Are vaginal checks always necessary?

Not always. They’re important to confirm labour progress, but guidelines suggest they should be limited to every 4 hours unless there’s a medical reason for more.

Can too many checks harm my baby?

Excess checks mainly increase the risk of infection for both mother and baby, especially after membranes rupture. They don’t directly harm the baby otherwise.

Can I refuse a vaginal check?

Yes. Consent is required. However, refusing may limit your doctor’s ability to monitor progress, so discuss your concerns openly.

Is there a way to make vaginal checks less painful?

Relaxed breathing, changing position, and asking for checks to be done between contractions can reduce discomfort.

Vaginal Checks in Labour: Why They’re Done and Your Rights

Labour is unpredictable. Sometimes progress is smooth; other times it slows down, stalls, or becomes complicated. Doctors and midwives use vaginal examinations (VEs) as one of the main tools to monitor progress. For many women, these checks are the only way to know how far the cervix has dilated and whether the baby is moving down.

What Exactly Is a Vaginal Check?

A vaginal check, or vaginal examination, involves the doctor or midwife inserting two gloved fingers into the vagina to feel the cervix and the baby’s position. No machines are used — it’s entirely based on touch and clinical skill.
During a check, the clinician assesses:

Cervical dilation – how many centimetres the cervix has opened (0 to 10 cm).
Cervical effacement – how thin the cervix has become.
Baby’s station – how far the baby’s head has descended into the pelvis.
Presentation – whether the baby is head-down, breech, or in another position.
Membranes – whether the waters have broken and what the amniotic fluid looks like.

Each of these gives important information about whether labour is progressing normally or if intervention may be needed.

Why Frequent Checks Are Done

Doctors may recommend frequent vaginal checks for several reasons:

To measure progress: Labour is often divided into stages. If dilation and descent are happening steadily, labour is considered normal. If not, interventions such as oxytocin augmentation or a C-section may be suggested.
To detect complications early: A VE can reveal issues like cord prolapse (when the umbilical cord slips down), abnormal baby position, or cervical swelling. These require immediate attention.
To decide on interventions: Whether to give pain relief, rupture membranes, or proceed with assisted delivery often depends on cervical progress.
To provide reassurance: For some women, knowing how far along they are can be motivating during labour.

How Often Should Checks Really Happen?

According to the World Health Organization (WHO) and the National Institute for Health and Care Excellence (NICE, UK), vaginal examinations should be performed:

At admission to confirm you are in active labour.
Every 4 hours during the active phase of labour, unless there is a clinical reason to check more often.
Before giving pain relief, such as an epidural.
If labour seems to be slowing down or complications arise.

The WHO explicitly warns against too-frequent checks because they can increase the risk of infection, especially once the waters have broken.
In practice, however, Indian hospitals often perform them more frequently — sometimes every hour or even sooner. This is partly cultural and partly linked to concerns about litigation and outcomes.

Risks and Downsides of Frequent Checks

While vaginal checks are important, repeating them too often has drawbacks:

Discomfort and pain: During contractions, a vaginal check can feel extremely uncomfortable. Repeated checks may add to the distress of labour.
Infection risk: Each examination carries a small risk of introducing bacteria, particularly after membranes rupture. Studies show that more checks are associated with higher rates of chorioamnionitis (infection of the amniotic fluid).
Emotional distress: Some women feel exposed, violated, or anxious during repeated examinations, especially if not explained properly.
Loss of control: Frequent checks without consent can leave you feeling like labour is being managed to you rather than with you.

What Influences How Many Checks You Get?

Several factors affect how often vaginal examinations are done:

Hospital protocol – Some hospitals have rigid policies that don’t always match WHO guidance.
Doctor’s training and comfort – Some practitioners rely heavily on exams, while others use them sparingly.
Stage of labour – More checks are common in prolonged or complicated labour.
Risk level of the pregnancy – High-risk pregnancies often involve closer monitoring.
Cultural context – In India, deference to doctors sometimes means women don’t question the frequency of checks.

Alternatives to Repeated Vaginal Checks

While VEs remain the standard, some alternatives and supportive methods exist:

Partograph – A chart that maps labour progress using contraction frequency, foetal heart rate, and VE results. It helps avoid unnecessary repeats.
Ultrasound in labour – Some centres use intrapartum ultrasound to check baby’s position and descent, reducing the need for frequent VEs.
Listening to your body – Increased pressure, the urge to push, or changes in contraction pattern can sometimes guide decisions without constant checks.

Your Rights During Labour

It’s important to remember that:

You have the right to informed consent before each check. The doctor should explain why it’s needed.
You can refuse a check if you’re uncomfortable, unless there’s a clear emergency.
You can ask for a female provider if that makes you feel safer.
You can request that checks be limited to essential moments.

Knowing this can help you feel more in control during birth.

Emotional and Practical Support

Vaginal checks are as much an emotional experience as a medical one. You may feel pain, embarrassment, or even trauma. Having a supportive birth partner, doula, or nurse can make a difference. Ask them to stay with you during checks if you prefer.

Breathing techniques, position changes (such as lying on your side), or requesting a gentler examiner can also help. Remember, you are allowed to speak up and ask for your comfort to be prioritised.
Vaginal checks are a vital tool in monitoring labour. They help doctors know whether you and your baby are safe, when to intervene, and when to let things progress naturally. But too many can cause unnecessary discomfort and even increase risks. International guidelines recommend spacing them out, and you have every right to ask why a check is being done. Understanding the purpose and frequency of these examinations empowers you to take part in decisions about your own labour, balancing safety with dignity.
Whether you’re pregnant, a new mom, or navigating postpartum, you don’t have to do it alone. Join our support group to connect, share, and support one another.

FAQs on Why Do Doctors Do So Many Vaginal Checks During Labour?

Are vaginal checks always necessary?
Not always. They’re important to confirm labour progress, but guidelines suggest they should be limited to every 4 hours unless there’s a medical reason for more.
Can too many checks harm my baby?
Excess checks mainly increase the risk of infection for both mother and baby, especially after membranes rupture. They don’t directly harm the baby otherwise.
Can I refuse a vaginal check?
Yes. Consent is required. However, refusing may limit your doctor’s ability to monitor progress, so discuss your concerns openly.
Is there a way to make vaginal checks less painful?
Relaxed breathing, changing position, and asking for checks to be done between contractions can reduce discomfort.