Blessed Event Birth Services Inc

  • Home
  • About Me
  • Services
  • The Midwife Blogs
  • FAQ
  • Contact Me

Cervical Checks

4/15/2022

0 Comments

 
Picture
Cervical checks are one of the mainstays of obstetric care.  It is not unusual to get checked around 38 weeks even though labor has not begun.  Then you get checked at the hospital while they are admitting you when you are in labor.  You might get checked more than a few times during labor.  Why all these checks? Do they tell how much longer you will be in labor? Are they risk free? Do you do cervical checks in your midwifery practice?

Let's start with the last question first.  I do not do cervical checks as part of routine care in my midwifery practice.  If a client asks me to do a check, we will discuss the risks and benefits of checking before I actually do a cervical check.  In all honesty, I prefer not to check.  I use external cues to assess how well labor is progressing, and those cues have served me well during my midwifery career.

What are the reasons for cervical checks anyway? Before labor begins, a provider may use a cervical check to assess how likely it is a pitocin induction will work.  Sometimes providers want to know if dilation has started before labor has begun.  A check when you are admitted to the hospital is done to confirm dilation is happening during labor and can also be to show insurance enough progress has occured to justify admitting you.  During labor, many providers have an assumption of how quickly you should be dilating, so they check to see if your body is conforming to their assumption.

Cervical checks do not tell you how much longer until your baby is born.  They tell the provider how dilated your cervix is in the moment, and potentially how your baby's head is positioned in your pelvis.  A cervix can be at 4 cm dilation, and baby could be born in the next 30 minutes or less, or a cervix can be dilated to 9 cm and labor may last another 6 or more hours.  Honestly, I think medical providers feel the need to check dilation because they are not staying with you in the hospital as labor progresses, so they don't have the opportunity for assessing progress by external cues.

Cervical checks do have risks.  Cervical exams increase bacterial levels in the vaginal canal which might lead  infection, especially after the membranes have ruptured.  Even with the most scrupulous hygiene, and wearing sterile gloves for each check, that risk does not go away.  There is a risk they may unintentionally rupture the amniotic sac.  Cervical checks are uncomfortable and may cause stress or anxiety, which can slow your labor.  Cervical checks are subjective, dilation is estimated because we can't use a measuring tape to get a precise number, and the estimation may vary between providers.  I have seen this personally when the nurse estimates dilation at 7 cm, and the doctor checks within 10 minutes and estimates dilation at 5 cm.  Hearing that you have gone backward after hours of labor can be disheartening to put it mildly, and can cause unneeded stress.

I like to watch and wait for the body to let my clients know when dilation is complete.  Because cervical checks are uncomfortable, intrusive, have risks and don't give me big picture info, I rarely use them.  As a midwife, I understand each birth has its own unique pace and rhythm and my job is to support and nurture that, not try to manage it.
​

 



0 Comments

Catching Baby

4/1/2022

0 Comments

 
Picture
During my prenatal visits, and at the home visit, I ask my clients who is catching baby.  See, I do not have to catch baby.  I don't own that as a midwife, and I love providing guidance for another agreed upon person to catch baby.  I have helped Moms, Dads and Grandmas catch babies.

Once I know who is catching baby, we discuss what that will look like. I explain to them that I will be there right next to them talking them through everything if they want. I also let them know that if I see anything concerning, I will tell them  and I might need to step in.  I talk to them about what I do if the cord is wrapped around a neck or shoulder and that I will let tell them if I see signs of the cord being wrapped.  If I do see cord wrapping, I help whomever is catching baby navigate that, or if it is a really tight cord or a complicated wrapping, I will jump in to help with navigating that.

I love being able to guide Mom or Dad in catching their own baby.  I honestly think it is wonderful that the first hands to touch baby are Mom or Dad's and not mine. If there is a reason for me to help, I do so as quickly as possible and then get baby into Mom or Dad's hands right away. 

We have all seen the pictures of a provider who has just caught a baby holding baby up like a trophy for everyone to see.  Everytime I see a picture like that I cringe.  Baby should not be put on display even for one second, your baby should be in your arms as soon as they are born with no delays.  

In my practice, I fully support my clients who desire to have someone else catch the baby and I do everything in my power to let that happen.  It is so satisfying to me as a midwife to enable and support that choice for clients.

0 Comments

    Author

    Gail Webster, CPM

    Gail is a Certified Professional Midwife serving Manhattan, Junction City, Fort Riley and other areas in Kansas.  


    When Gail is not occupied with birth work, she enjoys reading, quilting, baking, riding her motorcycle and spending time with family.
    ​

    RSS Feed

    Sign up for my blog

    Archives

    March 2023
    February 2023
    January 2023
    December 2022
    November 2022
    October 2022
    September 2022
    August 2022
    July 2022
    June 2022
    May 2022
    April 2022
    March 2022
    February 2022
    January 2022
    December 2021
    November 2021
    October 2021
    September 2021
    August 2021
    July 2021
    June 2021
    May 2021
    April 2021
    March 2021
    February 2021
    January 2021
    December 2020
    November 2020
    October 2020

    Categories

    All
    Breastfeeding
    Dads
    Due Dates
    Home Birth
    Kansas
    Labor
    Midwife
    Newborn
    Nutrtion
    Postpartum
    Postpartum-mood-disorders
    Prenatal
    Prenatal Care
    Sleep
    Ultrasound
    Water-birth

Proudly powered by Weebly