Cervical Exams

“I will advocate for (or decline) an exam based on the information I need.”

Used to check cervical dilation during pregnancy or in labor. You the client are in charge of your body! You will always be asked for consent before your midwife checks your cervix. If you have any history of trauma and have not discussed this with your midwives we encourage you to disclose this. If you are uncomfortable having a sit down discussion about your history, you can send us a simple message in your portal with as much or as little information as you’d like to provide. We provide trauma-informed care for all of our clients. However, knowing in advance if this could be triggering for you allows your midwife to engage in shared decision-making and help determine whether this option is appropriate for your care. Your midwife will use a sterile glove and sterile lubricant to reduce the risk of infection. It can be uncomfortable. Your midwife will wait until you are ready and encourage you to take a nice relaxing breath, on your exhale she will insert two fingers slowly. Breathing out will help relax your pelvic floor muscles. (If it’s too uncomfortable we encourage you to say stop, it won’t hurt our feelings! We would never want to do anything that could cause emotional or physical pain.) We will explain what we are feeling. After you are encouraged to take another deep breath and on exhale we will remove our two fingers completing the exam.

POTENTIAL REASONS TO CONSENT TO AN EXAM

  • After 39 weeks and you are just curious.

  • Do we need to consider encouraging labor (close to 42 weeks, estimating a larger baby, hx of precipitous birth and trying to make sure your midwives are there with you, etc)?

  • Do we need more information about baby’s position?

  • When you come to the birth center or the midwife joins you at your home to see if we are in active labor or close.

  • Is there any cervix left before we start pushing?

  • I’ve been pushing a bit and not feeling like I’m making any change, am I fully dilated?

  • Should I consider a change in birth location or am I close enough to

    having my baby?

  • Can you tell if my pushes are bringing baby’s head down?

Membrane Sweep

A membrane sweep in a manual procedure in which your midwife will do a cervical exam and if you are dilated she will gently separate the amniotic sac from the cervix with a sterile gloved finger in a circular motion. This separation releases prostaglandins, which may stimulate contractions and encourage the onset of labor. Research shows us that 2 membrane sweep within 48 hours are more effective.

It may help labor start naturally, especially around or after 41 weeks

It may reduce the need for a medical induction

It may cause cramping or spotting

It may cause irregular contractions or prodromal labor (contractions that aren’t making cervical change)

It can be uncomfortable for some people

It does increase the risk of infection, your midwife will take the steps to reduce this risk but it’s never 100%

Although rare there is a risk of it accidentally causing your membranes to rupture.

We encourage all clients to do their own research ahead of time before making these decisions. Here is a great podcast (that can also be read) from Evidence Based Birth.