Updated: Jul 13, 2022
Last week I attended a birth as a doula and during her 4 hour labor, the midwife asked to check my client's cervix twice. My client declined both checks. The baby was born without a single finger ever in the vagina.
As someone who sees a lot of heavily managed hospital births, this was amazingly refreshing to me. It was wonderful to see the body do it's thing without a doctor's hands. I wish more births were like this, but unfortunately we live in a cervix-obsessed birth culture.
Despite what you may be led to believe, in most cases, there is no medical reason for cervical exams.
You don't ever have to have your cervix checked.
Not while pregnant.
Not in labor.
Babies can be born without anyone's fingers in your vagina.
I want to be clear: cervical checks aren't necessarily bad. They can provide useful information. You might want one if you're considering a medical induction to know what medication to start with. Or you might want one upon admission to the hospital so you can go home if you're still in early labor. You might want one deep in the throes of labor, for your mental stamina.
But there are also lots of reasons not to get one. If your water is broken, cervical checks increase your risk of infection (fingers bring bacteria, and there's no longer a barrier protecting baby). If you have a history of sexual assault, a cervical check might be traumatic. If your labor is progressing "slowly" by hospital standards, a cervical check might put you at risk for c-section for "Failure to Progress" (learn more about why that diagnosis is crap here), or it might play mind games with you.
Most importantly, you might get, or not get, a cervical check JUST BECAUSE YOU WANT. This is a valid reason too. Patient preference should always be respected.
How accurate is a cervical check?
The cervix is not a clock. It's also not a crystal ball. Two of my doula clients had their cervixes checked last Monday. One wasn't dilated at all, and she had her baby 72 hours later. The other was dilated to 2cm, and she's still pregnant 9 days later.
This is a common theme. Cervical dilation is actually only ONE of SIX ways that labor progresses (learn about all six in this short video). People might take days to dilate one centimeter, and then they might go from 4-10cm in an hour.
Not only that, but measurement isn't exact either. To measure cervical dilation, a medical professional puts two fingers up your vagina and touches your cervix. They then guess-timate the space between their fingers and tell you how dilated they THINK you are.
As you can imagine, this leaves some room for human error. In fact, one study found that when two providers check the same cervix at the same time, they disagree on dilation 51% of the time. 11% of the time they actually disagree by 2 centimeters or more.
So remember, the next time a medical professional comes in your space, pops on gloves, and says, "hey there, hop up on the table and let's have a look-see at that cervix"... you don't have to.
Ask yourself: what information am I trying to gain from this cervical exam? What decision is the information going to influence?
If you want an exam in that moment, great.
And if you don't, that's great too.
You are in charge.
You get to decide.
You don't ever have to let someone put their fingers in your vagina if it doesn't feel right to you. That's rape.
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