No.

In fact you don’t need to have your cervix checked IN labor never mind before labor but that’s a whole other post.

When do cervical checks start in pregnancy?

If you’re in the US it’s quite likely that your OB will suggest a ‘quick check’ to see what’s happening starting around 37-38 weeks. In some parts of the world cervical checks are done throughout pregnancy. It is often assumed that expectant parents want this check but more parents are beginning to question the reasoning behind these vaginal examinations especially when you’ve had a healthy well pregnancy.

Should I get my cervix checked at 38 weeks?

Why are cervical checks necessary? - They’re not. A cervical check at 38 weeks will tell you what your cervix looks like on that Tuesday afternoon at 2pm. For most expectant moms it has no predictive value of when labor will start or how long your labor will last - unless you find out you’re 9cm (which isn’t very likely - but wouldn’t it be lovely!). It’s your cervix not a crystal ball. I’ve said this before - you could be 10% effaced with no dilation - leave your Doctor’s office feeling totally deflated…and have your baby in your arms later that night - or you could be 4cm and fully effaced with nothing more than period pain and STILL go 41 weeks.

Is a Cervical Check the same as a Memebrane Sweep?

A cervical check is not the same as a sweep which is considered a form of induction.

What Are The Doctors Actually Checking For?

• Effacement - how thin and stretchy your cervix is (it’s measured in percentages).

• Dilation - if your cervix has started opening. In a first time mom effacement happens first and then dilation.

• Position of your cervix - as your body gets ready to go into labor your cervix moves from a posterior position.

There’s so much happening quietly behind the scenes as labor approaches. Some moms notice mild crampiness but most don’t feel anything noticeable in those last few important days.

Are There Any Risks To Cervical Checks?

One of the biggest risks is your bag of waters releasing. One old study that compared the rate of early waters breaking (before labor) recored it happening in 6% of the group without vaginal exams, and for women who had weekly vaginal exams it went up to 18%. That’s significant. If your waters release accidentally that means you’re on the clock due to the risk of infection and if you don’t go into labor then that induction you were hoping wouldn’t happen is now going to be suggested. But another study suggested no difference. I wonder if some of these women had cervical sweeps and not just a simple check especially if they experienced spotting after. Sweeps without consent are not uncommon.

An 2018 study suggested mothers who had prenatal vaginal examinations were more likely to have babies with Group B Strep (a rare but life threatening complication). Why is that? Well, bacteria is being pushed up into the cervix. Similarly other bacteria can be moved into the cervix causing the waters to release early. If you’re in a country where GBS screening is routinely done such as the US and you’re found to be positive you’ll be offered antibiotics in labor. But in may countries there’s no universal screening these prenatal examinations may put your baby at risk.

Can a cervical exam start labor?

If your body is just about ready to start labor then yes. Any contact with the cervix has the potential to release prostaglandins and kick start the process. The more aggressive the exam the more painful it’s likely to be and the higher the likelihood that labor will start. This might sound like a good idea if you’re tired of being pregnant or are being offered a routine chemical induction at 39 weeks.

Here’s the thing - labor relies on the orchestration of so many different factors, hormones, baby’s position, and baby’s readiness to be born (lungs and brain readiness). If you’re full term and curious about what’s happening behind the scenes but don’t want to induce labor at your prenatal appointment be very clear with your provider that you do not want to have a cervical sweep or use your mindfulness practice to ride that wave of curiosity and trust that your body and baby will know when the timing is right.

Other Considerations.

Lubricant used in routine examinations changes your vaginal flora - read more here.

If your cervix hasn’t moved to a more central position it can be very very uncomfortable for your careprovider to reach your cervix (it can feel like they are reaching for your tonsils…). If you’re planning an unmedicated birth or want to push the epidural to later in your labor the stress and pain of the check can make you doubt your coping ability. In labor you have those brilliant labor hormones - but they’re not there at 2pm in your Doctor’s office.

If you’ve experienced sexual abuse you may find these checks to be triggering.

When Might a Cervical Check At Full Term Be Helpful?

You might just want to know what’s going on and if there have been any changes. That’s as valid a reason as any but if you’d rather not have a cervical sweep be sure you tell your careprovider. Or if you’re past 40 weeks and are discussing induction with your careprovider - but it’s still your decision.

How to Make a Cervical Check a Little Less Stressful?

• You should always have a chaperone with you when having a vaginal exam.

• You are always in control - at any point you can ask your careprovider to stop.

• Some women find it helpful to put their fists under the cheeks of your backside (especially if the cervix is far back). If you have any trouble with your hands a rolled up towel can help (this can be helpful in labor too).

• Use the Breathing for Vaginal Exams session during the check or Relaxing breath.

If you’d rather not have these checks simply say ‘no thanks - maybe next week’.

Hope this was helpful.

Tracy

Research

https://www.nature.com/articles/s41372-018-0182-z

https://link.springer.com/article/10.1007/s10096-018-3416-2

https://link.springer.com/article/10.1007/s10096-018-3416-2