Oh the dreaded cervical exam... One of the more universally annoying parts of the late pregnancy doctor visits is the cervical checks. No one is a fan. Get into labor, and it's even MORE annoying. But as we women do, we suck it up and deal, "because we have to". But what if I told you that you don't *have* to have cervical checks? Let's get started by talking about what a cervix even is and why we check them.... Your cervix is the opening between the womb and birth canal (ie. Uterus and Vagina). During pregnancy, your cervix is thick, high, and closed tight to protect your baby. Some people would describe it as feeling similar to the cartilage at the tip of your nose. However, as your body prepares to birth, the cervix becomes softer, thinner, and begins to open. Providers will often do an internal exam using their fingers to measure the cervical opening diameter (dilation), thinness (effacement) and baby's station (location in pelvis). A lot of people do get excited for a cervical check, don't get me wrong. It can be exciting to hear if your cervix is dilated or effaced at all. But knowing that data doesn't actually mean ANYTHING in the majority of situations. Your Cervix Is Not A Crystal Ball. A closed and tight cervix does not mean you won't go into labor any minute. An open and soft cervix does not mean you will go into labor any minute. It is important to maintain open communication with your provider and determine if a cervical exam is medically necessary or just "preferred". In a healthy, low risk, term pregnancy, a cervical exam is not typically medically necessary. The data from a cervical exam can be useful when discussing options for medical induction (we call this the Bishop's Score)
During labor, a cervical exam can be helpful in deciding if you are ready to be admitted to the hospital. Cervical data can also be helpful when determining if you want to utilize pain medications. If your baby seems to be in a "funky" position, your provider can sometimes better determine position by feeling your baby's head during a cervical check. But, as with everything, it is ultimately your decision to proceed with cervical checks or not. So in order to make an informed decision, you need to know the Benefits and Risks!
Benefits of Cervical Checks
Data could be helpful if you need to make a decision
Could help understand baby's position
May be encouraging to hear how much progress you have made with all of your hard work
Risks of Cervical Checks
Increased Risk of infection, especially if waters are broken
Accidentally breaking your water
Could be discouraging if you haven't progressed as much as you had hoped after lots of hard work
Things to consider
If you have a history of sexual trauma, how would cervical exams make you feel during this vulnerable time?
Cervical exams can trigger bleeding and contractions. This is typically not considered dangerous, however it is important information to be aware of. If you're coping really well with labor, how will you feel getting a routine cervical check
What if you've been laboring "in the zone" for hours and get a cervical check and your provider discloses that after all your hard work you're "only" 3 centimeters, when you were hoping to be 9 centimeters?
How often will your provider want to check your cervix during pregnancy? During labor?
Cervical dilation does not happen at a specific "pace". Some people could dilate from 0cm to 10cm in 2 hours, while others could take 4 hours to get from 2cm to 4cm.
Being 10cm dilated does NOT mean it is necessarily time to push. How would you feel if you were instructed to expend energy pushing when your baby and body may not be ready?
Questions for your provider:
How would you feel if I declined a cervical exam during pregnancy?
What would happen if I declined a cervical exam during labor?
As always, remember, you are in the driver's seat. You can make the decisions about what happens to your body during pregnancy and birth. Talk to your provider about your wishes and concerns during pregnancy to avoid any frustrating or unnecessary conversations during labor. Don't forget to practice thinking with your BRAIN (Benefits, Risks, Alternatives, Intuition, Now/Never)
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As always the information in this blog is intended for information and education purposes only. This information is intended to be used as a starting point for more research and discussion with your provider. This is not intended for medical purposes. Please direct all questions and concerns to your healthcare provider.
Jaimie Zaki, owner of Little Bear Services, LLC is a Birth Photographer, Labor Doula, & IBCLC serving families in South Jersey and Central New Jersey. Mother of three, military wife, and lover of coffee, Jaimie enthusiastically supports hospital and home births in Burlington County, Camden County, Mercer County, Atlantic County, Ocean County in New Jersey. If you reside outside of this service area, there are online courses and virtual support packages available! Jaimie is excited to serve your family! Learn more about Jaimie and the services she offers!
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