Cervix During Pregnancy Week by Week

The Perfect Labor Cervix – Short, Squishy, Paper Thin and Opening

 We live in an age obsessed with vaginal examinations.  Some caregivers start them as early as 37 weeks to ‘check’ and see if anything is happening.  A VE (vaginal exam) will tell you and your caregiver what your cervix looks like at this moment in time and I can tell you that can change in an hour!  Pre labor examinations are unnecessary and uncomfortable and won’t tell you when labor will begin or how long it’s for.  If you’d rather not have one – keep your underwear on during your prenatals.   Some care providers take these exams as an opportunity to stretch the cervix which is a form of induction so be sure to let your care provider know if you prefer to not have this procedure performed if you opt to have a vaginal check.  I’ve known moms to have an examination at 38 weeks and are already 4cm dilated and go to 41 weeks. Then there’s the moms who’ve been told ‘there’s nothing happening – your cervix is closed and tight’. You don’t have a dilated cervix, you don’t have a ripe cervix, you don’t have a soft cervix - yet you find yourself in labor and delivery the next day!

(Pre-labor cervical checks can sometimes result in bloody show and cramps for some moms).

What Does a Cervix Looks Like & How to Visualize the Cervix Dilation?

Cervix dilation can be hard to imagine. Try this - visualize the uterus like a balloon and the cervix is a thick collagen knot in pregnancy – keeping your baby safe.  The hormone prostaglandin starts to loosen, soften and open that knot for your baby as your body prepares for labor.  Imagining your cervix simply melting away can be helpful…or soft like a cashmere turtleneck with no resistance.

Cervix feels Soft and Squishy - Shortening and Thinning of the Cervix

Shorten and Become Squishy:  In those last few days and during labor itself there is a LOT going on with your cervix.  It has to thin/efface from 0 – 100% effaced.  This means it gets nice and stretchy before it opens (dilates) in a first time mom.  If you’ve given birth before it can all happen at once.  I’ve seen 2nd time moms ‘jump’ from 3 to fully dilated in 15 minutes (so once those surges become regular you may want to get moving to your place of birth or call your midwife).  

You might prefer to do a vaginal check yourself (or with the help of your partner) – see my blog here on the cervical check topic here. We’re obsessed with dilation and tend to forget that there are changes happening too at the top of the uterus (Fundus).  It has to thicken so it becomes a piston to push your baby out (without a huge amount of effort from you which is pretty cool). Some people even have a purple line between their butt cheeks to see how dilated they are and how deep in the pelvis baby is.

If you’re hoping to labor at home for a while keep in mind that a cervix that is effacing is progress! If you were 20% effaced yesterday and are 80% today – go you!!!   The hormones are doing a great job melting down those collagen fibers. 

Does your Cervix Move & How Quickly Can the Cervix Change from Posterior to Anterior Position?

Move: Yes, the cervix has to change direction.  Your cervix also has to move from a posterior position to a more central position.  If you feel like your careprovider is trying to reach your tonsils then chances are your cervix is still facing towards the back and attempts to pull the cervix forward can be extremely painful. Use Breathing for Vaginal Examinations in the GentleBirth App before the examination begins (listen to it ahead of time so you’re familiar with the imagery and breathing).

What is Full Dilation of the Cervix? 10cm, 9cm or 11cm?

Dilate: Full dilation in the textbooks is estimated to be 10cm however depending on your baby’s size full dilation for you might be 9cm or it could be 11. Vaginal exams are not an exact science - your dilation can even be recorded differently depending on the width of your providers fingers.

Does a high cervix mean labor is far away?

It’s one of those things. You can have a high posterior cervix and think you’ll never go into labor and give birth the next day. You can have a low, high, or average height cervix. A high cervix generally refers to a cervix that is more than three inches (7.62 cm) inside the vagina. If you’ve ever had a sweep attempted on a high posterior cervix it can be very uncomfortable (if you tried to find it yourself you might not have been able to reach).

Hope this was helpful! Read more about cervical exams here and don’t forget to start your perineal massage!