6 things your cervical exam tells us
6 things your cervical exam tells us
It's not just about how dilated you are!
During a cervical exam, your doctor or midwife uses two fingers to check your cervix. But what the heck are they feeling for and why do they do it?! This procedure can happen in a few different scenarios, such as at a prenatal visit if you're having contractions or nearing your due date, or during labor to monitor its progress.
Cervical exams should always be done with your consent. If your provider recommends it, ask why. If there’s no reason other than, “That’s just what we always do!” then you might be able to figure out how important (or not) it is.
Now onto what it is your cervix can tell us…
1. Dilation
Dilation measures how much your cervix has opened. A closed cervix is completely shut, while a fully dilated cervix is 10 centimeters wide, which is necessary for a baby to be birthed vaginally. However, dilation alone doesn't indicate active labor; some people might be 3 or 4 centimeters dilated for weeks before giving birth! It’s essential to consider other factors and as well as how the dilation changes over time to determine your labor status.
2. Effacement
Effacement refers to the thinning of your cervix. Typically, a cervix is 3 to 4 centimeters long, and this thinning is measured in percentages. If your cervix is completely thick, it's 0 percent effaced. Conversely, a fully thinned cervix is 100 percent effaced. First-timers often efface before they dilate, whereas those who've given birth before might dilate first. However, this pattern can vary from person to person.
For our visual learners…I’ve got you in this TikTok below:
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3. Station
Station indicates your baby’s head position relative to your ischial spines, the bony parts of your pelvis. If their head is level with these spines, it's at 0 station. This measurement ranges from -5 (head is high and not yet engaged) to +5 (head is crowning and visible).
4. Cervical Position
The position of your cervix can be posterior (far back), mid-position, or anterior (towards the front). A posterior cervix often means labor hasn’t started. If your cervix is very posterior, lying down or using pillows under your hips can help your doctor or midwife reach it during the exam.
5. Cervical Consistency
The firmness of your cervix usually indicates its readiness for labor. A cervix that isn’t in labor is typically firm, while a cervix preparing for labor softens. This softening is necessary before dilation and effacement can occur.
6. Fetal Position
If your provider can't determine your baby's position through feeling your abdomen, a cervical exam can help. As your cervix dilates more, the exact position of your baby's head (whether it’s facing down, up, or to the side) can be assessed.
Together, these measurements offer a picture of your labor progress, allowing you and your healthcare provider to make informed decisions about your care and delivery plan.
If you’re having your cervix checked and it starts to hurt or you want your provider to stop, please speak up and let us know. You are in charge of your body!
Until next time,
Dr. Jen
I will be forever grateful for my VBAC OB, who didn’t do ANY cervical checks before labor…. unless 1. induction was on the table 2. his patients requested them. The model of respectful, safe, trauma-informed care.
In labor, I had 1 at admission and 1 when I was complete. 2 total. Both consented.
Imagine that kind of respectful, trauma-informed care were possible at scale. Imagine all providers cared that much about patients…
He did maternal-assisted cesareans as well. Unfortunately, it seems to be a rare OB who seems women as human and not as inert, silent/silenced objects, to be “delivered of” a fetus via a series of complex interventions and assessments.