what does “checking your cervix” mean in labor?
water color painting by Shay DeGrandis for the kindred feminine
what does “checking your cervix” mean in labor?
if you’re in labor, whether you’re birthing at home, at a birth center, or in the hospital, your provider may offer a cervical check to assess your labor.
but what does it mean? why are they checking your cervix? what can your cervix tell you?
when you’re provider is checking your cervix they’re checking for three things:
dilation — how open your cervix is
effacement — how thin your cervix is
fetal station — where baby is in your pelvis
first, let’s chat about dilation
your cervix is doing two different things — it’s thinning and it’s opening. the opening, or dilation, is often the focus of what’s happening to the cervix. your cervix opening is measured in centimeters. it goes from zero centimeters and closed to ten centimeters and fully open to let baby come out of your uterus and into your vagina. the modern obstetrical model would have you believe that the cervix dilates one centimeter per hour, but we know that is very often misleading. i’ve seen some folks stay at five centimeters for five hours, and others go from five centimeters to ten in ninety minutes.
a cervical check is just a snapshot of what’s happening right now in this moment and it cannot tell you how much longer your labor will be.
second, cervical effacement
but dilation is only only half of the cervix story. the other half is called effacement. ‘effacement’ is the word for the thinning of your cervix.
when your uterus contracts, that action draws the muscle fibers towards your fundus, or the top of your uterus. which shortens or thins your cervix. it is just as important for your cervix to thin as it is for it to open.
generally speaking, once your rockin’ and rollin’ in active labor, effacement happens alongside of dilation. however, the first centimeters of dilation can happen without any effacement.
i really love this video by Childbirth educator Liz chalmers— i show it to every one of my birth clients — that uses a balloon and a ping pong ball and demonstrates the actions of contractions on the cervix.
lastly, and maybe most importantly, fetal position.
image designed by student midwife studygram
why do i say “maybe most importantly?” well, because often when you’re birthing — especially when you’re with a hospital provider — and you’ve reached ten centimeters dilated, you’re provider may say to you, “okay, it’s time to start pushing!” but what happens when baby is still up high in your pelvis and you start pushing?
at best, you push for a few hours, put off your providers pressuring you to have a surgical birth, and exhaustedly birth your baby.
at worst, you push for a few hours, and are too weak to push your baby out and you end up with a surgical birth or some other unwanted outcome.
those of us who study physiological, undisturbed birth know that just because you’re at ten centimeters doesn’t mean the best thing to do next is start pushing. when your cervix is full dilated and effaced, what i want to know alongside of that is: where is baby in the pelvis?
when you come to the end of your labor and it’s time to bring baby earthside, you should not be pushing to move your baby out of your uterus and into your vagina, they should already be in your vagina and you should be pushing them out of the vagina and into the world.
encouraging you to start pushing just because your cervix is fully dilated and effaced when baby is still high in the pelvis is one of the ways that providers unintentionally sabotage your birth.
so, when your provider tells you you’re fully dilated, your next question to them is, “how high up in my pelvis is my baby?” or “what station are they at?” and if baby is still up high, you get a break to breathe, and get prepared for the next part.
i like diaphragmatic breathing for this especially. breathing in through your nose as deeply as you can, bringing your breath down through your belly and into your pelvis, and exhaling through pursed lips slowly and controlled.
when i teach anatomy and physiology of the uterus i call the cervix the bouncer at club uterus. nothing and no one gets in our out if she doesn’t give her permission first. she opens and thins to let allow your baby to come to you and those things, alongside your baby’s position in the pelvis is what your provider is assessing when they’re checking your cervix. they may only share the dilation with you, and so i encourage you to get the full picture of what your baby and your pelvis are doing at that moment. you deserve that information!
xoxo,
tamara
