Hong Kong Chinese women's experiences of vaginal examinations in labour

Lai, Chit Ying; Levy, Valérie

doi:10.1054/midw.2002.0326

Cited by 65 publications

(36 citation statements)

References 17 publications

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“…Studies on VE focus more on the procedure during gynecology situation [2-8], women preference regarding gender [9,10], providers’ practices [11] and VE training for medical students [12-16]. Few studies examined women’s experiences of VE during childbirth [17,18], or explored providers’ actual practices [19,20] and none explored it in developing countries or the Middle East region.…”

Section: Introductionmentioning

confidence: 99%

The paradox of vaginal examination practice during normal childbirth: Palestinian women’s feelings, opinions, knowledge and experiences

et al. 2012

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BackgroundVaginal examination (VE), is a frequent procedure during childbirth. It is the most accepted ways to assess progress during childbirth, but its repetition at short intervals has no value. Over years, VE continued to be plagued by a nature that implies negative feelings and experiences of women. The aim of this exploratory qualitative study was to explore women’s feelings, opinions, knowledge and experiences of vaginal examinations (VE) during normal childbirth.MethodsWe interviewed 176 postpartum women using semi-structured questionnaire in a Palestinian public hospital in the oPt. Descriptive statistics were conducted; frequency counts and percentages for the quantitative questions. The association between the frequency of VE and age, parity, years of education, locale and the time of delivery was tested by Chi-squared and Fisher’s Exact test. The open-ended qualitative questions were read line-by-line for the content and coded. The assigned codes for all responses were entered to the SPSS statistical software version 18.ResultsAs compared with WHO recommendations, VE was conducted too frequently, and by too many providers during childbirth. The proportion of women who received a ‘too high’ frequency of VEs during childbirth was significantly larger in primipara as compared to multipara women (P = .037). 82% of women reported pain or severe pain and 68% reported discomfort during VE. Some women reported insensitive approaches of providers, insufficient means of privacy and no respect of dignity or humanity during the exam.ConclusionsPalestinian women are undergoing unnecessary and frequent VEs during childbirth, conducted by several different providers and suffer pain and discomfort un-necessarily.Practice implicationsAdhering to best evidence, VE during childbirth should be conducted only when necessary, and if possible, by the same provider. This will decrease the laboring women’s unnecessary suffering from pain and discomfort. Providers should advocate for women’s right to information, respect, dignity and privacy.

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Section: Introductionmentioning

confidence: 99%

The paradox of vaginal examination practice during normal childbirth: Palestinian women’s feelings, opinions, knowledge and experiences

et al. 2012

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“…A recent study [1], noted that in a group of 508 women, two clinicians differed in dilatation measurements by 2 cm or more in 11% of occasions. An inconsistent finding between examiners has been noted to cause distress in women and has resulted in them losing confidence in their health care providers [6]. Interestingly, one study [2] noted that where an error in measurement was recorded, the direction of the error was inconsistent i.e.…”

Section: Introductionmentioning

confidence: 99%

“…In addition to inconsistency, VEs can be unpleasant, intrusive and embarrassing for women [6,11,12]. Women with a history of fetal loss or previous gynaecological surgery have reported feeling distressed during such an examination [13].…”

Section: Introductionmentioning

confidence: 99%

The purple line as a measure of labourprogress: a longitudinal study

Shepherd

Cheyne

Kennedy

et al. 2010

BMC Pregnancy Childbirth

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BackgroundVaginal examination (VE) and assessment of the cervix is currently considered to be the gold standard for assessment of labour progress. It is however inherently imprecise with studies indicating an overall accuracy for determining the diameter of the cervix at between 48-56%. Furthermore, VEs can be unpleasant, intrusive and embarrassing for women, and are associated with the risk of introducing infection. In light of increasing concern world wide about the use of routine interventions in labour it may be time to consider alternative, less intrusive means of assessing progress in labour. The presence of a purple line during labour, seen to rise from the anal margin and extend between the buttocks as labour progresses has been reported. The study described in this paper aimed to assess in what percentage of women in labour a purple line was present, clear and measurable and to determine if any relationship existed between the length of the purple line and cervical dilatation and/or station of the fetal head.MethodsThis longitudinal study observed 144 women either in spontaneous labour (n = 112) or for induction of labour (n = 32) from admission through to final VE. Women were examined in the lateral position and midwives recorded the presence or absence of the line throughout labour immediately before each VE. Where present, the length of the line was measured using a disposable tape measure. Within subjects correlation, chi-squared test for independence, and independent samples t-test were used to analyse the data.ResultsThe purple line was seen at some point in labour for 109 women (76%). There was a medium positive correlation between length of the purple line and cervical dilatation (r = +0.36, n = 66, P = 0.0001) and station of the fetal head (r = +0.42, n = 56, P < 0.0001).ConclusionsThe purple line does exist and there is a medium positive correlation between its length and both cervical dilatation and station of the fetal head. Where the line is present, it may provide a useful guide for clinicians of labour progress along side other measures. Further research is required to assess whether measurement of the line is acceptable to women in labour and also clinicians.

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“…However, there is much discussion regarding its applicability [7][8][9] resulting in the American Association of Obstetricians and Gynecologists issuing guidelines on labor management 10 in 2014. Digital vaginal examination is also intrusive 11 , subjective 12 , inconsistent 13 and associated with infection 14 . Our group has recently described an ultrasound based partogram (Sonopartogram) based on non intrusive intrapartum ultrasound observations 15 using transabdominal and transperineal ultrasound.…”

Section: Introductionmentioning

confidence: 99%