I originally put together this post to give a friend a visual explanation of how she could check her own cervix during labor…Hold on, she did WHAT?!Thats right people, it is possible to check your own cervix for dilation. Heck if I was in labor I’d probably check myself every 5 minutes (are we there yet? are we there yet?). Here’s the thing. Checking a cervix only tells you what your cervix is doing at this one very second. It will not tell us when you are going to go in labor (if you arnt already, please see blog my titled “When to know when to go”), or when you will deliver. Childbirth is a game of watchful waiting and PATIENCE!! But for the neurotic clock watchers out there like me that just cant seem to just wait and do NOTHINGGGggg, here is a way you can have an idea of whats going on, what your midwife is checking for, and have a better sense of the changes your body is going through. Additionally touching in and around yourself could help to stimulate labor.
I’m sure there is some debate amongst healthcare providers about women checking their own cervices. But honestly, if we recommend having sex to get labor going, then I dont see the harm in helping women to feel more empowered and by giving them better insight to their own bodies. The key thing to remember is that most of the time, as you are getting ready to go into labor, everything gets more tender down there, so feeling around and touching your cervix may be uncomfortable. More so, most women dont know what their cervix feels like, and even if they do find it, they probably wont know right away what they are looking for. So if it is uncomfortable, or you are having trouble, please don’t feel like you need to torture yourself; just wait until your midwife checks you so it is worth any discomfort. But if you are dying to do something and feel more active in managing your labor, make sure you wash your hands real good, and use a sterile lubricant to avoid any irritation.
When you insert your fingers, go straight back as far as you can reach, until you feel something sort of “sticking out.” Feel along the sides and into the little pockets to measure with the end of your finger how much it is sticking out. That is how you can get an idea of the effacement, or the “thinning out” of the cervix. In women in their first pregnancies, your cervix must thin out before it can dilate. So if you are in earlyyy stages of labor, this will probably be the most useful thing to check for.
When you feel that smooth surface, think about it in terms of where on the cervix you are feeling. The donut shaped cervix pic is what you would see if you opened up your vagina. Its like the big house on the end of a cul de sac. If you are standing, you will prbly feel the surface (where the frosting on top of a donut would be) facing towards the floor, but everyones cervix is different esp in preg so it can be tricky! If you use your finger tips and feel around the center surface, you will be able to feel a small hole, like a dimple thats the part that dilates. A really good way to think of when you are feeling for that “crater like” opening.
Cervical Dilatation and Effacement
Using sterile gloves and lubricant, perform a vaginal exam and determine the dilatation and effacement of the cervix. A small amount of bleeding during the days or hours leading up to the onset of labor is common and called “bloody show.”
Dilatation is expressed in centimeters. I have relatively large fingers, and for my hands, I make the following generalizations:
1.5 cm: One finger fits tightly through the cervix and touches the fetal head.
2.0 cm: One finger fits loosely inside the cervix, but I can’t fit two fingers in.
3.0 cm: Two fingers fit tightly inside the cervix.
4.0 cm: Two fingers fit loosely inside the cervix.
6.0 cm: There is still 2 cm of cervix still palpable on both sides of the cervix.
8.0 cm: There is only 1 cm of cervix still palpable on both sides of the cervix.
9.0 cm: Not even 1 cm of cervix is left laterally, or there is only an anterior lip of cervix.
10.0 cm: I can’t feel any cervix anywhere around the fetal head.
Effacement is easiest to measure in terms of centimeters of thickness, ie., 1 cm thick, 1.5 cm thick, etc. Alternatively, you may express the thickness in percent of an uneffaced cervix…ie, 50%, 90%, etc. This expression presumes a good knowledge of what an uneffaced cervix should feel like.
Always remember to talk to your healthcare provider and get their opinions/advice before you try anything. They most likely will have a better understanding of your body specifics than I do (I probably have not checked your cervix before), and she can probably give you better guidance on where your cervix is etc. Also, PLEASE do not try this if your water is already broke or you think it might have broke. We dont need to be introducing any risks of infection here. Remember that these blogs should not be substituted for medical advice, and this is a controversial topic and some providers are against self cervical exams, or you may have extenuating circumstances that may put you at increased risk of complications. Please be safe and know what your provider recommends first. Good luck!