The Pre-labor Cervix is not a Magic 8 Ball 52
Each week, I get at least half-a-dozen searches to the blog related to pre-labor cervical dilatation.
Search terms/phrases like:
- dilated to a 4 and not in labor
- 0 cm 0 % effaced induction?
- 39 weeks and not dilated
- can you go into labor without your cervix being dilated?
- is it bad to have an “unfavorable cervix?”
- 37 weeks pregnant why aren’t I dilating?
And so on.
Whenever I read these phrases, I always feel a bit sad and mystified. Why are women so worried that their cervix isn’t dilating before labor? Who is making them feel as if their bodies are inadequate, or not cooperating, or unprepared for birth? Are they being misled by friends, family, popular culture, or even their care providers? How many of them even have a legitimate medical reason (such as threatened premature labor or impending medically-necessary induction) for their pre-labor vaginal exams?
Here’s the thing: your pre-labor cervical dilation is not a Magic 8 Ball. It cannot predict when you will go into labor.
Just ask around, and I’m sure you’ll find plenty of women (like myself before A’s birth, and like my mother before she gave birth to me) whose cervix was 0 centimeters dilated and 0% effaced less than 24 hours before their labors began.
I’m sure you’ll also find plenty of women (like my mother before my sister’s birth) whose cervix was 2, 3, 4, even 5 centimeters dilated for days, even weeks before their labors began.
And all of their pre-labor cervical dilatation (or lack thereof) was completely normal.
You might wonder, then, why care providers even perform vaginal exams prior to the onset of labor.
In some cases, there are legitimate reasons to evaluate cervical dilatation before labor. Some medical conditions (such as threatened premature labor and/or suspected “incompetent cervix”) might warrant a pre-labor vaginal exam. In addition, if a woman is planning an induction, it is crucial to know not only her cervical dilatation but also her cervical effacement, consistency, position, and the baby’s station so that her care provider can evaluate her Bishop’s Score. (The higher the Bishop’s Score, the greater chance of a successful induction–or one that ends with a vaginal birth. The lower the score, the greater the chance that the induction will end in a cesarean section, especially if this is the woman’s first birth.)
But other than these medical indications, most other pre-labor vaginal exams are performed either out of habit or to satisfy a woman’s curiosity–that is, without medical reason.
And in these cases, that “magic number” (only 1 cm? already 4 cm?) cannot predict when a woman will go into labor–no matter what your family, friends, or care provider tell you!
So for those people who have found my blog using the aforementioned (or similar search terms), and to all of my readers who wonder just what sort of fortune-telling powers your cervix has prior to labor, I want you to gather ’round.
Closer.
Closer.
It is completely normal for your cervix not to have dilated by 37 weeks, 38 weeks, 39 weeks, 40 weeks, and even after your estimated due date!!!
There. Is. Nothing. Wrong. With. Your. Body.
Allow me to say that one more time.
THERE IS NOTHING WRONG WITH YOUR BODY!!!
So in sum, if there is a medical indication for a pre-labor cervical check, then by all means, consult your care provider about your medical condition and determine the relative necessity of your exam.
And please, please learn your Bishop’s Score before an induction, especially if you are planning a non-medically necessary induction!
But if there is no medical indication for a pre-labor vaginal exam, then know that it is entirely within your right to refuse to have such an exam! (One of the best ways to refuse a pre-labor vaginal exam–besides politely telling your care provider that you do not want one–is to keep your clothes on in the exam room!)
And if you’d still prefer to have this exam–just to satisfy your curiosity (and trust me, I understand this curiosity completely)–then please remember that the number (or numbers) you hear at the end of the exam are not surefire predictors of when your labor will begin.
They’re not achievement awards or performance measures or signs on the Magic 8 Ball: they’re simply signals of the changes that your body is going through, or will go through soon.
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Did your cervix not dilate until you went into labor? Were you walking around for days or weeks with a cervix dilated to 2, 3, 4, 5…or even 8? Did you discuss your Bishop’s Score with your care provider before your induction? Do you wish you would have?
