise there!) This is his attempt to shift the buck, and shame the Mamma for his own ineptness.

    • I’ve heard a lot of horror stories about it too. Glad to know its not that bad with someone who is properly trained, just incase I ever need it.

  6. hmm – re-reading, I wonder if it wasn’t just a cervical exam – if the OB gave her a membrane sweep without telling her?

    One of the OBs I saw said almost exactly this to me when I told him the next week “you know that membrane sweep thing you did last week? I didn’t want it. I don’t want one.”
    I wouldn’t have even known what it was had there not been an intern the week before he did it explain it and tell me that at 39 weeks they offer it, that some women are ready for their pregnancies to be over and others are content to wait.

    Wondering… is it more painful when the cervix is barely or not open? [I know mine was like that - and baby wasn't ready when he did it]

    • That’s what I’m wondering too. Cervical exams in general aren’t really painful unless they add a twist in. I had a doctor try to manually dialate me without telling me and THAT was painful. I’ve heard of docs doing membrane sweeps without even bothering to mention it and the patient said it was painful. I actually read a story online about it last night where the doc did one only to find out the baby was actually 3 weeks premature. For any exams later on, I was simply told “You might feel some pressure, but you shouldn’t feel pain.”

      It sucks that they did that, but I’m glad you said something. Hopefully it makes him check himself in the future, though I doubt it.

      • I doubt it too; I know I and my husband aren’t the only ones who didn’t like him. His normal cervical checking wasn’t painful at all. I wonder if he was also trying to ‘manually dilate’ me now – ’cause he said ’1′ & I think it was just as unready as the week before – especially since baby decided he was ready the day after his first due date rather than around their documented u/s date.
        [something I forgot about when talking to the patient advocate here 8-S]

        • I’m sorry you had to go through that :(. I’m glad your baby decided to come on his own time rather than the doctor’s though.

          You can also be dialated to 1 or 2 and it won’t mean anything for a while. I think I started dialating around 34ish weeks, but was at 2 when I actually went into labor. I just don’t see the point in the whole manual dialating, checking etc. Baby will come when baby wants to come!

          • My sister said something similar about cervical checks…
            but – that OB here is gone {at least from this area}; found that out a couple days ago – from a ratemds.com rating and confirmed by a friend who didn’t like him either.

  7. I was told something to this effect after explaining my phobia of needles. That was with my first birth where I went on with no pain meds despite pitocin. So far with this pregnancy, all the nurse said when I mentioned it was “You’re not alone dear, lots of people don’t like them. I’ll be as fast as I can for you.”

    Childbirth pain is quite a bit different doc. Our body does things to compensate for the pain and its pain with a purpose. Like someone else said, we get to hold our baby at the end and that’s some pretty darn good motivation. Plus I know that childbirth pain is coming, I don’t know what you’re going to do when you jam your hands up my hooha.

  8. That is just silly. I have no pain tolerance (seriously a massage freaks me out), but I couldn’t wait to experience labor and birth Med free and it was awesome. My doula said that I was smiling when I was pushing her out. Don’t underestimate those birth hormones!

  9. This was my post. He was checking my cervix at 41+2 days to see if I had dilated at all. My husband was in the room with me and I could tell he(OB) didn’t like. I asked him to stop about 3x when it became too painful and he didn’t. I started crawling backwards up the table to get away from his hand and my husband had to physically remove the OB’s hand from me, yelling “stop!”. That’s when he made that comment.
    Apparently he was trying to strip my membranes….but when I asked how dilated I was he said “maybe a fingertip- if that”. I walked away from that experience feeling like I was raped.

    He wanted to induce me the next day but I went into labour that next am. And I did it without any drugs…(I’ve had 3 babies without any pain relief- the last 2 at home – one mw assisted and the most recent a UC). And guess who was at the OB at the hospital…you guessed it!

    I reported him 3 days later. But guess what- nothing happened.

    • Oh yeah, that was definitely a blame-and-shame tactic. He wanted to blame YOU for the fact that your husband stopped him from stripping your membranes after you told him to stop.

    • I had the same feeling after experiencing being manually dialated (without being told). It took me a while to really process those feelings, plus the fact that it was a woman who did it, not a man with me. I’m very very glad your husband stood up for you in a time you were vulnerable! It may not have done anything to him THAT time, but if enough women report him the possibility is there.. so don’t think that reporting him was for nothing!

      Congratulations on having your child the way YOU wanted.

    • Ooooh! That makes me mad that he was not held accountable. (BTW, who do you report this kind of stuff to?) Stories like yours are part of the reason why I never even considered birthing in a hospital.

      • You’d likely want to get into contact with the hospital Ombudsman. Not 100% sure though.

        • Ombudsman, patient advocate {if the hospital/region has one, there should be a link with contact info on the hospital/region’s website}, college of physicians and surgeons, the head[s] of whichever department[s] you want/need to complain about…

    • Twice I have felt taken advantage of, violated. Once was a fill in ob when mine was out. I think she did sweep my membranes, and it was annoying for days. I lost my plug (which just regrew) and bled…as well as had contractions for days. They eventually died down and I went a few more weeks before going into labor.

      With this same baby when I did go into labor, the nurse was doing cervical checks every 20 mintutes, and also stretched my 9cm cervix. So frustrating that I didn’t need it. Baby was OP and when the second OB on call checked me hours later, he stated that I needed to be moving (as I was begging to do). I wept for a day after my baby was born and finally told a postpartum nurse who encouraged me to write my complaints down. I did report that nurse, and did end up finding out with my last baby she was no longer in OB nursing and the nurses on the floor did not like her. I don’t think my case alone caused her to be let go, but I bet it was at least one part of it. I have never felt so angry with a nurse, and seriously thought if I would have seen her as I was leaving I might say or do something I’d regret. I had anxiety about it for months after the birth and finally realized she had abused me, she had been doing all those cervical checks…stretching my cervix, and even stretching my perineum (why with baby #6?). Totally unneeded. Unfortunately, I think I would have felt better at the time if I could have brought myself to fire that nurse. I just froze and obeyed.

  10. So when a marathon runner flinches for treatment of an injury or something we’re supposed to belittle them and say they’ll never be able to handle the pain of a marathon again? I felt like the contractions were like peaks and compared it to the pain of long distance running up a hill, yes, there was pain but it actually warned me. I woult begin to feel a contraction, it would peak and then subside. It’s not like I was suddenly jabbed with the contraction…I was warned and could work to keep myself calm and under control.

    And I think once I was swept without my consent or knowledge, it hurt and for days I was having contractions, lost gobs of plug stuff, and was awake for nights with the pains. Then they just stopped. I went for another 3 weeks before I was in labor, and feel the OB was out of line (was not mine, my OB was out of office that day). This is why I refuse internal exams at the end of pregnancy. No one can mess with nature.

    • I gotta say… After I cut my finger badly when at home alone (and it would not stop bleeding) I was telling the story to a friend (who had two births with epis and all the hospital interventions). She said “And you think you’re going to have a NCB?”

      I know she was feeling defensive, but really? It wasn’t that the pain of cutting my finger was overwhelming, it was the fact that I injured myself and it wouldn’t stop bleeding– and I was all alone. It was scary. It was pathological, not natural. And furthermore, I have run (and completed) two excruciatingly slow marathons. One where I injured myself early on and insisted on completing it, and one where I became very sick about halfway through (and completed it). But the fact that I was scared when I cut my finger and it wouldn’t stop bleeding for hours? Means I can’t handle a birth without drugs? And that’s because…??

      • Its a totally different pain though. Being cut absolutely sucks, but its a total surprise too. I cook so much so you would think being burned, cut etc wouldn’t be so much of a shock but it still is, and it still hurts, and I’ve done birth without pain relief! You’ve got 9 months to anticipate labor pain (especially if you’ve been through it before) and you’re totally right, its a build up pain with a peak. So you do get a pretty good warning before the actual pain hits, PLUS the pain doesn’t last and last and last. Eventually it subsides and you get a break.

  11. This really just serves to underline how hyperfocused the (gosh, I want to say “birth industry”) is on pain PAIN PAIN EVERYTHING TO SAVE YOU FROM THE HORRIBLE PAIN THAT YOU MAY NOT SURVIVE.

    I’m not discounting that childbirth is “naturally” painful for most women (even without all the interventions that generally make it more painful). But it’s not ALL ABOUT pain, people don’t generally die, completely lose their minds or even pass out from the pain, and particularly not from pain that has a pretty definitive stop point (the vast majority of natural labors not lasting more than 24-48 hours), and which almost always have “breaks” between painful moments.

    But it’s easier to control women when it’s ALL ABOUT PAIN (which we will “save” you from). Even very open-minded friends of mine, when discussing NCB/HB, have said things like, “Well, yeah, it’s kind of silly to suggest epidurals for everyone, when everyone has a different pain tolerance.” And I’ve had to say, well, A) I don’t think of myself as having a serious “pain tolerance” (though I’ve run a couple of slow marathons, so there is that), but B) NCB/HB and avoiding the cascade of interventions is not really about the pain issue, and whether I can “handle it” or not. It’s much bigger than that. It’s not, well, I’ll see if I can handle the pain, and if not, I’ll “get the drugs” and no discussion of any other intervention (most or all of which will be pushed regardless of pain meds). It’s not, hey, if you could take some Tylenol-equivalent and cut the pain of contractions by 50% or more but the whole physiological process would remain the same– because if that were the case, sure! Why not? But that’s not what happens with an epi or IV drugs, and more significantly, the pain is usually quite a bit less when other interventions (pitocin, AROM, lithotomy, etc.) aren’t in place.

    But with the fear of pain being so centralized, everything goes hand in hand. It’s easier to push painful and complicating interventions when they’re accompanied by the promise of complete pain relief. And when “complete pain relief” (the epi) has been given, it’s easier to do whatever you want (pitocin, episiotomy, whatever) because the patient has been effectively stripped of agency.

    I didn’t mean to ramble, but I think it’s a really central problem (both cause and effect) that the fear of pain is so centralized in childbirth. It’s not that there is no pain, it’s that when all the focus is on pain, the conversation is not being framed in a productive or complete and accurate way.

    • I so want to copy and paste this to a pregnant friend of mine. A lot of people (fortunately not her mother) have been telling her how lucky she is her pain tolerance is so high because it’s going to hurt to have the baby. She’s mostly blown them off but I can see her freaking out about it a little. Birthing a baby is not about pain. Pregnancy is not about pain. The whole thing is supposed to be about family, and getting to meet your child. Not “It’s going to hurt, so you should just let us do a c/s.”

    • *copy paste save*

  12. Way to go, doc. Showing your ignorance of all the complexities taking place in a woman’s body during labor to help manage the pain. Big difference between laboring with the flood of helpful hormones that are present and the shock to the cervix when someone sticks something in it that doesn’t belong.

  13. “Oh, so you cannot stand my cervix to do what it wants to naturally. Thanks for messing with my natural birth by abusing me without my consent.”

  14. Some of these comments about painful cervical exams remind me of the link The Unnecessarean just posted about med students and other health ‘professionals’ who will do pelvic exams on anesthetized women. They have no idea, really, how to gauge if the woman is tolerating it well or not, because they’ve only practiced on patients who can’t tell them whether they feel anything or not – so it’s completely useless to practice on the drugged-up woman. That, and you didn’t get her consent first. I wonder if this is how this care provider learned how to do a pelvic? :?

  15. med students and other health ‘professionals’ who will do pelvic exams on anesthetized women.

    This literally makes me sick to my stomach. I can’t even begin to phrase how sick and twisted that is.

    GAH…Any anesthetized woman, or just the pregnant ones?

  16. It’s really appalling how many OB GYNs either don’t know or don’t care that their exams are UNNECESSARILY painful. Any good midwife can do a painless pelvic exam or cervical check and a nearly painless membrane strip (I’ve experienced all of these, as well as very painful ones by careless or callous physicians – and one extremely painful cervical check by an ER doctor during a miscarriage which caused a similar kind of comment by the dr when I complained).

    Dear Doctors,
    Cervical exams should NOT BE PAINFUL. If your patient experiences pain YOU ARE DOING IT WRONG. GET BETTER.
    From, women everywhere

    @cheeks: any anesthetized woman.

    • My old GYN would nick me every time he did an exam. I didn’t say anything the first time (I was young and stupidly thought they had to do that). It wasn’t until I complained to a girlfriend (soon to be a nurse) that I was told differently. She made it clear that IT IS NOT SUPPOSED TO HURT LIKE HELL. When I commented to my GYN the next time he blew it off as “You’re to sensitive. Everyone bleeds.” New doc, no prob. But then, she’s a woman with fancy toys. :)

      • I had a few that hurt, but I also had one doctor that was really good at getting things done and over with without any pain. I never quite appreciated that until I had little mrs. stabby hands in the labor room.

        So there are some OBs (I think I even had a NP in my last pregnancy who was good at them) who can competently do a cervical exam without pain. Just not many of them. I think part of the problem is the huuuuuge rush they’re in. They’re not careful. No, not everyone bleeds. I never once bled from a cervical exam, except maybe the “I just manually dialated your cervix” one, but I couldn’t tell you for sure on that one.

  17. This reminds me of my birth, which was in a hospital, but completely drug free. I was in a meditative state my whole labor and kept very quiet and calm. My cervix tore during the birth, and I had to have it repaired. I whined so loud! The nurse remarked “You’re making more noise now than you did your whole labor.” I replied “No one was inflicting the pain on me before!”

    I thought that was actually more painful than anything else.

  18. I complain like crazy when I stub my toe, but don’t complain at all pushing out my ~10 lb babies. People need to shift their paradigms or something.

  19. It’s so funny when people think you must have a high pain tolerance to have a natural birth. When I was pregnant with my second child and having a non stress test at 32 weeks (I have type 1 diabetes) the monitor was showing regular contractions, but I could not feel them. The nurse suggested that maybe I just don’t know what a contraction feels like. I just stared at her for a minute and said “well, I have had a baby before, so yes I do know what a contraction feels like.” And then she said “well you didn’t have an epidural so I thought maybe you never felt the contractions last time”. Oh, yes, because the only reason someone would not get an epidural would be if they couldn’t feel the contractions or weren’t in any pain. Right. I was in pain, I felt the contractions, but I just chose a different way to handle them than getting an epidural. It isn’t because I have a high pain tolerance, it’s because I planned to have a natural birth.

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