Vaginal Exams & “Failure to Progress”: The Lie

Show Notes:

Ever heard the terms "failure to progress" or "mandatory vaginal exams"? We'll talk about the lies behind these phrases and the choices you have when it comes to your body and your birth experience.

[1:12] The reviewer of the week, Fishsbxksnainazhmonger, (and no, I didn’t just type a bunch of random letters, lol) said: “I love this podcast! The birth course and this podcast were so helpful for me when I was in my 4th pregnancy. I’m now on my 5th, and I’m catching up on all the episodes I missed while I wasn’t pregnant. 😉 I love the practical advice for birth and the encouragement to have a plan and to listen to your body! All things I didn’t really know with my first three births. This knowledge made all the difference with my 4th birth! I’m looking forward to all the knowledge I have yet to learn, even as a mom of almost 5! I totally recommend this podcast and tell all my pregnant friends about it!”

With every pregnancy, I learned a little bit more until I became comfortable with everything I knew. There’s always more to learn! I hope you enjoy the content here! 💜

[2:32] Okay, so bear with me for a long intro on this week’s topic. 😅 I know it’ll be an extremely helpful topic, and I’m hoping it’ll answer the question of what in the world “failure to progress” means when it comes to labor.

[3:07] Vaginal exams are given from the time women get their menstrual cycles, which is such an invasive procedure at any age! 🙅🏼‍♀️ Once pregnant, vaginal exams are made to be the norm, and the OPTION to decline the exam often isn’t even given! 

[5:48] When you arrive at the hospital, in order to be admitted (or so they say 😒), a vaginal exam is done to make sure you’re in “real labor.” (I discuss what “real labor” looks like at hospitals.)

[6:45] Guess what? The vaginal exams continue! 😑 Once you’re admitted, these exams can be done every hour but could potentially be done more than that to give nurses an idea of where you’re at in your labor. They want to know if your labor has “stalled” to the point of “failure to progress.”

[7:21] So what does “failure to progress” mean? 🤨 Well, I’m so glad you asked! This is exactly what we’re going to discuss! My hope is that by the end of this episode, you’ll have a little more clarity on your rights and whether or not you CHOOSE to have vaginal exams done.

[7:55] What are the benefits of vaginal exams? They can tell you the direction of your baby. ↘️ This can only determine the direction if your water has already broken though. Another benefit is that you could have increased dilation with each exam.

[9:31] What are the risks of vaginal exams? First off, they are uncomfortable and for some, painful during labor. If you have endometriosis, fibroids, cysts, or a sensitive cervix, vaginal exams can be painful! (Not to be the bearer of bad news but . . . vaginal exams also make the next few contractions after the exam more painful.) 😭

[10:16] Most of the time, the exams have to be done while you’re on your back. I’ve also seen providers do exams with moms in different positions (hands and knees or squatting), which funnily enough, changes the dilation! 🤔

[10:48] Exams can be discouraging if you’re constantly hearing “no progress” or “very little progress.” 😞Another risk is that bacteria can be introduced to the vagina and uterus, and if your water has already broken, the risk is even higher!

[11:08] A rough exam can actually break your bag of waters, which will remove that protection you have against infection. 🦠 The information gathered from the exam such as dilation, effacement, and station can also be used in a way that is not beneficial for mom and baby. 

[11:44] What is failure to progress? (Excuse me for a second while I get on my soapbox. 📢 I’m super passionate about this topic, you guys!) The #1 meaning behind it is failure to be patient on the part of the provider. 

[12:12] I’m going to discuss other meanings behind failure to progress. 🚫 It is NOT a failure on the part of the mother! Your body was made to birth your baby! “Failure to progress” is also subjective and there is no standard across the board because no birth is exactly the same.

[13:46] What are some other ways to measure where a woman is at in her labor? 📏 We’ll address each of those here!

[15:05] In addition to paying attention to mom and the signs of her body, you can also see physical markers for labor progression: things like the purple line or the Rhombus of Micaelis. 🟣

[16:38] Another sign is that the birth partner’s hands are required to move lower for counter-pressure. It’s also needed constantly. There are also signs of transition such as getting shaky, burping, or vomiting. 🤮

[18:14] Let’s talk about natural stalls! We have a whole section about this in the My Essential Birth course! Stalls are a very normal occurrence: periods of activity and periods of rest. 😴

[19:17] A lot can still be happening when contractions slow or stop! Birth is hard work! It’s not always go, go, go with labor and that’s okay! 📈

[20:12] I share my experience with my third baby. I was a VBAC mom, had been having prodromal labor for a week, and 24 hours of active labor. I 100% would have had a Cesarean, if I were at a hospital. 🏥

[22:07] However, because I was SUPPORTED not just “allowed” to birth my baby the way my body needed to, my son had excellent APGAR scores, he was my biggest in weight, and it was the most incredible experience of my life. I had a vaginal birth, no tearing, and walked up to my bed afterwards. 🤱🏼

[22:50] It’s crucial for moms to trust their bodies and trust the process. Our bodies are made to grow, nourish, and birth our babies without medical intervention. Birth is not an emergency. 🆘

[24:59] Do labors stall to a point of no return? What causes this? What inhibits progression? I list things like environment (bright lights, unfamiliar noises, smells, people, etc.); being told something is wrong with your body; relying on an epidural. 💉

[26:16] This reason for stalling is HUGE! Not being prepared for birth! Providers are preparing a mom to rely on medication versus on her body. Moms need to be taught how to work through contractions, what options are available to her, and being given a choice! Let me say it louder for the people in the back: YOU 👏🏼 HAVE 👏🏼 CHOICES! 👏🏼 

[30:26] Sooo what can you do? How do we solve the problem? 🤷🏻‍♀️ A few options would be: out of hospital birth, hiring a midwife, looking for care outside of a provider, etc. 

[31:23] For those giving birth in a hospital, be vigilant, be prepared, talk to your provider before you’re in labor about failure to progress and what their protocols are, hire a doula, etc. We talk about more options as well. 🗯

[33:35] I probably should have said this at the beginning of the episode: vaginal exams are NOT required. ❌ That also includes upon entry to the hospital. The hospital cannot deny you entry. 

[34:36] You know what else you can do? Block out the haters. 😎 Lol. Just put earbuds in to ignore the negative things people may be saying. 

[35:03] You may hear “You might just be someone that needs a little help . . .” and then they offer you an epidural, Pitocin, forceps, or other kinds of intervention. Don’t be defeated or discouraged. Your body was made to birth your baby! 💪🏼

I know this was a lot of information about vaginal exams, natural stalls, and failure to progress. Overall, I want you to know that vaginal exams are not an absolute way to determine where you are at in your labor progression. It is simply one tool of many. You have a CHOICE. 👍🏼 or  👎🏼

Feel free to email us at [email protected] or DM us on Instagram @myessentialbirth if you have any questions!

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ALL the best,


Links Mentioned:

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