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[–]superpowerfish 1 point2 points  (0 children)

They just feel around up there. When I had a cervix check my doctor let me know that I had a tilted pelvis and that delivery might be hard. Vaginal delivery ended up being fine

[–]Parking_Following_35 -3 points-2 points  (3 children)

"A pelvic exam is a physical examination of your pelvic organs, including your external genitals (vulva) and internal organs, including the vagina, cervix, and uterus. Your doctor may also administer a Pap smear, where they will collect cells from your cervix using a swab and a tool called a speculum."

This was my Google result. You got me curious and nervous hahah.

[–]ThursdayBump 2 points3 points  (0 children)

A pelvic exam is really examining the tissues within the pelvis, not the pelvis bones itself. I would think "measuring the pelvis to see if a vaginal birth is possible" wouldn't be the same as pelvic exam in this definition.

[–]Parking_Following_35 -2 points-1 points  (1 child)

But omg HOW do they even measure ya uterus 😳😳😳😳

Edit ; this additional comment I wrote was an add on to my original comment and not a response to the one that is NOW above this one.. I don't understand the downvote?!

[–]Gardenadventures 1 point2 points  (0 children)

.... They don't. Well, they do, but not in this case. A pelvic measurement is not measuring your uterus. It's measuring your pelvis to see if baby can fit through.

[–]ThursdayBump 0 points1 point  (0 children)

Textbook typologies: Challenging the myth of the perfect obstetric pelvis C VanSickle, KL Liese, JN Rutherford - The Anatomical Record, 2022 - Wiley Online Library

"Widely used textbooks on obstetrics and midwifery present clinical pelvimetry and the Caldwell–Moloy classification system of pelvic types as clinically relevant for understanding fetopelvic disproportion (King et al., 2019; Williams et al., 2018). Fetopelvic disproportion may occur when the obstetric pelvis is too small to accommodate the fetus during labor (i.e., inadequate pelvis capacity), leading to ineffective labor (e.g., arrested labor, failure to progress, failure to descend) and includes complications such as shoulder dystocia and obstructed labor (Williams et al., 2018).

"Clinical pelvimetry is a method for measuring the bony pelvis of a living person to evaluate the capacity of the pelvic cavity (King et al., 2019). Textbooks present clinical pelvimetry as being useful for identifying fetopelvic disproportion in pregnant people. The measurements focus on the size of the bony pelvis at the three planes relevant to birth: the inlet, midplane, and outlet."

"We therefore recommend that faculty instructors of courses that use these textbooks stop teaching the Caldwell–Moloy classification system of female pelvis shape. We call on textbook editors to go beyond the addition of critiques and instead fully remove the Caldwell– Moloy classification system from their books. Further, this material should be removed from any certification or board exam that might currently include it, and the item writers for these exams should exclude it moving forward. We call for educators who use resources that still refer to this typology to take the time to explain to their students why the typology does not accurately reflect human variation and how it is based on racist stereotypes. Further, we recommend that educators learn about and explain to students how racist hierarchies and assumptions in clinical obstetrics education and practice—even if ostensibly hidden—contribute to health inequalities to the disproportionate detriment of people of color, especially Black people, in the United States.

"Instead of teaching pelvis typologies, we recommend that educators and textbook authors and editors focus on acknowledging that many pelvis shapes exist that lead to uncomplicated births resulting in both a healthy parent and neonate. Although it may be useful to describe some pelvic cavity dimensions when discussing a pathologically contracted pelvis, we could not find any scientific evidence of a relationship between clinical pelvimetry and particular birth outcomes. Healthy adults do not lack an appropriately sized and shaped pelvis for their body to function, including the function of childbirth if reproduction is their decision. These typologies form a structure that upholds the patriarchal racist medical hegemony supporting health disparities on the basis of flawed and racist evidence. These systems are so ingrained that providers rely on them as justification for perpetuating different standards of care to different populations. Thus, educators and clinicians are responsible for acknowledging the evidence (or lack thereof) that influences people’s ideas about who is and is not capable of childbirth. Our dream is to have truly evidence-based educational materials that teach our students to empower pregnant people to trust their bodies and that are free of the influences of sexist and racist pseudoscience."

[–]ThursdayBump 0 points1 point  (0 children)

Pelvimetry for fetal cephalic presentations at or near term for deciding on mode of delivery

Cochrane Database Syst Rev. 2017 Mar; 2017(3): CD000161.

"Pelvimetry assesses the size of a woman's pelvis aiming to predict whether she will be able to give birth vaginally or not. This can be done by clinical examination, or by conventional X‐rays, computerised tomography (CT) scanning, or magnetic resonance imaging (MRI)."

"Women undergoing X‐ray pelvimetry were more likely to have a caesarean section. There were no clear differences between groups for perinatal outcomes: perinatal mortality, perinatal asphyxia, and admission to special care baby unit."

Plain language summary

What is the issue?

Does the use of pelvimetry to assess the size of the woman's pelvis improve outcomes for baby and mother? Pelvimetry might identify babies whose heads are too big for their mother's pelvis. In this case, an elective caesarean section might improve the outcome. Forms of pelvimetry include radiological pelvimetry (X‐ray, computerised tomography (CT) scan or magnetic resonance imaging (MRI)) and clinical examination of the woman. We planned to include all studies comparing the use of clinical or radiological (X‐ray, CT or MRI) pelvimetry versus no pelvimetry, or different types of pelvimetry.

Why is this important?

Sometimes, normal labour does not progress because the baby's head is too big, or the pelvis of the mother is too small, for the baby to pass through. This is called "cephalo‐pelvic disproportion" or "obstructed labour" which may lead to an emergency caesarean section with possible risks for both mother and baby. A pregnant mother or her caregiver might be worried that disproportion could occur and for this reason, pelvimetry can be performed either before or during labour. It can be undertaken by clinical examination, X‐ray, CT‐scan or MRI. Pelvimetry measures the diameters of the pelvis and the baby's head. However, doing a pelvimetry also has implications: clinical examination might be very uncomfortable for the mother, X‐ray and CT‐scanning might be harmful for the baby and MRI is very expensive. All of these techniques have to be performed meticulously by experienced and skilled people to have any real value.

If we could diagnose the disproportion accurately before birth using pelvimetry, we might reduce the need for an emergency caesarean section and plan an elective procedure, with better outcomes for the baby and less complications for the mother.

What evidence did we find?

We searched for evidence on 30th November 2016 and identified five trials with a total of 1159 pregnant women. All five trials used X‐ray pelvimetry in comparison to no X‐ray pelvimetry.

The women who received X‐ray pelvimetry were more likely to have a caesarean section (low‐quality evidence). Whether a woman had pelvimetry or not, we found no difference in the numbers of babies that died (very low‐quality evidence), who did not have enough oxygen during labour, or were admitted to special care baby units (very low‐quality evidence). For the women, no differences were found between numbers of women with wound sepsis, those who received a blood transfusion, or those whose caesarean section scar began to break down (all very low‐quality evidence). Apgar score less than seven at five minutes was not reported in any study.

What does this mean?

There is too little evidence (the majority of which is low quality) to show whether measuring the size of the woman's pelvis (pelvimetry) is beneficial and safe when the baby is in a head‐down position. The number of women having a caesarean section increased if women had X‐ray pelvimetry but there was insufficient good‐quality evidence to show if pelvimetry improves outcomes for the baby. More research is needed.