Being that we started discussing this, Ithought it warranted its very own thread!

Interested to hear everyone's thoughts and will put my two penneth over tomorrow!

What do you think? and why?

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I think it totally depends on the situation.

In a low risk labour, I am happy to do as few VEs as possible, and will avoid them completely if I can. You need to be confident that you can assess progress in labour in some other way though, you can't just blindly meander onwards. I usually build up a 'big picture' of what's going on taking into account many factors - the length, strength and frequency of contractions and how they are changing over time, mum's general behaviour during and between contractions, the position of the baby (are descent and rotation occurring?), physical signs of late first stage such as the purple line and the rhombus of michaelis, indicators of transition, etc etc etc.

However, not all labours are low risk and physiological, and in these cases you often need to do VEs to know that labour is porgressing. It is generally not a good idea to have someone with an epidural and syntocinon without knowing that their labour is progressing, and because many of the physiological signs of progress are masked or not present for these women, a VE becomes a bigger part of the picture.

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Love Dory xxx
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Dory always says what I want to say but better. So ... what she said... lol

What Id like to add tho is how many of you come accross women who want very regular VEs to assess progress? I have cared for a few women in labour who pretty much insist on a VE and one every hour!

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I have cared for a woman who litterally did her own!! And they give is the lowdown on infection control etc... It was quite disconcerting when she did it hourly, you can imagine, detail are not required here!!! Needless to say she couldn't tell what was going on, and was mighty peeved when we requested she stop doing it, she had already had ARM thus the risks were huge as regards to infection, no matter how many times we empasised this point she continued, twas all documented don't you worry peeps.

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OMG! Thats my nightmare scenario!

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Oh yes, I wouldn't mind but the day before I had been 'taken to one side' to tell me that I should be wearing gloves to carry a tea tray, when remaking a bed, and that we should now be using sterile water for VE's so??? you must ask whats the point??

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It's a difficult one really isn't it. I don't really see me being able to not VE for a while after qualifying because I don't have any knowledge yet and certainly no intuition (if I have these I would like to think tht i wouldn't unless they asked me to)

Also though whilst training, I haven't really got to see normality very much and thisis where our training makes it difficult, I undertsand the neccessity to train in a high-risk unit but by doing so we see little normal labour and particularly with minimal analgesia, certainly very few women are given the confidence to be able to labour and deliver their baby wthout assistance, that is what is so wrong with the hospital environment IMO, normal birth is tough in there, there is far too much available to interfere (including the midwives)

I can also imagine getting stick for not doing 4-hourly VE's in my trust by most of the other staff, let-alone the senior staff and doctors!

I admire you, Dory for your ethos and sticking to it, but doubt in the same environment that i would have the guts to. I hope that changes and is another reason to want to get out into community midwifery.

Women requesting regular VE's? yes, I have seen this alot (I was like that with my first!) and often the midwife I have been working with (lots of different ones) will do a VE if they are very distressed, they are often talked out of it unless there are other signs to VE.

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I personally have no issues with women assessing the progress of her cervix. You could facilitate it by talking her through it and I am more interested to hear of descend and how much of the baby's head she can feel and how far her fingers went in before feeling the head.

God i don't think I could have reached to do my own ve i had trouble putting my own knickers on!!

Sorry not really related to op but will be able to contribute to these discussions when I finally start uni

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Haha yes.

well I do have a problem with women doing their own examinations, from an infection point of view, if they want to wear gloves fine, but I do not want to be accused of poor hygiene standards (hypocritically) due to a woman, trying to feel her cervix, with no gloves possible SRM, unclean hands etc..

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