Do I Need to Have Vaginal Exams in Late Pregnancy?

Get the scoop on whether this common exam is necessary.

A pregnant person on a bed
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Narong Jongsirikul / Shutterstock.com

So you really hate the vaginal exams during pregnancy. What happens if you just say, “no?”

The short answer, in most cases, is probably nothing. As long as you’re not having complications that suggest premature delivery, infection, premature rupture of membranes, heavy bleeding, or some other big problem, you can tell your doctor, nurses, and/or midwife to keep their fingers outta there.

Vaginal exams aren’t absolutely necessary, agrees Catherine Harth, M.D., OB-GYN and associate professor of Obstetrics and Gynecology at the University of Chicago. That said, sometimes they're helpful, says Dr. Harth. However, oftentimes, they don’t tell us all that much—and they don't indicate when labor is going to start. They’re usually just a progress report of what the cervix has done so far.

In each of my pregnancies, my doctors started checking my cervix at 38 weeks, announcing it could “go any day now." Then I waited on pins and needles, expecting the other shoe to drop. I hung out for weeks at three-to-four centimeters dilated and still went overdue with a couple of my babies.

“There are some situations where it’s useful to know if a patient’s cervix is favorable [getting ready to labor]. For example, if her water breaks, but she’s not contracting and her group B strep test was positive. We want to know what her cervix was like at her last doctor’s visit. If her cervix was already dilating, we might want her to come into the hospital for antibiotics sooner than later. If it was still closed, we might not need to rush,” explains Dr. Harth.

In general, however, expert opinion is mixed on whether or not these exams are needed. “There’s been some debate in the medical literature though about the utility of doing cervical checks in the last weeks of pregnancy. If the patient is healthy, we know the baby’s head is cephalic [presenting head first in the birth canal] and it’s not going to change how we manage her care, it’s not absolutely necessary,” says Dr. DeHarth.

Some pregnant people don’t mind the exam at all and they like the update. These people might hear that their cervix is softening and dilating and feel hopeful that the end is in sight. Or it might help them to feel like their body is doing what it’s supposed to.

RELATED: Ultrasound: A Trimester-by-Trimester Guide

Unfortunately, the news isn’t always encouraging. You might feel discouraged and anxious If you’re a week overdue, your cervix is tightly closed and showing no signs of opening soon. That’s what convinced me I was going to be pregnant forever. I went a little nuts over this news.

So, if you're not a fan, tell your doctor. Chances are good they’ll say, “Oh, OK, well, ummm, no problem. Let’s not do it.” If they insist, ask why they want the information and how it might (or might not) change your care.

Then, make your own decision about it. It’s just like your parents told you: No one has the right to touch your body without your permission. Does your no-exam policy make your healthcare provider’s job more challenging? Maybe. Maybe not. Health care is not a cookie-cutter operation and you have the right for your care to be customized to your needs and wishes.

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