Hannah W de Klerk1, Elise Boere1, Rik H van Lunsen2, Jannet J H Bakker3. 1. a Midwifery Academy Amsterdam-Groningen , Amsterdam , the Netherlands. 2. b Department of Sexology and Psychosomatic Obstetrics and Gynecology , Academic Medical Center , Amsterdam , the Netherlands. 3. c Department of Obstetrics and Gynecology , Academic Medical Center , Amsterdam , the Netherlands.
Abstract
INTRODUCTION: Vaginal digital examination (VE) is a routine medical procedure during labor to assess the start and progression of labor. This study explores women's experiences with VE's during labor in the Netherlands. METHODS: An exploratory anonymous online survey was distributed among Dutch women who underwent a trial of labor and gave birth to a living term child in the previous six months. Unadjusted odds ratios are calculated to establish associations between women's characteristics and reporting a negative experience with VE's. RESULTS: Of the 159 women who met the inclusion criteria, 56 women (35.2%) reported a negative experience with the VE. These women reported more pain, embarrassment, not being able to relax, not feeling respected and not feeling the possibility to stop the examination. The odds of reporting negative experiences increased by giving birth in hospital, an instrumental delivery, more examinations, more different caretakers performing the examination and caregivers not introducing themselves before the examination. About 41.7% of the women reported being examined more often than advised in national and international guidelines (every two to four hours). DISCUSSION: Although our study is limited, it shows that experiences with the VE during labor can be negative and should be considered carefully. We promote research of and teaching the use of additional noninvasive methods to assess progression of labor in daily clinical practice. We conclude that the number of VE's during labor should be restricted as much as possible. VE's should only be performed in the interest of the woman in labor, after her informed consent and preferably performed by as few different caregivers as possible.
INTRODUCTION: Vaginal digital examination (VE) is a routine medical procedure during labor to assess the start and progression of labor. This study explores women's experiences with VE's during labor in the Netherlands. METHODS: An exploratory anonymous online survey was distributed among Dutch women who underwent a trial of labor and gave birth to a living term child in the previous six months. Unadjusted odds ratios are calculated to establish associations between women's characteristics and reporting a negative experience with VE's. RESULTS: Of the 159 women who met the inclusion criteria, 56 women (35.2%) reported a negative experience with the VE. These women reported more pain, embarrassment, not being able to relax, not feeling respected and not feeling the possibility to stop the examination. The odds of reporting negative experiences increased by giving birth in hospital, an instrumental delivery, more examinations, more different caretakers performing the examination and caregivers not introducing themselves before the examination. About 41.7% of the women reported being examined more often than advised in national and international guidelines (every two to four hours). DISCUSSION: Although our study is limited, it shows that experiences with the VE during labor can be negative and should be considered carefully. We promote research of and teaching the use of additional noninvasive methods to assess progression of labor in daily clinical practice. We conclude that the number of VE's during labor should be restricted as much as possible. VE's should only be performed in the interest of the woman in labor, after her informed consent and preferably performed by as few different caregivers as possible.
Entities:
Keywords:
Childbirth; midwifery; psychological well-being; vaginal examination; women’s health
Authors: Kwame Adu-Bonsaffoh; Hedieh Mehrtash; Chris Guure; Ernest Maya; Joshua P Vogel; Theresa Azonima Irinyenikan; Adeniyi Kolade Aderoba; Mamadou Dioulde Balde; Richard Adanu; Meghan A Bohren; Özge Tuncalp Journal: BMJ Glob Health Date: 2021-11