Cervical checks during labor are a common practice that medical providers use to assess the progress of labor. While they can provide valuable information, there are also risks associated with cervical checks. In this article on PregnancyBoss, we will explore the reasons why medical providers perform cervical checks during labor, what information they can provide, and the limitations of this practice. We will also discuss signs and symptoms to suggest cervical dilation is occuring and how to know if your cervix is dilated without an exam. Understanding cervical checks during labor can help you make informed decisions about your birth plan and ensure the best possible outcome for you and your baby.
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Understanding Cervical Checks During Labor
Reasons why medical providers perform cervical checks during labor?
Medical providers perform cervical checks during labor for several reasons. Here are some of them:
- To assess labor progress: Cervical checks can help healthcare providers determine if labor is progressing as expected and if the woman is ready to push.
- To assess the baby’s position: Cervical checks can help healthcare providers determine the position of the baby in the pelvis, which can be important for determining the safest way to deliver the baby.
- To check for complications: Cervical checks can help healthcare providers identify any complications that may arise during labor, such as a prolapsed cord or a cervical lip.
- To make informed decisions: Cervical checks can provide helpful information that can help women and their healthcare providers make informed decisions about their labor and delivery.
- To determine if labor has started: During prenatal appointments, cervical checks can help healthcare providers determine if labor has started or if a woman is experiencing false labor.
What does a cervical check measure?
During a cervical check, a healthcare provider measures several aspects of the cervix. Here are the measurements that a cervical check can provide:
- Length of the cervix
- Dilation of the cervix, which is how “open” the cervix is
- Effacement of the cervix, which is how thin the cervix is
- Station of the presenting part of the baby in the pelvis, which is how far down the baby’s head is in the pelvis
- Position of the baby in the pelvis
- Consistency of the cervix
How are cervical checks done?
Here are the steps involved in a cervical check during labor:
- Verbal consent: The healthcare provider should obtain verbal consent from the woman before performing a cervical check.
- Sterile gloves: The healthcare provider will put on sterile gloves to prevent infection.
- Two fingers: The healthcare provider will insert two fingers through the vagina into the cervix.
- Assess dilation: The healthcare provider will assess the dilation of the cervix, which is how “open” the cervix is.
- Assess effacement: The healthcare provider will assess the effacement of the cervix, which is how thin the cervix is.
- Assess station: The healthcare provider will assess the station of the presenting part of the baby in the pelvis, which is how far down the baby’s head is in the pelvis.
- Assess position: The healthcare provider will assess the position of the baby in the pelvis.
- Assess consistency: The healthcare provider will assess the consistency of the cervix.
- Record findings: The healthcare provider will record the findings of the cervical check in the woman’s medical chart.
Related: Mucus Plug In Toilet After Peeing
What is the position of the patient during a cervical check?
During a cervical check, the position of the patient can vary depending on the healthcare provider and the woman’s preference. Here are some possible positions for a cervical check:
- Lying on your back with your legs bent, feet together, and knees apart
- Lying on your side with your knees bent and a pillow between your legs
- Squatting or standing with support
- Leaning forward on a bed or table with your knees bent
Related: What Is The Miles Circuit To Induce Labor?
Are cervical checks painful?
Cervical checks during labor can be uncomfortable or even painful for some women, while others may not experience any discomfort at all. Here are some of the experiences women have reported:
- Cervical checks tend to be a sharper, shorter pain, although some women may experience cramping afterwards.
- The level of discomfort can depend on the position of the cervix, with a more posterior cervix being more uncomfortable.
- Some women have reported that cervical checks become less painful as labor progresses and the cervix moves down.
- Relaxing, pressing down, raising hips, and wiggling can help make vaginal exams less painful.
- Women who have a history of trauma or pelvic floor pain or dysfunction may find cervical checks to be painful or uncomfortable.
- Some women may not experience any discomfort during cervical checks.
Related: Castor Oil To Induce Labor
How to make cervical checks less painful?
Here are some tips to make cervical checks less painful:
- Relax: Staying relaxed and allowing your butt to stay flat on the bed can make the exam faster and less painful.
- Breathe: Taking deep breaths and focusing on your breathing can help you relax and manage any discomfort.
- Ask for support: Bringing in your partner, your mom, or a good friend can help distract you and provide emotional support during the exam.
- Change positions: Changing positions, such as squatting or standing with support, can help make the exam less painful.
- Communicate with your healthcare provider: Let your healthcare provider know if you are experiencing any discomfort or pain during the exam. They may be able to adjust their technique or provide additional support to make the exam more comfortable.
How long does a cervical check usually take?
A cervical check typically takes only a few minutes to complete.
What are the limitations of cervical checks?
Cervical checks during labor are not risk-free and have some limitations. Here are some of the limitations of cervical checks during labor:
- Discomfort for the woman: Many women find cervical checks very uncomfortable or even painful.
- Disruption to the labor process: Cervical checks can disrupt the labor process, especially if they are performed too frequently or if the woman is not relaxed during the exam.
- Increased risk of infection: Cervical exams can increase the risk of infection, even when performed carefully and with sterile gloves.
- Possible premature rupture of membranes: An exam may increase the risk of premature rupture of membranes.
When could it be a good time to get a cervical checks during your labor timeline?
Here are some instances when it could be a good time to get a cervical check during your labor timeline:
- To assess labor progress: Cervical checks can help healthcare providers determine if labor is progressing as expected and if the woman is ready to push.
- To assess the baby’s position: Cervical checks can help healthcare providers determine the position of the baby in the pelvis, which can be important for determining the safest way to deliver the baby.
- To check for complications: Cervical checks can help healthcare providers identify any complications that may arise during labor, such as a prolapsed cord or a cervical lip.
- To make informed decisions: Cervical checks can provide helpful information that can help women and their healthcare providers make informed decisions about their labor and delivery.
When could be a good time to decline a cervical checks if you are wanting to limit them?
If you are wanting to limit cervical checks during labor, there are several instances when it could be a good time to decline them. Here are some of them:
- If you have a history of sexual abuse or sexual assault: Cervical checks can be very deep and profound, especially for women who may have a history of past sexual trauma or abuse.
- If you are uncomfortable with them: Cervical checks can be uncomfortable or even painful for some women, and they can disrupt the labor process if performed too frequently or if the woman is not relaxed during the exam.
- If you are at low risk for complications: If you are having a low-risk pregnancy and labor, you may not need cervical checks as frequently as someone who is at higher risk for complications.
- If you are not interested in knowing your cervical dilation: Some women may prefer not to know their cervical dilation and would rather rely on other signs of labor progress.
How often are cervical checks performed during labor?
Cervical checks are usually performed every 2 to 3 hours during labor unless concerns arise and warrant more frequent exams. However, the frequency of cervical checks can vary depending on the healthcare provider and the stage of labor. For instance, some providers may initiate routine exams earlier or later, while others may not perform a vaginal exam until the woman is in labor. Additionally, some providers may perform cervical checks more frequently if the woman has a specific medical condition or if complications arise.
Can cervical checks induce labor?
Cervical checks themselves do not typically induce labor. However, they can sometimes trigger contractions or cause discomfort, especially if the cervix is already somewhat ripe or if the examination is particularly vigorous. These contractions, known as “Braxton Hicks” contractions, are usually not strong or regular enough to initiate full-blown labor.
In some cases, if a healthcare provider performs a cervical check when a person is already in early labor, it may coincide with the natural progression of labor and could potentially make the contractions feel more intense. However, it’s important to note that the cervical check itself is not the cause of labor; it’s just a way to assess the progress of labor that is already underway.
How to know if your cervix is dilated without an exam?
It’s generally not possible to accurately determine the extent of cervical dilation without a medical examination, as it requires a healthcare provider to assess the cervix’s opening manually. However, there are some signs and symptoms that may suggest cervical dilation is occurring, but these are not precise indicators and should not replace a professional evaluation.
What are signs and symptoms to suggest cervical dilation is occuring?
There are several signs and symptoms to suggest cervical dilation is occuring. Here are some of them:
- Change in contraction: Women in early labor tend to move and talk through their contractions. When they stop to concentrate or focus, it may be a sign that labor is progressing.
- Belly is higher: As the baby moves down into the pelvis, the belly may appear higher. This can be a sign that labor is progressing.
- Bloody show: The release of the mucus plug, which can be tinged with blood, can be a sign that labor is progressing.
- The Purple Line: The purple line is a line that appears on the skin between the anus and the vagina. As labor progresses, the line moves up towards the vagina, indicating that the baby is descending.
- Leg check: The midwife or healthcare provider can check the tension in the muscles of the upper leg. If the muscles are relaxed, it can be a sign that labor is progressing.
- Vocalization, focus, movements: Women in labor may become more vocal, focused, and move around more as labor progresses.
Cervical check vs. membrane sweep
Cervical check and membrane sweep are two different procedures that are often performed during pregnancy and labor. Here are the differences between the two:
Cervical Check:
- A cervical check is a procedure where a healthcare provider inserts two fingers through the vagina into the cervix to assess the dilation, effacement, station, position, and consistency of the cervix.
- A cervical check is used to assess labor progress, determine the position of the baby in the pelvis, check for complications, and make informed decisions about labor and delivery.
- A cervical check is usually performed every 2 to 3 hours during labor unless concerns arise and warrant more frequent exams.
Membrane Sweep:
- A membrane sweep is a procedure where a healthcare provider sweeps a gloved finger across the membranes that connect the amniotic sac to the wall of the uterus.
- A membrane sweep is performed once the cervix has begun to dilate and can’t be done if the cervix is still closed.
- A membrane sweep helps release prostaglandins, which can trigger the uterus to begin contracting and potentially put the woman into labor.
- A membrane sweep can be uncomfortable or slightly painful, and it can cause vaginal bleeding or spotting, accidental rupture of membranes, and painful contractions.
Related: What Is Membrane Stripping?
Are cervical checks necessary?
It’s a complex question. Are cervical checks essential? Not typically in most cases. However, when employed judiciously, they can serve as a valuable evaluation method to steer the direction of labor and tailor the care plan to better match the patient’s requirements.
Conclusion
Understanding cervical exams during labor can provide important information about labor progress and the position of the baby, but they are not always necessary and can be uncomfortable or even painful for some women. It is important to communicate your wishes with your healthcare provider and understand the potential benefits and harms of cervical exams during labor.
Frequently Asked Questions (FAQs)
Can cervical checks induce labor?
Cervical checks do not induce labor, but they can cause discomfort or even pain for some women. It is important to communicate your concerns with your healthcare provider.
Can I refuse cervical checks during labor?
 Yes, you can refuse cervical checks during labor. However, it is important to communicate your wishes with your healthcare provider and understand that cervical checks can provide important information about labor progress and the position of the baby.
When do doctors start checking for dilation?
Doctors may start checking for dilation during the last part of pregnancy, often starting at around 36 weeks, although some providers may initiate these routine exams earlier or later. During labor, cervical checks are often done during transition or when you start pushing to see if the cervix is fully dilated.
