I was on call recently and had a woman attempting a VBAC. She had gotten an epidural and so I went to lie down for a bit. I slept almost two hours then got up to go check on her and my other patient. In a three hour period, my patient had been checked 6....yes, 6 times by the nurse! And she was ruptured! I asked the nurse why she felt the need to check the patient 6 times in a three hour period and she told me she did it because the patient would ask! Give me a break! It's her first baby vaginally....it won't fall out (and if it does - great, that's the point!). We were assured of her progress. There was nothing on the strip indicating the need for a vaginal exam. Are you fer real????
I rarely ever do that many vaginal exams in a woman's entire labor!!!!
There is research that shows after the fifth exam (one membranes are ruptured), a dramatic increase in the risk of infection. So keep your damn fingers out of there please!
Some nurses are really good about this but others drive me nuts. I have written as an order, no vaginal exams without checking with me first. I just can't always rely on the nurses' judgement as to when a vag exam might be appropriate. Really, some of these nurses have been doing this as long as I have been alive. You really ought to be able to look at a patient and tell a lot about where she's at based on how she behaves, what she says, etc. If the patient is smiling and laughing during a contraction and is ruptured...I don't care if she's a grand multip...it's not likely to fall out - don't check her!
I was always taught that you should only do a vag exam if it will change your managment. I try very hard to stick to that, I think it's a great rule!