How to Check Your Own Cervix for Dilation?
(First published - Sept 2019…before social distancing).
Not for the Squeamish but Might be for the Curious
Text message received by Mom2Be at 40 weeks + 3 days
Anything happening?
Mom - Cervix is squishy and 2cm :)
Friend - Didn’t know you had a prenatal today would have met u for coffee.
Mom - No OB appointment today – back on Tuesday if no baby
Friend - So how do u know ur 2cm?
Checked my cvx myself this morning
Friend - :-O
Ok, so this is an imaginary conversation but there is a growing trend of Moms taking their healthcare into their own hands – literally. It comes up in almost every workshop I teach and given what’s happening in the world right now getting to know your cervix close to full term might help some you stay out of the hospital a little longer. In the ‘good ol’ days’ before Covid, research was published recommending parents stay out of the hospital until you were at least 4-5 cm to significantly reduce your chances of having an unplanned cesarean or medication (if you were planning on not having meds). Now there’s the added benefit to help limit your exposure to Covid-19 and other hospital bacteria. Plus with some hospitals still restricting partner support spending more time at home has it’s benefits.
It can be a helpful way of gaining information about changes that are happening and can help you make decisions in labor. If you’ve had fertility challenges before becoming pregnant this is probably already familiar terrain for you especially if you’ve followed natural fertility methods to become pregnant. Some moms do it weekly at 38 weeks out of curiosity when they’re doing their perineal massage.
Not something you’d considered before? Read on.
What does a Dilated Cervix feel like?
During your monthly cycle your cervix changes in consistency and position (yes it moves!). Getting used to what your cervix feels like during pregnancy means you are aware of the changes taking place in the lead up to labour – and during the birth process itself….(shortening/thinning)effacement of the cervix, (position) the cervix moves forward and it opens – dilates.
Somehow a woman touching her own cervix seems to be a taboo for many. Ironically it seems to be more acceptable for a complete stranger (or several strangers) to explore this area in a clinical capacity in the name of medicine but suggesting to a woman to do the same exam herself or have her partner help her often results in a strong reaction.
Why do we feel so negative about exploring our own bodies in a sensitive way in the privacy of our own homes?
How to find your Cervix
Finding your cervix for the first time can be challenging but every woman can find her own cervix with a little patience and practice. Trust me – it’s in there! Squatting seems to be the position of choice for most women.
Start Here!
(Please use common sense - checking your cervix is not advised if you have been having bleeding during your pregnancy or have been diagnosed with placenta previa)
A US student midwife has created a website of pictures of her cervix taken at the same time each day - http://beautifulcervix.com/ (a few of my pics are there). A pregnant cervix is usually much darker in colour due to increased blood volume.
What do Birth Professionals Think?
Personally - anything that helps a mom learn more about her body to help her make decisions about her labor is great. Many of my midwifery and doula colleagues agree. However when you arrive at hospital and announce that you’re a ‘stretchy 4’ - be prepared for some interesting looks… Also - depending on where you live you might be offered a vaginal exam at your 38 or 39 week appointment? Do you have to have these vaginal checks ahead of labor? Nope.
Check your own cervix for dilation, it’s not rocket science
"I think it's an empowering thing for a woman to check her own cervix for dilation. This is not rocket science, and you hardly need a medical degree or years of training to do it. Your vagina is a lot like your nose- other people may do harm if they put fingers or instruments up there but you have a greater sensitivity and will not do yourself any harm.
"The best way to do it when hugely pregnant is to sit on the toilet with one foot on the floor and one up on the seat of the toilet. Put two fingers in and go back towards your bum. The cervix in a pregnant woman feels like your lips puckered up into a kiss. On a non-pregnant woman it feels like the end of your nose. When it is dilating, one finger slips into the middle of the cervix easily (just like you could slide your finger into your mouth easily if you are puckered up for a kiss). As the dilation progresses the inside of that hole becomes more like a taught elastic band and by 5 cms dilated (5 finger widths) it is a perfect rubbery circle.
"What's in the centre of that opening space is the membranes (bag of waters) that are covering the baby's head and feel like a latex balloon filled with water. If you push on them a bit you'll feel the baby's head like a small hard ball If the waters have released you'll feel the babe's head directly.
OK - if actually touching your cervix isn’t for you - maybe a visual can help?
If the thoughts of checking your own cervix isn’t appealing but you’d still like to be able to see if you are beginning to dilate before leaving for the hospital Moms can purchase sterile plastic speculums online - here You’ll still need the help of a partner to tell you what they’re seeing.
5 ways to estimate & check cervix dilation without an internal examination
Fully dilated = anal pouting (the rectum looks like it’s trying to air kiss).
Passing stool involuntarily (poop happens and it usually means baby is close). You just can’t help yourself but to bare down and go with those urges.
The purple line (Hobbs line) that creeps up like a mercury thermometer from anus to top of bum crease. When it reaches the top, the woman is fully dilated (increase in intrapelvic pressure affects bloodflow in the sacral area). The trick here is to check any line you already might have and it can be harder to see in darker skin.
Hobbs line
During a surge the uterus swells upwards as it pulls in the dilating cervix. Before labor at full term you can get about 5 fingerbreadths of measurement between the fundus and the tip of the breastbone (xyphoid). As labor progresses this measurement decreases at about 2 cms per fingerbreadth. I.e., 1 1/2 fingerbreadths between these two points would be equal to 7-8 cms dilation.
The sounds you make also help skilled nurses/midwives/doulas estimate where your labor is….we’re always listening out for the slight catch in the throat as you start to bare down involuntarily at the end of a surge…you might be asked “are you feeling pressure? Do you feel like you need to poop?”
And of course there’s ‘the face’….. (birth partners say vigilant!)
If we can learn to see our bodies as our friend rather than our enemy we’re in a great position to accept the wisdom our bodies are only too delighted to share with us – if we want it.
Your cervix is at your service!
If you’re anxious about cervical exams in labor try the GentleBirth ‘Easier Vaginal Examinations’ breathing practice in the GentleBirth App(iOS & Android) - you can read about it here.
Learn more in the ultimate guide to birth - GentleBirth - Your Positive Birth Begins Here (free in the GentleBirth app).
So? Never ever - or maybe? Would you try checking your own cervix in labor to stay home longer?
*Please note - if you have had a complicated pregnancy and your careprovider wants you to come in as soon as labor starts be sure to follow your careprovider’s advice*
Tracy