There is an unexplained joy, and also a bit of nervousness, as you get closer to the due date. You cannot wait to hold the baby in your arms, but at the same time, you fear the pain of labor and delivery. By now, you may already know about the process of labor and how your body changes at the time to bring the baby into the world.
Childbirth comprises three stages, and the opening of the uterus, which allows the baby to come out, is a crucial one. Medically, this process is termed as cervix dilation.
In this MomJunction post, we tell you how the cervix dilates, what are the signs, and the procedure to check the cervix for dilation.
What Is Cervix Dilation?
It is the opening of the neck of the uterus, which happens in the first stage of labor. The cervix dilates (uterus opens) due to contractions, and is a vital part of labor and delivery. The dilation is measured in centimeters. It starts from 1cm and grows to 10cm when it is called a complete dilation (1).
If your due date is around the corner and your cervix is dilating, then it could mean you will soon get into labor. Typically, the cervix starts to dilate in the first phase of labor, which is also called the latent phase (1).
Dilation And Effacement: What Is The Difference?
The stretching and thinning of the cervix is called effacement. Cervical efficacy is measured in percentage and mostly happens before dilation. The cervix thins and softens at first, and then opens. This happens when labor begins, which is usually around week 37. However, in some women, it could happen during week 38 or later.
Usually, in the first pregnancy, the cervix dilates during labor or after the contractions start. And in some cases, cervical effacement and dilation might happen just before the labor (2). As every pregnancy is different, the occurrence of effacement and dilation can differ.
You will know when dilation happens. All you need to do is pay attention to your bodily changes.
How Do You Know If Your Cervix Is Dilating?
You will be able to notice even the slightest of changes in the body if you are observant as you near the due date. The following signs indicate that the cervix is dilating.
- Lightning crotch: It is the sudden and intense pain experienced in your vagina when your baby descends. Some pregnant women say that the pain feels like a punch in the crotch. When you experience such pain near your due date, it could be an indication of cervix dilation (3).
- Frequent uterine contractions: When you experience frequent contractions, say six or more in 60 minutes, it might lead to cervix dilation. Such frequency of contractions usually happens before the due date (4).
- Ruptured membranes or breaking of water: This generally happens during the active phase of stage one labor. When a gush of water is released, the pressure might open the cervix.
- The purple or red line: When the labor progresses, some women get a purple line (discoloration) extending from buttocks to down. This line has proved to have a correlation with the cervical dilation (5).
- Mucus plug discharge: Mucus plug works as a seal to your cervix, and protects your little one from bacteria. So when your cervix opens, the mucus plug comes out (6).
- Bloody show: Brown or pink colored discharge could be a result of dilation. If you start noticing some stains, then it might mean your cervix has dilated (6).
- Others: There are other evident signs such as breathing or moaning due to contractions, a difference in your sense of smell, or curling of your toes. All these could be the result of cervix dilation.
If you do not notice any of the above signs, then you can manually check your cervix for dilation.
How Does Checking Cervix Dilation Help?
Checking cervical dilation helps you to know how close you are to labor and the effective management of labor. When your due date is nearing or has passed, your doctor may check the cervix to see if it is dilated.
Procedure To Check The Cervix For Dilation
- Preparation to check cervix: It is always good to get this done by a professional. In case you are doing it on your own, seek medical advice.
i. Sanitized and gloved hands: The person performing the procedure should make sure that the fingernails are cut and clean, use sterilized gloves for hands. Otherwise, there could be chances of infections and cuts.
ii. Comfortable position: Squatting is the preferred position. However, you can choose any other position that is comfortable for you.
- Steps to check cervix dilation: Follow these steps to check if the cervix is dilated.
i. Use two fingers: Index and middle fingers are inserted into the vagina and against the cervix to gauge the opening. Avoid the anal area.
ii. Assess the dilation: The two fingers should feel the cervix and the opening to assess the length.
- Dispose of the gloves: Once the examination is done, the gloves have to be disposed of.
You can use the cervix dilation chart to compare your dilation with.
Cervix Dilation Chart:
The below chart has been taken from the US Operational Obstetrics and Gynaecology (8).
|Length in cm||Assessment|
|1.5cm||One finger fits in tightly and touches the head of the fetus|
|2cm||One finger is loose, and there is no space for the second finger|
|3cm||Two fingers fit in tightly inside the cervix|
|4cm||Two fingers are loose in the cervix|
|6cm||2cm of the cervix is palpable on two sides|
|8cm||1cm of the cervix is palpable on two sides|
|9cm||Less than 1cm is left/only anterior lip of cervix felt|
|10cm||Cervix is not felt around the head of the fetus|
Although professionals generally recommend checking of cervical dilation, there are certain cases where they do not suggest it.
When Not To Check Your Cervix During Pregnancy?
The cervix should not be checked either by you or by a professional in these cases.
- In case you have had bad experiences with checking the cervix for dilation, you should avoid trying it again.
- If it causes too much pain, then stop doing it.
- When the placenta is covering the cervix (placenta previa), it is not recommended to check the cervix.
- If you have any sutures, you shouldn’t check your cervix.
If your doctor finds it risky to check cervical dilation, then do not attempt it. Cervical dilation should only be done when your medical professional has recommended it. Otherwise, do not attempt it.
Next, we see if it is possible to dilate the cervix to speed up the labor process.
Are There Ways To Dilate The Cervix?
Yes, there are natural and medical ways to dilate the cervix. To dilate the cervix, it has to be softened (cervical ripening) first. Usually, medical experts prefer waiting for it to happen naturally. But in some cases, it becomes necessary to dilate the cervix and induce labor.
Some of the natural methods include walking, using a birthing ball, taking herbal supplements, indulging in sexual intercourse, and nipple stimulation. Medical methods include medications and medical/surgical procedures such as stripping of the membranes (9).
While you can check the cervix for dilation, you can also be mindful of the changes happening in your body. Talk to your doctor about what you feel and take suggestions. Avoid doing anything by yourself, especially when you think it is risky. After all, it is yours and your little one’s life that you are taking care of.
Did you get your cervix checked for dilation when you were pregnant? Let us know about your experiences.
2. Cervical Effacement and Dilatation; Michigan Medicine University Of Michigan
3. Braxton-Hicks or Real Labor Contractions; Epigee Women’s Health
4. Recognizing Premature Labor; UCSF Health
5. A. Shepherd and et al.; The purple line as a measure of labour progress: a longitudinal study; BMC Pregnancy & Childbirth (2010)
6. How to tell when labor begins: Frequently asked questions labor, delivery, and postpartum care; The American College of Obstetricians and Gynecologists (2011)
7. Nursing Care of Childbearing Families: Clinical Education Center and Simulation; University of Colorado Denver
8. Operational Obstetrics & Gynecology: Labor and Delivery; The Healthcare of Women in Military Settings
9. J. L. Tenore; Methods for Cervical Ripening and Induction of Labor; American Academy of Family Physician (2003)