Vaginal examinations: a symptom of a cervical-centric birth culture

I have never been one for lots of cervical exams. As a nurse and a midwife I see them as something to be used only when necessary. They are uncomfortable and really have little bearing on the plan of care. Its crazy the numbers of exams women are forced to endure before and during labor. I had two cervical checks during my pregnancy. One when I arrived at the hospital with a ruptured water bag and another three days later when I said in the midst of labor “i think the baby’s coming” and I was ready to push.

One of my biggest pet peeves is the prenatal cervical check. I am always on a soap box about how unnecessary they are. They are painful and can be very damaging psychologically for a woman. Most women leave there prenatal appointment after a cervical check saying “my cervix is still posterior :-(” as if that is a problem when its perfectly normal.

This great post goes into the labor cervical exam and how unnecessary they are. Its a good read.


This post is about routine vaginal examinations (VE) during physiological birth ie. an uncomplicated birth without any medical intervention. The VE is a useful assessment in some circumstances, but it’s routine use in an attempt to determine labour progress is questionable. As birth knowledge evolves, and research challenges the current cervical-centric approach to labour progress, there is an opportunity to shift practice. I’m hoping this post will inspire readers to reconsider their beliefs and practices regarding cervixes and VEs.

History: the rise of the cervix

How did we get fixated on what one small area of the body is doing during the complex and multidimensional birth process? An article by Dahlen et al. (2013) discusses the history of VEs. It seems that midwives (and others) have been performing this intervention throughout recorded history. However, for most of this time VEs were carried out in response to suspected pathology eg. an obstructed labour or an unusual…

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