As your due date approaches, you might hear more about cervical exams. Let’s break down what cervical exams are, what they can tell us, and why they shouldn’t be the only factor in how we think about labor progress.
What Is a Cervical Exam?
A cervical exam is a manual check where your healthcare provider manually inserts two fingers inside of you to assess changes in the cervix, including dilation (how open it is), effacement (how thin it is), and station (where the baby’s head is positioned). These exams can be done at the end of pregnancy during prenatal visits (sometimes as early as 36 weeks) or more frequently once labor begins.
Typically, providers perform these checks to see how much the cervix has changed in preparation for birth. The main indicators a cervical exam measures include:
1. Dilation: The cervix gradually opens from 0 to 10 centimeters to allow the baby to pass through.
2. Effacement: The cervix shortens and thins out, often measured as a percentage from 0% (not thinned at all) to 100% (fully thinned).
3. Station: This refers to the baby’s position relative to the pelvis and is expressed in numbers, such as -4 (higher in the pelvis) to +4 (crowning).
These changes are signs that your body is preparing for labor but they’re only a snapshot of your cervix in that exact moment.
What a Cervical Exam Does Tell Us
Cervical exams can be helpful for understanding where your body is in its preparation for labor. For example, if you’re 39 weeks and your cervix is beginning to efface and dilate, it’s a sign that your body is starting to get ready. In labor, these checks can gauge how far you've come, letting us see if contractions are causing cervical changes as labor intensifies.
What a Cervical Exam Does Not Tell Us
While a cervical exam can show you your cervix’s current state, it doesn’t predict when labor will begin or how quickly it will progress once it starts. Many women are surprised to learn that it’s possible to walk around for weeks at a few centimeters dilated, while others can go from zero to active labor in a matter of hours.
A few things to remember:
- Dilation doesn’t always mean labor is close. You might be a few centimeters dilated at your 38-week appointment and still make it to your due date (or beyond!).
- Cervical changes can happen quickly, slowly, or even pause for a while.
- Checking too often can sometimes create unnecessary stress or discouragement if there hasn’t been “progress,” even though it’s normal for the cervix to work in its own time.
- There is an increased risk of infection to the baby, especially if your water has broken.
Your Choice in Exams
Cervical exams are optional and you have the right to decline them if you don’t feel they’re beneficial. It’s worth discussing with your provider to understand their purpose and timing. Some women find comfort in knowing their body’s progress, while others find the exams disrupt their focus or create anxiety, especially during labor.
Trusting the Journey Over the Numbers
As a birth doula, I see labor as a journey that unfolds in its own time. Cervical exams give us a little information, but it’s far from the full picture. Your body knows what it’s doing and it will progress in the right time. So take those numbers with a grain of salt, stay connected to how you feel, and remember, your body will open when it’s ready.
If you are interested in learning more about birth doula support, taking a HypnoBirthing class or hiring me as your doula, fill out this contact form or email julia@motherbirth.net.
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