Does doctor insert finger during pregnancy?

It is common for doctors to perform pelvic exams during pregnancy. This may involve inserting fingers into the vagina to check the cervix. However, routine digital cervical exams are no longer recommended during normal, low-risk pregnancies. Here is a quick overview of when and why a doctor may insert their fingers during pregnancy:

Early pregnancy – A pelvic exam may be done at the first prenatal visit to confirm pregnancy, check the size and shape of the uterus, and inspect the ovaries and cervix.
Throughout pregnancy – Digital exams may be performed if there are certain complications to check dilation, effacement, or position of the cervix.

Late pregnancy – Doctors typically begin performing weekly or biweekly cervical checks starting around 36 weeks to see if labor is progressing.
During labor – Vaginal exams are commonly done every few hours during active labor to assess cervical dilation and station of the baby’s head.

So in summary, it is quite common for a doctor to insert gloved, lubricated fingers into the vagina during the later stages of pregnancy and labor, but not as a routine procedure early in low-risk pregnancies. The exam is quick and allows the doctor to gain important information about the progression of pregnancy and labor.

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When Would a Doctor Perform a Pelvic Exam During Pregnancy?

Here is more detail about the common reasons a doctor may perform a digital pelvic exam during pregnancy:

Confirming Pregnancy

During the first prenatal visit, which usually occurs between 6-12 weeks, the doctor will typically perform a pelvic exam. This allows them to:

Palpate the uterus to confirm pregnancy by the size and shape.

Check the size of the ovaries.
Inspect the cervix for any abnormalities.
Collect a pap smear if needed.

This early pelvic exam provides important baseline information as the pregnancy progresses.

Checking for Complications

Pelvic exams may be performed periodically during pregnancy if certain complications arise for which the doctor needs to assess the cervix. Examples include:

Vaginal bleeding – An exam can help identify the source of bleeding, such as the cervix or placenta.

Preterm labor – Checking for any dilation or effacement of the cervix early in pregnancy.
PROM (premature rupture of membranes) – An exam confirms if the amniotic sac has ruptured prematurely.
Placenta previa – Determining how close the placenta is to the cervix.

Incompetent cervix – Monitoring for early cervical changes that may require intervention such as a cerclage.

If the doctor needs to check the condition of the cervix for any of these reasons, a sterile gloved finger is inserted to feel the cervix. This allows assessment of dilation, effacement, firmness, and position.

Routine Late Pregnancy Checks

Starting around 36 weeks of pregnancy, digital vaginal exams are commonly performed at each prenatal visit to check the progression of labor preparation. This helps determine:

If the cervix is softening, thinning out (effacing), and beginning to dilate
How far dilated the cervix may be
The position of the cervix relative to the pelvis

These routine exams may occur weekly or biweekly. It allows the doctor to assess whether the body is making changes signaling impending labor.

During Labor

Digital pelvic exams are performed frequently during active labor, as often as every 1-2 hours. This allows the doctor to monitor the progression of labor by checking:

Cervical dilation – How many centimeters dilated the cervix is during labor.

Effacement – The thinning and opening of the cervix from 0-100% effaced.
Station – The position of the presenting baby’s head in relation to the ischial spines of the pelvis.
Position – The part of the head the baby is presenting with, such as the crown, brow, or face.

These parameters help the doctor evaluate if labor is progressing normally and guide any decisions about interventions.

What Does the Pelvic Exam Entail?

The process for a typical pelvic exam during pregnancy involves:

The woman lies back on an exam table with feet in stirrups.

The doctor performs a sterile scrub of their hands and puts on sterile gloves.
A lubricating jelly is applied to the fingers which are inserted into the vaginal opening.
One hand presses externally on the abdomen to help bring down the uterus while the other hand’s fingers gently examine the cervix.

The doctor assesses the degree of dilation, effacement, firmness and position of the cervix based on what they feel.
Fingers are withdrawn and the doctor removes gloves.
Findings are explained to the patient along with implications.

The actual examination lasts less than a minute in most cases. Doctors are specially trained to make this assessment swiftly and efficiently.

For the patient, there may be some minor discomfort from insertion of the fingers. But there should not be significant pain. Taking slow deep breaths can help relax the pelvic muscles and make the brief exam easier.

Are Pelvic Exams Necessary?

Routine early pregnancy pelvic exams were once common, but growing evidence has challenged this practice for low-risk pregnancies.

Potential downsides of frequent pelvic exams during normal pregnancies include:

Discomfort for the patient
Slight risk of introducing infection

No good evidence of benefit for mother or baby in uncomplicated pregnancies

Due to lack of proven benefit and some potential harms, most major health organizations have changed guidelines to recommend against routine pelvic examinations before 6-12 weeks or after 37 weeks in normal pregnancies.

However, the American College of Obstetrics and Gynecology still endorses pelvic exams as part of first trimester initial lab work and the United States Preventive Services Task Force concludes there is insufficient evidence to formally recommend for or against routine exams.

So there is still some debate, but the trend is clearly shifting away from frequent pelvic exams in healthy low-risk pregnancies. They are still clearly warranted in higher risk pregnancies or when complications arise.

What About Membrane Sweeps?

One type of vaginal exam doctors may perform is called a membrane sweep, which is done in late pregnancy around 38-40 weeks. This procedure involves the doctor or midwife inserting a finger through the cervix to rotate against the wall of the uterus.

The purpose is to try to separate the membranes of the amniotic sac from the cervix and uterus. This action releases prostaglandins which may stimulate labor naturally. It may be recommended for women hoping to avoid induction.

There are some risks such as introducing infection or accidentally rupturing the amniotic sac. Whether membrane sweeping actually helps induce labor is still under debate, with some research showing it makes little difference.

Due to the potential risks and lack of strong evidence of benefit, the decision about having a membrane sweep should be made carefully between a woman and her doctor based on her specific pregnancy circumstances.

What About Sex During Pregnancy?

A common concern is whether sexual intercourse is safe late in pregnancy, since penetration of the penis can stimulate the cervix similar to a pelvic exam.

However, most experts agree that women with normal, low-risk pregnancies can engage in sex throughout pregnancy without concerns. Sex is not linked with causing early labor.

The fetus is protected by the amniotic sac and cervical mucus plug. As long as there are no complications like preterm labor or placenta previa, sex will not directly impact the pregnancy.

Some key points about sex during normal pregnancies include:

Orgasm may stimulate mild uterine contractions but does not cause preterm labor.
Penetration and contact with semen can help “ripen” the cervix but does not trigger labor.
After 36 weeks, prostaglandins in semen may help prepare the cervix for labor.

If cramps occur after sex, they are usually mild Braxton Hicks contractions.
Oral sex and self-stimulation are also safe during pregnancy.
Positions may need adjustment as the belly grows.

Of course, women should avoid sex if they have unexplained bleeding, premature rupture of membranes, placenta previa, or signs of preterm labor. But in normal low-risk pregnancies, sex can be safely enjoyed up until the water breaks.

Coping With Discomfort from Exams

While pelvic exams and membrane sweeps during pregnancy are quick and medically necessary procedures, they can cause some women anxiety or discomfort. Here are some tips to help cope:

Take slow deep breaths during the exam to relax your muscles.

Communicate any worries or discomfort to your provider.
Ask your provider to explain step-by-step what they are checking.
Request smaller speculum or more lubricant if needed.

Bring someone into the exam room for support.
Remind yourself exams provide important information to ensure a healthy pregnancy.
Know that any discomfort is temporary and stays in the room.

Do a calming activity after like meditation or talking with a friend.
Discuss any sexual trauma history with your provider so they can be extra gentle.

While pelvic exams can be distressing for some women, they do not have to be. Talk to your provider so they can help you stay relaxed and comfortable during necessary exams.

Questions to Ask Your Provider about Exams

To help ease your mind regarding pelvic exams during pregnancy, here are some questions you may want to ask your obstetrician or midwife:

Why do you recommend a pelvic exam at this stage in my pregnancy?
What exactly are you checking when you perform the exam?

How can I relax my muscles to make the exam more comfortable?
How often will I need pelvic exams as my pregnancy progresses?
Is every exam necessary or are some mainly routine?

What will you do if you detect any problems like dilation or effacement early on?
Can I opt out of certain exams if they make me extremely anxious?
Will you explain what you feel and show me my progress on a dilation chart?

What alternatives do I have if I wish to avoid frequent exams?
How accurate is judging dilation by manual exams versus ultrasound?

Having an open and informative discussion with your provider can help you understand the reasoning for exams and prepare both physically and emotionally.

Conclusion

In summary, digital pelvic examinations are very commonly performed by doctors in the later stages of pregnancy and during labor to check the cervix. Manual exams provide information to help monitor the progression of pregnancy and labor.

While once routine in early pregnancy, recommendations are now shifting away from frequent pelvic exams in low-risk women. They are still indicated for high-risk pregnancies or when issues like bleeding arise. Patients should discuss the necessity of any exams that cause anxiety or discomfort with their obstetric provider. With some preparation, exams can be approached positively as a healthy part of bringing a baby into the world.