Are Vaginal Exams Necessary In Labour – Introduction to informed consent in birth

In the realm of childbirth, vaginal exams (VEs) often become a focal point of discussion, wrapped in misconceptions and undue stress. My journey as a holistic birth practitioner has revealed the profound impact these exams can have, particularly on those with sensitive pasts. One incident early in my career stands out, involving a woman deeply fearful of VEs due to her history of sexual abuse. I assured her that consent was hers to give, offering her relief as she prepared for a hospital birth.

However, despite clear communication of her wishes, a challenging scenario unfolded. A doctor, disregarding her refusal, proceeded with an exam while I was momentarily absent. Upon my return, I found myself advocating fervently for her right to refuse, confronting the doctor’s unjustifiable actions. This experience highlights a critical issue: the disregard for consent and the autonomy of birthing women in the name of routine practice.

This incident is not isolated but echoes the experiences of many women feeling disempowered during childbirth. It underscores the necessity for informed consent and the need to challenge the status quo surrounding VEs. Through my blog, I aim to shed light on the rights of birthing women, emphasising that VEs, while potentially useful in specific contexts, are not mandatory and should be a matter of choice.

Are Vaginal Exams Necessary?

Historically, VEs were reserved for complicated births, with early midwifery advocating patience over intervention. Yet, as childbirth moved into the hospital setting, a mechanistic view took hold, leading to the routine use of VEs and the partogram, often without solid evidence supporting their necessity or efficacy.

Today, we stand at a crossroads, with emerging research challenging long-held practices and advocating for a more individualised approach to labour assessment. This shift calls for a reevaluation of the necessity of routine VEs, recognising the diverse patterns of labor and the unique experiences of each birthing woman.

The choice to undergo a VE should be informed, respecting the birthing woman’s autonomy and understanding of her body. Alternatives to VEs exist, focusing on less invasive methods of assessing labour progress, such as observing behavioural and physical signs. These approaches honour the holistic nature of childbirth, prioritising the comfort and empowerment of the birthing woman.

As we move forward, advocating for evidence-based practices and respecting the voices of women becomes paramount. Education and advocacy play crucial roles in empowering women to make informed choices about their childbirth experiences. By challenging outdated practices and promoting a more respectful, individualised approach to childbirth, we can ensure that every woman feels supported, informed, and empowered in her decisions.

For a deeper exploration of this topic and to understand the full scope of choices available to you during childbirth, I invite you to read the complete blog on my Substack. Together, let’s navigate the path toward more empowering and respectful childbirth experiences.

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