Gloves and vaginas
For a moment, consider your vagina (or for the menly folk out there, consider your own genitalia but in a different context). Consider what it means to you, and who touches it. Consider the way in which they touch it, ask your permission to get up close and personal with it, worship it and carress it, discover it and explore it. Consider how you were brought up to think about your vagina - a naughty place, a private place, a special place, a great place… the ideas vary.
Think about how it is touched in day to day life. It’s wiped, washed or rinsed, dried, tucked into lacy frilly underwear or something functional, thought about regularly, rarely or never. If hands are near it, it’s often in a sexual manner with lots of connotations of love, passion, caring, friendliness, permission and fun*, and usually because you want it.
*Please keep in mind that I’m not touching on anything other than normal to great touching and views here. Sexual abuse and misuse of vaginas is not what I’m talking about here just yet, ok? Maybe for another day.
There are also no gloves. There may be latex involved, and should be in some cases, but for most stable, longish term relationships, or at least at the baby making phase, there aren’t.
So how then does wearing gloves during vaginal exams as a midwife, change how we view the vagina? I agree that on one hand (ha ha), wearng gloves is of the utmost importance for maintaining ones safety when bodily fluids are around. I’m not debating whether people should glove up before undertaking an exam. What I am debating is how wearing gloves depersonalises the whole process and makes it ok to do things that we wouldn’t even consider doing with a lover, or with our own.
VEs can hurt like the Hades, and are often of no practical use, though employed for lots of reasons. They are REALLY intrusive as well which isn’t really surprising given that hands are being stuck places. Would we as midwives think differently if our hands were ungloved? Would it be more of a person to person contact, with the attendant asking of permission and respect for surfaces and places, rather than a matter of gloving up, lubing up and progressing? I’m not trying to be crass here but the way that I’ve seen VEs done is truly like that - similar to a dentist gloving up and poking in your mouth.
Student midwives probably need to distance themselves from vaginas because of what we see of them and are asked to do to them. They are the most amazing and mysterious pieces of the body to me, and they are beautiful and lovely. They all vary, and are as individual as faces. I feel it an honour to be invited into the woman’s confidence as she spreads her legs and births a babe into the world. But to see it draped with green sheets, disinfected and probed, detached from the woman it is part of, set aside from the emotion and pain involved in birth, bothers me to the core. To see VEs done "to check progress" when it’s clear that the babe is not being born right this second, and so progress is somewhere less than stage 2, and all that it’s going to do is disappoint the woman and give the midwife something to write on the partogram, makes me so sad.
Perhaps this dehumanisation is part of why c-section rates are sky rocketing. Women can’t cope with the assult on their vagina and go into the fight-or-flight reaction we all have to assults of our person, and labour stalls.
How could you possibly expect any other animal to birth the way we do, under lights, with invasive procedures, monitors, machines that go ping, a revolving door of staff and few familiar faces?
You get post of the week for this one, ducky!
Xx.L
Comment by Louisa — July 30, 2007 @ 8:09 am
Well said! I’m really not keen on the way that it is expected that the first thing done when you get into hospital in labour is a VE and that if things seem to be taking too long for the midwife/docs liking, more VEs are done. Small wonder so many labours seem to not progress when an unfamiliar person is shoving hands roughly into areas that should be treated gently and with respect. The intent in my labour is that there will be one, maybe two VEs at most, one to check for cervical lip when I start to feel like pushing and *possibly* one earlier if I feel like letting them!
*ahem* I’ll climb down off the soapbox to give others room now
Comment by Ness — July 30, 2007 @ 7:49 pm
I don’t like the idea of a VE being the first port of call, as it were, in a doctor/midwife to woman relationship. That said, the gloves and the attitude of “let’s get it over with” helps me to distance myself from it as much as it must help the examiner. Speaking in terms of pap smears and check-ups etc., I -like- this distance. I’d find it frustrating to be given ‘gently gently’ treatment under these circumstances. As far as I’m concerned, it’s business vs. pleasure. However I’ll be interested to see how I feel about this if/when I have children.
Comment by Adie — July 30, 2007 @ 10:05 pm
Stunned.
That was so well worded!
With my third birth (second hbac) I was told… I don’t need to know where you are! I LOVE MY MIDWIFE! Her partner constantly offered to check… which only led to my pure fear of my uterus failing me after the c/s for my first child…
And yes, having strangers touching you can make all the difference. Especially when nurses start to scare you with “oh his hands are so big, just let me do it”… no wonder the kid turned around to mostly breech during labour! I was scared too!
Comment by k. — July 31, 2007 @ 5:30 am
Great post! Very thought-provoking, too.
My first reaction is that how I’d like my body treated depends on whether the person is there for business or pleasure.
If it’s a lover, slow and gentle touch is most personal and (safe sex considerations aside) skin-to-skin contact maximises intimacy.
But I probably don’t want to feel this intimate with a health care giver. I’m not a mum so, speaking as the recipient of pap smears, I’d prefer that my doctor be business-like with my body. When one needs to touch another person’s body, the client’s personal space needs to be preserved via mental rather than physical means. Latex can give a sense of that - great to help maintain a professional distance, lousy for sexual intimacy.
Doctor, please respect my body, please ask me for permission to touch me, but don’t caress me. Do what you need to do, then get out.
Comment by Adele — August 2, 2007 @ 4:50 pm
Well, having now had VE’s during the birth process I can comment that the worst part in that context is actually that they make you lie on your back! When having massive contractions that require your full attention there is no way you want to lie on your back so someone can shove hands inside you and make you more uncomfortable. Other than that aspect of it I honestly can’t say they bothered me much, I was already naked in front of a number of people I hardly/didn’t know so having them probe me wasn’t humiliating or anything. If anything it was good to have the check so there was some idea if I was making progress or not. In the end I think it was the poking of my cervix during the VE that got me going again…
Still a very interesting and sensitive topic, I may need to think about it again in a few weeks…
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Comment by Myk — August 12, 2007 @ 10:16 pm
This is fabulius, and I agree wholeheartedly with the way youve explained the whole thing. For me, in my one HBAC, my midwife was very very cool and only checked twice because I wanted her to. Maybe I was too indoctrinated by the whole “progress” BS from my first 2 births, but she was not all obsessed. As you mentioned, somehwere less than stage two! LOVED that part!
Laying on my back, as a 42 weeks preg beached whale mama in pain, now that was the problem for me. I just coped with that last contraction and you want me to what???
Yuck.
I do think it is the gloves, BTW and I always was fascinated by the old pics in SpiritualMidwifery where they were barehanded, for what its worth.
Comment by Housefairy — August 17, 2007 @ 12:56 pm
Excellent post! I think a lot of VE’s depend on the attitude of the examiner BEFORE we examine. I know people who don’t even introduce themselves before they glove up & go for it!
There is a time & a place for a VE - when used correctly they can be encouraging to a woman, ‘you’re almost there’ etc. Used wrongly & a woman will feel violated & angry.
Comment by Agatha — August 23, 2007 @ 1:42 am