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  • Writer's pictureKirstie Broughton

You can say no to a vaginal exam!

How to know when I’m in established labour, without a vaginal exam

There are many reasons why a person may not want a vaginal exam during their birth, they may have experienced previous birth trauma, maybe sexual abuse, maybe they have a fear of birth or maybe they simply know their rights and don’t want one.

Some people may think it’s tricky to say no, but it’s totally up to you if you want a stranger to insert their fingers in to your vagina. They have as much right to do this as you do to a stranger in the street.  Please remember this fact! You also don’t need to provide a reason for not wanting one, NO is a full sentence and you do t need to have a conversation about it if you’re not comfortable doing so.

Your midwife may want to do a vaginal exam to asses cervical dilation (this means how far your cervix has opened) and to see how far away the baby is down the birth canal. They may tell you how many centimetres you are dilated and whether your in early labour or established labour. Established labour is around 4/5cm dilated. Once you get to 10cm it’s classed as fully dilated.

You may also be told that you should stay at home until you’re in established labour, but how do you know!

At present, due to the pandemic, a lot of maternity units are not allowing birthing people to have their partner with them until they are in established labour. So how do you know what stage of labour your in if you don’t want a vaginal exam? It’s a pretty big deal to have someone do this if it’s something you aren’t happy with.

On this note, a health care provider must get your verbal consent to check for cervical dilation, it is illegal to do this without consent. It’s known as cohesion if you say yes, just because they’re telling you you can’t go in the pool until they’ve checked, or you can’t have your partner with you until they’ve checked you’re definitely in established labour or you can’t have any form of pain relief until they examine your cervix. .

A good midwife or obstetrician will know how to check whether you’re in established labour without doing a vaginal exam. Here are a few ways they might be able to tell…

Your behaviour: During early labour you could probably go about your daily tasks, maybe make a cup of tea, watch TV, play with other kids or have a shower. During established labour you may enter ‘labour land’. This means your attention may disappear from the room and you’re concentrating internally and seem like you’re in your own little world. This is a good sign that things are progressing well.

Chatting: You’re likely to have been able to hold a conversation in early labour and maybe even talk through a contraction, or say a word or so. When you enter the ‘labour land’ mentioned above it’s likely you’ll stop talking so much.

Mexican hot legs: As the person works harder, blood is drawn away from extremities to be utilised by the uterus. Thus, the legs get progressively colder from the ankle to the knee once labour progresses. At the start of labour the whole leg will be warm. At around 5cm the leg will be colder from the ankle to around mid calf.

Breathing changes and sounds: You may start to focus inwards and may hum, sigh and grunt. Your breathing pattern is likely to change, blowing away tension with long exhalations.

You may ask for help: Your brain knows that you’ve entered established labour and without even thinking about it you ask for extra support.

Losing your inhibitions: Previously you may have wanted to be covered up and worried about bodily noises and similar things happening. Once your in established labour you’re much less likely to care! By the way, midwives and doulas don’t care about clothes and bodily noises, so try and relax!

Hiding: Similar to the first point I made but you may actually retreat into a corner. Often people may adopt an all fours type position, facing the wall or corner of the room. Wanting to be alone, to have privacy and be able to turn inwards. It’s a great sign that things are moving along.

Purple bum crack line: Beautifully said don’t you think! 🤣 The real name for this part of your body is the anal clef, the more dilated you are, the longer the line appears.

There are lots of other signs as well, these are just a few off the top of my head right now.

So as you can see there is no need for someone to perform a vaginal exam, unless you want one. It’s your body, your baby and your choice!

To see how I may be able to support you throughout your birth please take a look at or maybe you’re considering my Active Birth Preparation Workshops

I’m happy to have a chat any time, so please do get in touch or 07920212669

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