Chapter 19: Advanced skills for pregnancy and birth
How to do a vaginal exam
It is difficult to describe how to do a vaginal exam in a book. Vaginal exams are
best learned by practice. Be sure to have an experienced person teach you before
you try doing one yourself.
1. Explain to the woman what you are going to do and why.
2. Have the woman rest on her back with her legs bent and open.
3. Wash your hands well with soap (see page 53). Put on sterile or very clean
4. Gently put 2 fingers into the mother’s vagina. If she is in early labor, you will
usually have to reach inside almost as far as your fingers will go to find the
cervix. If the woman is in late labor, the cervix may be pushed closer to the
outside by the baby's head.
5. Feel the cervix.
If the cervix is closed,
it feels long and firm,
like your nose.
As the cervix begins to
open, it gets more flat.
The opening cervix feels like
open lips stretched over the
baby’s round, hard head.
The baby’s head will feel hard behind the cervix. If you feel something soft
behind the cervix, the baby may be breech (bottom first).
Sometimes, near the end of labor, the cervix is
almost open enough but there is a little bit of
cervix left on one side. It is best to wait until the
cervix is gone for the mother to start pushing.
When you cannot feel the cervix at all, it is
completely open. It is now safe for the
mother to start pushing.
The cervix is
completely open —
now it is safe to push.
A Book for Midwives (2010)