a Midwifery Academy Amsterdam-Groningen , Amsterdam , the Netherlands.
b Department of Sexology and Psychosomatic Obstetrics and Gynecology , Academic Medical Center , Amsterdam , the Netherlands.
J Psychosom Obstet Gynaecol. 2018 Jun;39(2):90-95. doi: 10.1080/0167482X.2017.1291623. Epub 2017 Feb 22.
Vaginal digital examination (VE) is a routine medical procedure during labor to assess the start and progression of labor. This study explores women's experiences with VE's during labor in the Netherlands.
An exploratory anonymous online survey was distributed among Dutch women who underwent a trial of labor and gave birth to a living term child in the previous six months. Unadjusted odds ratios are calculated to establish associations between women's characteristics and reporting a negative experience with VE's.
Of the 159 women who met the inclusion criteria, 56 women (35.2%) reported a negative experience with the VE. These women reported more pain, embarrassment, not being able to relax, not feeling respected and not feeling the possibility to stop the examination. The odds of reporting negative experiences increased by giving birth in hospital, an instrumental delivery, more examinations, more different caretakers performing the examination and caregivers not introducing themselves before the examination. About 41.7% of the women reported being examined more often than advised in national and international guidelines (every two to four hours).
Although our study is limited, it shows that experiences with the VE during labor can be negative and should be considered carefully. We promote research of and teaching the use of additional noninvasive methods to assess progression of labor in daily clinical practice. We conclude that the number of VE's during labor should be restricted as much as possible. VE's should only be performed in the interest of the woman in labor, after her informed consent and preferably performed by as few different caregivers as possible.
阴道指检（VE）是分娩过程中的常规医疗程序，用于评估分娩的开始和进展。本研究探讨了荷兰女性在分娩过程中进行 VE 的体验。
一项探索性的匿名在线调查分发给了过去六个月内经历过试产并生下活产足月婴儿的荷兰女性。计算未调整的优势比以确定女性特征与报告 VE 体验负面之间的关联。
在符合纳入标准的 159 名女性中，有 56 名（35.2%）报告了 VE 体验负面。这些女性报告了更多的疼痛、尴尬、无法放松、不被尊重和感觉无法停止检查。报告负面体验的几率随着在医院分娩、器械分娩、更多的检查、更多不同的护理人员进行检查以及护理人员在检查前不自我介绍而增加。约 41.7%的女性报告称，她们的检查频率高于国家和国际指南建议的频率（每两到四小时一次）。
尽管我们的研究有限，但它表明分娩过程中的 VE 体验可能是负面的，应仔细考虑。我们提倡在日常临床实践中研究和教授使用额外的非侵入性方法来评估分娩进展。我们得出结论，分娩过程中的 VE 次数应尽可能限制。VE 仅应在为了产妇的利益、在她知情同意的情况下进行，并且最好由尽可能少的不同护理人员进行。
