why cervical dilation isn't all it's cracked up to be
Your cervix is not a crystal ball. Nor is it a magic mirror or psychic. The state of your cervix at any given time cannot predict the future of how your labour will go. It cannot predict when you will go into labour, how long you will be in labour or how intense your labour will be.
An internal examination, when a doctor, nurse or midwife checks your cervix, is more like a snapshot of that given moment. They are really looking at four things when they examine you. They check:
The position of your cervix. Your cervix actually points toward your backside, which is called the posterior position, before moving forward or anterior. This can happen days or weeks before labour begins.
The ripening of your cervix. Throughout most of pregnancy your cervix is firm like the cartilage at end of your nose. As labour nears it will become soft like pouty lips. A soft, ripe cervix is more likely to thin and open.
Effacement, also known as the thinning of your cervix. This is often given in percentages such as, you are 50% effaced/thinned. This can also happen days or weeks before labour begins.
Dilation, the most talked about change to the cervix. This is how open your cervix is and is measured in centimeters. This can also happen days or weeks before you go into labour. Dilation will not begin until at least some progress has been made in the three properties listed above...
Most people are so caught up in TELL ME HOW FREAKIN DILATED I AM that they forget that there are three major changes that are also occuring- the position change, softening and thinning which are all critical for labour to begin.
My “dilation wheel,” showing the stages of dilation up to 10 cm!
So why can't these changes predict labour? The simple answer- because everyone's body is different. Every pregnancy and labour is also different. A mum to be may be examined and hear her cervix "is firm, thick and only 1 cm dilated" and feel totally deflated. (I won't go into my dislike of the word "only" now but I despise it when labour progress is discussed). That same woman may have her baby within hours! On the opposite end of the spectrum, an expectant parent may be told they are 75% effaced, soft and 4 cm dilated and not go into labour for DAYS. Your cervix does not predict anything and it certainly doesn't indicate how relaxed you are, how safe you feel or what your hormones are doing to help labour begin and progress.
The unpredictability of labour is something that can cause fear and anxiety for parents to be. So often we want answers, we want predictions and we want estimates. Part of my antenatal sessions with birth doula clients and once-off consultations involve the discussion of these fears, looking at all the paths labour may take and discussing other signs and indicators that labour is progressing or getting closer without relying so heavily on the state of one's cervix.
