The Ethics of Cervical Checks During Labor

Abstract: Digital cervical examinations are performed at least every 4 hours during labor to assess dilation, effacement, and fetal head station. However, these checks raise significant concerns related to informed consent and patient autonomy. Current practices often fail to empower women to make autonomous decisions about their care during labor. This presentation will emphasize the ethical necessity of fully informed consent, particularly considering the discomfort and potential trauma that invasive digital exams may cause, especially for women with histories of sexual violence.
In addition to advocating for better communication between healthcare providers and patients, this presentation explores research regarding the promising alternative of trans-perineal ultrasound as a less invasive, more accurate method of assessing cervical dilation. Ultrasound has demonstrated potential to reduce rates of infection while providing objective, reproducible data that could help both patients and providers to make more informed decisions.
By exploring the limitations of digital exams and the promise of ultrasound, this presentation demonstrates a new and practical approach to improving care during labor. It also calls for more in-depth research into the feasibility, cost-effectiveness, and efficacy of trans-perineal ultrasound compared to the standard of care. This topic has significance beyond the bioethics sphere because it can cause tangible improvements in clinical outcomes of laboring people, from encouraging more dialogue between patients and physicians to reducing the rates of unnecessary c-sections. This presentation will provide a unique perspective by bridging clinical practice with ethical principles of respect, autonomy, and informed decision-making.

Keywords: Trauma-Informed Care in Obstetrics, Women's Health and Clinical Decision-Making, Patient Autonomy and Informed Consent