The problem with vaginal examinations.

Why UK Maternity Services Need to Move Beyond Cervix-Centric Care

Maternity services in the UK remain overwhelmingly cervix-centric, with vaginal examinations still used as a primary measure of labour progress. While these assessments have long been standard practice, it's time to re-evaluate their centrality in birth care.

A vaginal examination is just one of many tools available to health care providers.

A vaginal examination is an assessment, NOT a prediction. It tells us about cervical dilation and effacement at a specific time, just like taking a photograph it only captures what is in frame in that moment. It doesn't provide reliable foresight into how labour will unfold. In fact, the progress of labour varies significantly from person to person, and cervical changes can happen quickly, slowly, or even in fits and starts. This variability is totally normal but makes vaginal exams a subjective measure that doesn't reliably indicate birth outcomes.

Too often, the number of centimetres dilated becomes the focal point of decision-making, influencing interventions, transfers, or even undermining confidence in physiological birth. This narrow lens can contribute to unnecessary stress and intervention, rather than supporting the full picture of labour—one that includes emotional well-being, movement, coping strategies, and instinctive behaviours.

It’s crucial for maternity care to embrace a more holistic, woman-centred approach, where the cervix is seen as just one piece of the puzzle and not the whole picture.

Consider - the potential impact the information and assumptions gathered from this routine examination could have on your birth outcome.

Remember - you do not have to consent to an examination if you do not wish to.

Admission to the maternity unit and/or pain relief can not be withheld from you if you choose to decline an examination.