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Dear Marianne and listmembers, Fascinating thread - this conversation regarding rectal examination and observation of women in labour to determine progress. I have two aspects to contribute. In my own first labour (1970) the midwife (large tertiary training hospital in Sydney NSW) said to me, "I'll just look how you are doing?" and then did a rectal examination - I was so shocked and clearly remember thinking "what am I doing here? They don't even know which hole to look in!" The other is that during my midwifery ' training' early 70's (Adelaide, SA) no one did VE's or PR's, (except private obstetricians and that's a whole different story) we had to observe (all the women were on the bed) and be able to tell when someone needed moving to the second stage rooms and then the women were only ' allowed' to push when the head was on view. I didn't do one VE nor PR the whole of my training. It was only when I went to other hospitals and other states and " it was expected" that I learnt through trial and error how to do VE's. That too is a whole story in itself - gaining confidence and competence in VE's and then, after a few years of active VE'ing along with active management of labour, I gave up " doing" them altogether, (unless a woman particularly requests one/needs to know where she is 'at' or labour is not progressing according to the way the woman's behaviour is demonstrating she is progressing - if you know what I mean) - back to observation of the woman's signs and behaviours! Margaret Duff is in NZ - her documentation of labour behaviour is fascinating and very useful for validating midwifery work - making the invisible visible. She is presenting her research at the Keeping Birth Normal conference in Brisbane, Australia run by CAPERS 12th June 04. smiling, thinking of the wheels turning... Carolyn Hastie Midwifery Educator John Hunter Hospital Newcastle, NSW Australia +61 2 4921664 [log in to unmask]