ABSTRACT: Videotapes of women during the second stage of labor and their caregivers were examined in this descriptive study to determine how caregivers performed sterile vaginal examinations. Conversational analysis techniques were used to analyze the data. Results showed that the examinations were performed in a ritualistic manner by all caregivers, and the way the ritual was enacted repeatedly demonstrated the power of the caregivers over the women. The most common reason for performing the procedure, to help the woman push better, seems to be specific to the second stage of labor and is not described in the literature. The authors offer suggestions for better use of the examination, and recommend that it be performed far less frequently than is common.