How to Measure Cervical Progress in Labor

By Heidi Gonzales

How to Measure Cervical Progress in Labor. In labor, we seem to focus on just one factor when it comes to progression: the dilation of the cervix. We tend to believe that each time the doctor checks the cervix, it should be two or three centimeters further and then we are extremely disappointed when it isn't. What many women fail to realize is that dilation isn't the ONLY number they should be concerned with to measure progression. The cervix makes progression in four ways: position, softening, effacement and dilation. Read on for the additional steps to observing your progress.

Check the position of the cervix. The first change that the cervix makes is positioning. Before labor, the cervix is usually high and posterior, meaning it points toward your back. As you get closer to labor, your cervix begins to move lower and forward into an anterior position. This can happen a few weeks before, a few days before, and perhaps even during the early part of labor.

Check to see if the cervix is softening. The second change is that the cervix will soften. Typically, the cervix feels like the tip of your nose, which is sort of firm. As you get closer to labor, prostaglandins will help to soften your cervix so that during a vaginal exam, it will now feel squishy, not firm. Semen also helps to soften the cervix.

Check for effacement. The third change is that the cervix will efface, or thin out. This means that the length of the cervix shortens. Effacement is measured in percentages. 0 percent means that the cervix has not thinned at all. 50 percent means the cervix is about half the length that it was. 100 percent means that the cervix is paper thin and marks the completion of the effacement phase.

Check for dilation. The fourth and final change is dilation, or opening of the cervix. Dilation is checked during a vaginal exam and is measured in centimeters. Measurement begins at zero centimeters dilated to 10 centimeters. Ten centimeters is the point at which you'll be encouraged to push.

Tip

Remember that advancement in any of these areas signals progression. The cervix sometimes opens quickly, or it can take many hours. Many things affect the progression of labor, including emotional situations, physical discomforts and which baby this is for you. Before making a decision to augment your labor or have a cesarean due to "lack of progress," ask the doctor if there have been any changes in your cervix in any of these areas. Don't get stuck on the "dilation" number. Follow the above steps for observing progression in the other areas.

Warning

Once your water breaks, your exams may be limited to prevent infection.

About the Author

Heidi Gonzales is a midwife, childbirth educator, doula, American Heart Association BLS instructor, author and editor for the Childbirth and Postpartum Professional Association e-mag. She left the Navy after 10 years to pursue her passion in birth work. She has attended over 60 births in Louisiana and has helped over 150 families through birth consultations. She volunteers as a childbirth educator at a pregnancy crisis center in Louisiana and also as an online career mentor.