Recommend, 2018

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Share I am in labor: How often should I have a vaginal touch?

Armando @armando_bastida

When an obstetrician or midwife wants to know how a childbirth evolves, she gives women a vaginal touch . It is an intervention in which two fingers are introduced into the vagina in order to use the professional's sense of touch to determine how much the woman has dilated.

The problem is that it is not a "test" that can be done very often, because vaginal touch, besides being annoying for many mothers and besides generating anxiety, can increase the risk of infection and can also help the mother to disconnect of your body and your delivery and (re) connecting with the world, distracting it.

For this reason, it is recommended to make the minimum possible vaginal exams and to determine those minimums the Ministry of Health has valued the scientific evidence in this regard and has explained in the Clinical Practice Guideline on Normal Birth Care how many touches would be desirable for a woman who she is in labor .

What the scientific evidence says

In a study that analyzed 146 mothers who gave birth in 1986 and who had an infection at birth, compared with the total number of deliveries that year (8428) in Nigeria, it was observed that the factors that predisposed to suffer a puerperal infection was anemia in pregnancy (increased risk by 69.2%), prolonged labor, defined as a period greater than 12 hours (increasing the risk by 65.7%), performing five or more more vaginal touches (increased the risk by 50.7%) and artificial rupture of membranes (increased the risk by 31.5%).

Other studies comment something similar, being especially relevant the number of vaginal touches made when predicting a maternal and / or neonatal infection. That is, there is a direct relationship between the number of touches made to a woman and the risk of an infection both the mother and the baby .

What are the recommendations

Knowing this, the Ministry of Health recommends:

  • That in normal conditions the vaginal touches are made every 4 hours.
  • That vaginal exams will be performed before 4 hours in those women whose labor progresses slowly, if there are complications or if the woman shows a feeling of wanting to push (in these cases the professionals can skip the 4-hour rule to make an assessment in that particular moment).

And before doing a vaginal touch, the following should be taken into account:

  • It must be confirmed that touch is really necessary and that the information obtained will be important in the future of the birth, since it will allow decisions to be made.
  • That a vaginal touch is an exploration that can be very annoying, especially if the woman does not feel comfortable, and I do not speak physically, but psychologically, with this invasion. With this I mean that it is imperative that the professional is present, that he communicates exactly what he is going to do, that explains what he expects to find, that resolves any doubt about it, that is carried out with maximum privacy and, evidently, that he does so with the express consent of the mother and in a climate of maximum respect .
  • That vaginal touches are associated with an increased risk of infection
  • That in case of not finding the expected results, they communicate with delicacy, with empathy and showing themselves, the professional, as close to the woman as this one requires (that is, that resolves all the doubts of the mother and that is lent in case can do something for her).

I do not know what experiences you have had with the vaginal touches, but I have found women who have taken it as something more in childbirth, without any problem, and others who have seen as professionals and students were almost in line to touch their vagina to have to end up hearing from the gynecologist's mouth "does not progress

...

Of course, we have touched it so much that in the end we have hardened the cervix ", finishing the delivery, as you imagine, in cesarean section.

More information | Clinical Practice Guideline on Normal Birth AttentionFoto | Eyeliam on FlickrIn Babies and more | The vaginal touch, The purple line: an alternative to vaginal touches

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