Unless there are health concerns or complications, there is no medical reason to have routine vaginal examinations as part of your regular pregnancy visits.
Reasons for a vaginal examination
Performing a pap test
Pap tests are recommended for women every 2 years. Pap smear in early pregnancy is safe and does not cause miscarriage.
Checking signs of an infection
The hormones of pregnancy affect the environment of the vagina, making you more prone to thrush or an overgrowth of vaginal bacteria (called ‘Gardnerella’). A vaginal examination with a speculum can help making the diagnosis and if required, a swab tests is needed.
Looking for a cause of bleeding
If you experience bleeding during your pregnancy a vaginal examination with a speculum is needed to try and find out the cause of the bleeding.
Sweeping (or Stripping) the membranes
Or a ‘strip and stretch’. It involves a vaginal examination, by placing 2 gloved fingers through the opening of the cervix and then separating the membranes or sac (holding the waters and baby), from their slight attachment to the lower segment of the uterus. The aim is to trigger a local release of Prostaglandin hormones by the cervix and perhaps induce labour.
Sweeping the membranes can be quite uncomfortable for the woman and sometimes a small amount of bright red bleeding for 24 hours or so afterwards.
Making decisions about induction methods
The position, softness and openness of the cervix need to be assessed to make decisions about the best way to perform an induction of labour.
Seeing if the waters have broken
If you think your waters have broken, contact your hospital you are booked in for advice. Keep any pads or underwear and take them with you. If there is some doubt as to whether your waters have broken, the following methods are used to try and determine if they definitely have by:
- A speculum examination to see if water is coming away from the cervix.
- AmniSure test.
How a vaginal examination is done
This involves the woman partially undressing from the waist down and lying on her back on the bed, resting comfortably with her knees bent, feet together and allowing her knees to fall comfortably apart. The doctor usually puts a small amount of K-Y gel and places their first 2 fingers inside the woman’s vagina until they feel her cervix.
This is a metal or plastic instrument, shaped a little like a duck’s bill. The woman needs to lie on her back on the bed and rest comfortably with her knees bent.
Her bottom needs to rest on the lower edge of the bed and her feet are usually placed on a slightly lower platform, at the bottom of the bed. This position helps makes the procedure less uncomfortable. The end of the speculum is gently slide into the vagina. Once in place, the ‘bills’ of the instrument are opened slowly, this separates the walls of the vagina, allowing the doctor to look inside and view the woman’s vagina and cervix.
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