Vaginal Exams are a common procedure during labor and birth, but I have found that they aren’t always understood.  We have some great suggestions on how to support your partner while they are having an exam, but first it’s important to get some background information on this procedure. 

 

Why do vaginal exams sometimes hurt?

The sensations felt during a vaginal exam can vary from person to person. There are a few factors that can have a big impact on how a vaginal exam feels 

  1. Position of the cervix – during pregnancy and prior to the start of labor, the cervix is usually in a posterior position. This means that the cervix is pointed towards the spine.  Due to this positioning, it can be difficult for your provider to reach your cervix. The distance to the cervix is greater than it is during labor.  As labor progresses the cervix will move to a midline position and then an anterior position.  This movement will make the cervix easier to reach and vaginal exams are generally more comfortable.
  2. Tension in the body – when you are tension and your muscles are contracted the vaginal exam can be more difficult for the provider and more painful for the patient.
  3. Finesse of the person doing the exam – performing a vaginal exam is a manual procedure and as such there can be quite a variety in the technique of the examiner. Some providers have a gentle touch and long fingers to easily asses your cervix, while other can be rough and unskilled. While supporting families in labor as a doula, I have witnessed woman receive a vaginal exam from two different care providers within a short window of time and they report that the experience differed greatly.
  4. Previous physical or sexual trauma – if you have experienced physical or sexual trauma prior to a vaginal exam, you might have a difficult time during the exams. Vaginal exams can trigger memories from the experience(s) making the process challenging. It is recommended to make sure that all your care providers are aware or your abuse so that they can be sensitive to your situation and perhaps even limit vaginal exams if possible.
    How to support:  Ask for options

    When done in the office of your OB/GYN or midwife prior to the start of labor there is a chance that a vaginal exam is optional.  Providers sometimes suggest an exam because they think that their patients are wanting to see what is happening with their cervix. If you ask to skip this exam the answer is often yes without a second thought.

    If your partner is interested in avoiding vaginal exams during labor, make sure that you talk this over with your care provider and include this information on your birth plan. When an exam is suggested, ask if it is an optional procedure. Your care providers should provide information about why the exam is being done and what decision will be made with the information that they get from the exam. 

      How to support: Stay close

      I often see partners move away when the care provider comes into the room or begins a procedure.  I know that they are trying to stay out of the way of the doctors and nurses, but this is the opposite of what we recommend.  When your partner in labor is going to have a vaginal exam performed, move closer and hold her hand. This close physical support should help put her at ease during this procedure.

      How to support: Encourage Breathing

      Long slow breaths in and out is a great method for decreasing tension that is held in the body.  Pair this breathing technique with the word “release your muscles, limp and loose” and you will find that your partner will start to relax. If you breathe side her at the same pace and rhythm, it will be easier for her to follow. Using these breathing techniques should help decrease the pain for the vaginal exam.