Know All About Pelvic Exam During Pregnancy

When Is Pelvic Exam Performed During Pregnancy?

Usually, a pelvic exam is performed during the first and third trimester unless there is some complication in the pregnancy and the pregnant woman needs continuous monitoring.

• During the first trimester, the pelvic exam is conducted where the doctor checks whether the cervix is being properly sealed with a mucus plug. The tests like Pap smear are also conducted during the first trimester of pregnancy. If nothing is wrong with test results, usually there will be no more pelvic exams up to the 36th week of pregnancy.
• After the 36th week of pregnancy, the doctor will do pelvic exams more frequently or even every visit. This is to monitor the effacement and dilation of the cervix so that it will be easy to determine how near the delivery is
• A doctor may also do a pelvic exam more frequently if there are any of the following complications and it requires close monitoring:
• If you have a medical condition that increases the risk of a preterm labor
• If you experience spotting
• In the case, you experience any vaginal infections (like genital herpes)
• If there is some growth in the pelvic area

How Is Pelvic Exam Performed During Pregnancy?

Usually, they conduct the examination of the size, shape, and position of the pelvic organs during a pelvic exam. A pelvic exam includes two components – manual and visual.

Manual assessment includes the examination of the external genitalia (vulva) and inside the vagina for an internal assessment of the vaginal walls.

The visual examination is performed with a small device – a speculum. This device allows a clear view of all the pelvic organs which helps in easy evaluation.

Procedure:

• While performing a pelvic examination, remove your lower clothing and lie on your back on the examination table
• The doctor will ask you to draw your knees up and spread them wide apart
• He will place a gloved index and middle finger into the vagina and assesses the cervix
• A speculum exam is the next step. During this exam, a speculum, which is a hollow cylinder with a rounded end that is divided into two hinged parts, fairly like the mouth of a duck, is used. The doctor inserts the speculum into the vagina to expand it for examination. When inside, the two halves of the speculum will open up, making it easier for the doctor to examine the cervix and the upper part of the vagina
• The doctors may also conduct a pap smear test during this time of the pelvic examination
• Bladder and rectal examinations are also usually included in a pelvic exam to rule out the chances of UTI and hemorrhoids
• During the final weeks of pregnancy, through a pelvic exam the doctors find out:
  • Effacement and dilation of cervix
  • Position of the cervix
  • How far into the pelvis the baby is descended
  • Presentation of the baby

The pelvic exam towards the final week of the pregnancy also has an advantage. The pelvic exam has a higher chance to stimulate the cervix so labor induction is not necessary.

Are There Risks In Pelvic Exam During Pregnancy?

A pelvic exam has its own risks during pregnancy:

• The risk of infection increases even though the doctor uses sterile gloves. This is because there are chances of the bacteria from the vagina moving towards the cervix.
• As already mentioned, the examination can stimulate the cervix and initiate labor and if you are not due or your baby is not ready to be born, it can increase the chances of preterm labor.
• A pelvic exam has a chance to cause PROM(premature rupture of membrane).
• After a pelvic exam, the doctor asks the pregnant women about the extension of dilation and when can they expect to go into labor. If the days pass and still there is no sign of labor, it can make the pregnant woman anxious and in this anxiety, she can give her consent or request for labor induction.

Things To Remember

If your doctor insists on a pelvic exam, you should ask him for a specific reason for the exam. Also, try to understand what he is trying to find out. Also, clear the doubt if in any way it will affect your pregnancy or delivery. In the case the doctor fails to convince you about having a pelvic exam, you have a right to decline it or request a second opinion.

If you decide to go ahead with the exam, here are the following things you should keep in mind:

• Your bladder is empty
• You are comfortable and properly covered
• Ensure your privacy
• Breathe deeply and relax your pelvic floor muscles. This will decrease the discomfort of the exam

Deciding to go in for a pelvic examination during pregnancy should be totally on you. Understand why the doctor suggests a pelvic exam and what the doctor is trying to find out and how it is going to help with your pregnancy. A doctor cannot perform the pelvic exam without explaining the procedure and taking your consent.