Compared with routine two hourly vaginal examinations, routine four hourly vaginal examinations may have little or no effect, with data compatible with both benefit and harm, on: augmentation of labour (rr 0.97, 95% ci 0.60 to 1.57; one study, 109 women); and spontaneous vaginal birth (rr 1.02, 95% ci 0.83 to 1.26; one study, 150 women). Abstract. objective: vaginal examinations (ves) in labour are a routine part of intrapartum care. current u.k. guidelines recommend that ves are offered to women at regular intervals of not less than 4h and only performed when justifiably necessary. however, justification may be interpreted differently by different midwives.
The number of ves carried out (mean 2.9, sd 1.5, range 1–7) increased as length of time in labour in hospital increased. approximately half the sample (52%) had 3 or more ves during labour. almost 70% of women had more ves than expected when the criteria of 4 hourly ves was applied. the most common reason given by midwives for performing a ve. Main results. we included four studies that randomised a total of 755 women, with data analysed for 744 women and their babies. interventions used to assess labour progress were routine vaginal examinations, routine ultrasound assessments, routine rectal examinations, routine vaginal examinations at different frequencies, and vaginal examinations as indicated. Assessing progress is central to intrapartum care and is predicated on detecting and preventing morbidities for both the labouring woman and her baby.228 following freidman’s229,230 influential work in the 1950s, describing temporally normative progress through distinct stages and phases of labour, clinicians routinely plot cervical dilatation against time to detect and take action on any. A vaginal examination (ve) is an extremely intimate examination which is performed regularly and accepted as a routine procedure by midwives during labour.1,2 a ve can be performed digitally, or by using instruments such as a speculum.3 in midwifery care, a woman in labour is often subjected to at least one ve, and often these are repeated every 4 hours on obstetric orders or according to the.
Assessing progress is central to intrapartum care and is predicated on detecting and preventing morbidities for both the labouring woman and her baby.228 following freidman’s229,230 influential work in the 1950s, describing temporally normative progress through distinct stages and phases of labour, clinicians routinely plot cervical dilatation against time to detect and take action on any. A vaginal examination (ve) is an extremely intimate examination which is performed regularly and accepted as a routine procedure by midwives during labour.1,2 a ve can be performed digitally, or by using instruments such as a speculum.3 in midwifery care, a woman in labour is often subjected to at least one ve, and often these are repeated every 4 hours on obstetric orders or according to the. Vaginal examination is painful and distressing to many women. 1, 2 a cochrane systematic review on routine vaginal examination for assessing progress of labor finds only “2 studies that met our inclusion criteria” and concludes that “it is surprising that there is such a widespread use of this intervention without good evidence of effectiveness, particularly considering the sensitivity. She added: “although vaginal examination is necessary during labor, but it should not be done too frequent” (hassan et al., 2012 p5) all the papers, bar dixon et al. (2013) reported findings on pain and distress during examinations, through the primary data, and many of the women expressed that whilst they experienced pain, vaginal examination was necessary during labour.
Vaginal examination is painful and distressing to many women. 1, 2 a cochrane systematic review on routine vaginal examination for assessing progress of labor finds only “2 studies that met our inclusion criteria” and concludes that “it is surprising that there is such a widespread use of this intervention without good evidence of effectiveness, particularly considering the sensitivity. She added: “although vaginal examination is necessary during labor, but it should not be done too frequent” (hassan et al., 2012 p5) all the papers, bar dixon et al. (2013) reported findings on pain and distress during examinations, through the primary data, and many of the women expressed that whilst they experienced pain, vaginal examination was necessary during labour.
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