C.A.B.S. Birth Blog |
It's a common in many places, including where I practice: A person with a healthy pregnancy goes to see their provider, usually around week 34-35 and their provider requests to begin cervical exams during every appointment until delivery. It can be disappointing to find out baby's head is not engaged in the pelvis, or you are not dilating yet. On the flip-side you can be told you are 3 cm dilated and baby is low, and wait weeks before labor actually begins. Once the expecting person is ready to go to the hospital, they are told a cervical exam is necessary to see if labor is advanced enough to be admitted. Once in the labor room exams are often requested every few hours the person is in labor. Seems like a lot, doesn't it? It turns out, those checks are only useful for some information, and if nothing is suspected to be wrong, they are usually not medically necessary. (If you have or suspect a complication, cervical exams can be necessary. Discuss your options with your provider! ) Why does this matter? It matters because every time a procedure is done it comes with risks/benefits. To understand if the benefits outweigh the risks you need to know how your cervix works before and during labor. You should also know what information you can and can not get from a cervical exam during these points, their risks and benefits. Then you can make an informed decision if the exams are for you.
I hear lots of parents and pregnant people relate dilation to how close they are to birth; but dilation is nowhere near the whole picture of all of the changes the cervix makes during late pregnancy and labor to be ready to give birth. For baby to be born vaginally your cervix needs to do four distinct things. The changes can happen in different orders or speeds from person to person and birth to birth, but they all need to happen. How the cervix Prepares for birthIt ripens Normally your cervix is about 1 to 1 1/2" in length, and firm. If you push on the tip of your nose, its firmness is something close to that. For your cervix to change it needs to get softer, or ripen. Prostaglandins are the hormones responsible for doing this. They are found in semen which is one of the reasons sex can be helpful to bring along labor, they are also found in evening primrose oil (do not use without provider approval), and within yourself. They are also in the suppository medications that are used in labor induction. When your cervix is ripe it softens to be soft and stretchy, kind of like your cheek. Go ahead and poke your cheek now, I know you wanna! It shifts forward. Normally your cervix rests in a posterior position, or "to the back" of the vagina. If your cervix is to be aligned with the vagina to make a straight passage for baby it needs to shift forward to an anterior position. This usually happens as baby's head and/or contractions put pressure on the cervix. Hormones are also responsible because for this to happen easily your cervix needs to be softer.
Read on! my next post, "your cervix isn't an oracle part 2" will offer more information about cervical exams!I am not a licensed medical provider. Nothing in my blog post is meant to be medical advice, merely information to open a dialogue with your care provider. While research is important, so is a good relationship with your provider. Please speak to them about all aspects of your care.
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AuthorHi, Jessie here. I'm a doula, mother, and wearer of many hats. All things birth related are my passion. It brings me great joy and satisfaction to serve clients and educate families. I am new to blogging, and excited to share with you all lots of different things about birth. Archives
May 2020
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