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cervical dilation 101: frequently asked questions March 11, 2007

Posted by guinever in : birth, birth stories, doula, health, labor, pregnancy , trackback

What is the cervix? The cervix is the bottom part or neck of the uterus. The cervix opens during labor so the baby may pass through the womb into the birth canal and be born.

What is effacement? Effacement is the thinning and softening of the cervix which is measured in percentages. Usually the cervix is long, hard, and closed, and at this point the effacement would be at 0%. Towards the end of pregnancy, Braxton Hicks contractions occur (sometimes you aren’t aware that you’re having contractions) which start this effacement process. Once the cervix starts to efface, then it can start to dilate too. As effacement continues, the cervix softens, becomes mushy, and then slippery. When fully effaced at 100%, the cervix has virtually disappeared against the baby’s head.

What is dilation? Dilation is the opening up of the cervix and is measured in centimeters. A fingertip dilated means about 1 centimeter dilated. Full dilation is 10 centimeters. Once full dilation occurs, the cervix is completely gone and over the baby’s head, and the mother may push the baby out to be born.

What causes the cervix to change? The uterus is a muscle that contracts or tightens. During a contraction, the baby’s head (or other presenting part), pushes down on your cervix, causing it to dilate and efface.

Why does backward dilation sometimes happen and is it normal? First of all, yes it’s normal and is not something to be worried about. Backwards dilation can occur if the baby’s head isn’t pressing as hard on your cervix as it once was. If your labor slows down and you’re not having any contractions, the cervix can close up a little. Don’t worry, once contractions pick up, you’ll soon be dilating again. A change in dilation can occur when someone new is checking your cervix. One nurse’s five cm dilated, 85% effaced may be another nurse’s six cm dilated, 80% effaced.

Feel free to ask a question and then check back later for an answer, but please don’t ask me when I think you are going to have your baby. You will find additional clarification of when your labor may start by reading  What does being 2 centimeters dilated mean?

How long does it take the cervix to dilate 5 centimeters?
For more articles about pregnancy and birth, please refer to my welcome page.

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Comments

1. guinever - December 5, 2009

Dear Laura, failure to dilate is the same thing or at least one component of failure to progress.

2. guinever - December 5, 2009

Dear Farrah, you asked what long and 2 fingers means. The long part would mean that the cervix still has a lot of shortening or effacing to do and 2 fingers means that she was able to insert 2 fingers, meaning 1-2 centimeters dilated.

3. guinever - December 5, 2009

Dear Ashaa,
It is very normal to feel pressure while you’re walking. These are braxton hicks contractions. Hypnobirthing is a wonderful method of childbirth preparation and many women have peaceful, natural births using the techniques. Having mucous is totally normal especially towards the end of pregnancy. Hope you have a wonderful birth.

4. Amanda - December 12, 2009

Hi I noticed that you’ve mentioned that some babies are ready 36-38 weeks and some aren’t ready until 40-44 weeks. Is this related to a woman’s cycle length? For example, would a woman who had a 30 day cycle be more likely to go past 40 weeks than someone who had at 26 day cycle?

Dear Amanda, It is partly related to a woman’s cycle. The estimated due date is based on a 28 day cycle, but if you have a much longer cycle or are irregular, but the doctor still estimates your due date based on your last menstrual cycle (rather than establishing your due date with an ultrasound in the first trimester,) then your due date could potentially be “wrong.”

The other part of what I mean is that simply some babies need more time in the womb than others until they are ready to be born. Just like the hundreds of apples on a tree mature at different rates even though they’re from the same tree–you wouldn’t want to pick them all at the same time because you would end up with some unripe, not very tasty apples.
~blessings, Guinever

5. Rebekah - December 14, 2009

Hello! My name is Rebekah and I have been having extreme back pain along with some abdominal pain. I have also had an increase of vaginal discharge. At 28 weeks I was told that I was dilated 1cm and 40% effaced. My back pain or my abdominal pain has not stopped. I will be seeing my OB this friday, putting me at the 30 week mark. This is also my third child and I have never experienced this with either of my other pregnancies. Should I be concerned? Can you give me any advice? Thank you!

Rebekah, the back and abdominal pain could be that you are carrying the baby extra low and your muscles have been strained. If this is the case, you might be sore for a few more weeks while the muscles heal. Don’t lift your other children or do other heavy lifting. Also, getting on your knees, propping up some pillows and leaning your upper body on them with your butt up in the air will help alleviate the pain by putting the baby in a different position for a while (just trying to describe the position so that it makes sense….)

This is only a possibility and you should definitely discuss this with your doctor on Friday. Sorry you’re in so much pain and I hope the remainder of your pregnancy is much more comfortable. ~blessings, Guinever

6. Michelle - December 15, 2009

I am 28 weeks 5 days pregnant and 4 days ago I went to the hospital due to cramping and a lot of pressure in my pelvic area. The nurse said that i had a slight UTI and that i was also dilated to 1cm. They gave me some medicine for my UTI and sent me home. I went to my doctors appt yesterday and he said that it is normal to be dilating this early because i am having baby number 5. I have also had 2 miscarriages both with d&c’s. The last one was in March 2009. I just was wondering if it is normal to be dilating this early and am i being crazy for feeling like i should be concerned??

Michelle, you’re not crazy at all for being concerned. This is your sweet baby! And yes, with this being baby #5, it’s totally normal and ok to be dilated to a 1. If you feel like you’re opening up more (like increased cervical pressure or having contractions) you can definitly go checked out to make sure. ~blessings, Guinever

7. cherie - January 26, 2010

My due date is tomorrow. I had a doctor appointment this morning. Doctor checked me and I’m 2cm dialated, cervix is soft and babies head is really low. I feel a lot of pressure when I walk around. Is it possible I’m dialating a lot more now, and will go into labor tonight or tomorrow. This is my second pregnancy and my last birth was quick and painless.

Cherie, it’s quite possible that you are dilating more and could be in early labor. Only time will tell. ~blessings, Guinever

8. Alex - February 11, 2010

My due date is Feb. 19, 2010, I had my doctors apt on Tuesday which my ob gave me a membrane sweep to get things going. This is my third pregnancy, I have never gone past 38 weeks and I was wondering is it normal to spot after the membrane sweep. Also, I had intercourse with my husband to see if that would help get things goin and I noticed I had pink discharge. Does this mean that da membrane sweep worked and I’m dialating? I have had some cramping and braxton Hicks increase in pain. Help please.
Thank you,
Alex

Dear Alex, it is totally normal to spot after a membrane sweep. The cramping and extra braxton hicks are a result of the membrane sweep and may eventually lead to labor. Hang in there. You won’t be pregnant for long! ~blessings, Guinever

9. angie - February 15, 2010

hello, i’m a first time mom-to-be and i’m 36 and half weeks pregnant. i had an appointment today (2/15) and the doctor said the baby was sitting really low and that i was 1 cm dilated. my problem is that i’ve been having pains and pressures but i have no idea if these are braxton-hicks or if the baby is just moving around alot. (she’s a very active baby) my doctor and many mom’s have told me that i’ll just know when i’m having contractions. so my questions are: A) is it normal that i have absolutely no idea if i’m even having contractions? and B) even reading up on what contractions are supposed to feel like, i’m clueless! exactly what am i supposed to be looking for?

Angie, when your contractions get stronger and you’re actually in labor, you’ll definitely be able to feel them. Not everyone can feel the braxton hicks contractions. Please read my article on what contractions feel like.
~blessings, Guinever

10. Kayla - February 18, 2010

Hello, first off I love the website! It is very informative. Now my question. I went into the hospital on Sun after having contractions since Sat night starting about 5-6 min apart. They kept getting closer and by sunday morning they were 2-3 min apart lasting 45 seconds to a min and 15 sec.

So Sunday i went in about 3 and I was 1-2cm dialated and baby was a little high. So they kept me and checked me again the next morning around 10 I was 3 cm dialated and baby was very low. the contractions were still the same. They kept me still.

(Might I add that this is exactly how my labor with my first son went he was born at 38 weeks and 2 days. My contractions never really got much worse and I never dialated more then 2-3cm, until my doctor broke my water and then my son went from 2-3 to being in my arms dialating, pushing and all in 18 min)

Anyways so they kept me and checked me at about 3 that afternoon and I was still the same….so i had told them again about what happened with my son and how nothing would progress further until my water was broken.

They said they would not break my water until I am 40 weeks?! Even though the contractions had been doing something they dialated me from 0 – 3 from really high and baby not engaged to really low and baby engaged.

I am 38 weeks and 4 days today and this have been going on since sunday so 5 days. The contractions are still there and I am trying my best to ignore them. But I live 45 min from the hospital and would have to wait to get someone to pick me up to take me.

I am worried about not making it to the hospital, about all the contractions stressing the baby out, about my water not breaking and how long I will have to wait. I have also been feeling alot less movement. Some movement but less so that is also causing me to worry.

So I guess some of that was just a vent but my question is do you think the hospital has done the right thing by sending me home and leaving my water in tact? Is there anything I can do to help things progress or encourage the water to break? Any ideas, suggestions or words of encouragemt would be great. Thank You so much

Also I would like to add that I have been loosing mucus plug, and also having bloody show.

Kayla, I think you’re going to have your baby soon whether AROM is performed or not. (artificial rupture of membranes or breaking your water.) I’m sorry that you’re having all these contractions and they’re not really going anywhere for you. All I can say is soon, you will have your baby in your arms. The only caution I would add is if your baby were still high, breaking the water would not be a good idea, but it sounds like your baby is lower now and engaged? If he isn’t engaged, breaking the water can cause cord prolapse or the cord coming out before the baby. That would result in an emergency c-section.

I wouldn’t worry about the contractions stressing the baby out. They might stress you out mentally, but baby should be fine. Have you talked with your doctor directly or have you only been dealing with the nurses at the hospital? (who then of course communicate with your OB.) Being that far away from the hospital, I would just pay attention to the contractions and if they get a little more intense or if you’re feeling any pressure, get there right away.

I’m surprised that they didn’t go ahead and do AROM given your OB history.
~good luck to you!!! Guinever

11. Kayla - February 18, 2010

Yes he is engaged now. I have been dealing with my OB as well as who ever was on call so it’s a little frustrating. It is also not the OB who delivered my son as he is no longer practicing in the area.

I have been feeling more increased pressure and urinating so much more frequently. As well as alot of rectum pressure making me feel like I need to use the bathroom constantly.

The Ob at the hospital just kept saying it’s so hard to decide what to do we just wish you were 40 weeks it would make it alot easier. I want my baby to be ready and to come out healthy most importantly. But I just feel like my body gets stuck here and that little push would help sooo much, espcially living so far away from the hospital.

Would you think it would be a good idea to have my husband use strile gloves and check my cervix for me? If so what would he look for….how would we know how dialated I was or if baby’s head is there would we feel it. Does it matter how far in we find the dialated cervix and babies head….what should I look for before going back into the hospital? Thank you sooo much for your help!

Kayla, I wouldn’t necessarily recommend your husband checking your cervix because it is a learned skill and he wouldn’t really know what he’s feeling for.
How long have you been having pain in your rectum? Is that a new development? If it is, I really think you should think about heading for the hospital or call your OB and describe what you’re feeling and let them make the call.
You might like this birth story of an unplanned homebirth.
~blessings, Guinever

12. Sarah - February 20, 2010

I am 37 weeks an 2 days pregnant. Lately my stomach has been hurting like a dull throbbing pain an sometimes a sharp stabbing pain to the middle around my belly button. I also have been feeling pressure an a weird feeling in my vagina (Like the Dr. is checking me with a test swab). My friends who have had children say that it’s dialation could that be? I haven’t been feeling any contractions though. But when he moves the pressure an the feeling in my vagina is stronger. Could I be dialating an could labor be right around the corner???

Sarah, Pressure and stabbing pain around belly button sounds like contractions to me=) So yes, I’d say that labor could be just around the corner for you. ~blessings, Guinever

13. JS Lewis - February 20, 2010

Greetings! 2nd child, 30 wks, soft cervix, LOTS of contractions. Bit of background……With my 1st child I had Braxton-Hicks starting at 18 wks, (this one started at 12 wks). I was NOT the typical “come in when they are 1-2 mins apart” or “you get a breather between contractions”. I would have a contraction and before it would go away, the next one would come on just as painful. 1st child born 2 1/2 wks early at 7lbs14oz. I feel like an insomniac, irritable, pressure down under, back pain, again, LOTS of “contractions” (Braxton-Hicks) is there something I can do other than a warm bath, drink a glass of water, if standing… sit, if sitting…stand because these suggestions aren’t helping. I thank you for your time and sharing your knowledge with a typical “expectant mother”. Graciously awaiting your reply! ~JSLewis

Dear JS Lewis, some women have an “irritable” uterus. It sounds like that’s what is happening with you. So are these painful contractions so early or are they just always there that you can’t get any rest? It sounds like you are doing everything you can to stop them except taking meds…~blessings, Guinever

14. Nicole - February 27, 2010

Hello. I am 14 weeks pregnant with my third child. In July of last year I had a LEEP because of HPV. My doctor told me that it would be possible for me to have an incompetent cervix from the procedure. I had some green-mucous like discharge a few days ago and mild cramping. I havent seen my doctor since the first visit, and my next appointment is on March 10th. I tried to feel my own cervix and I am not quite sure what normal is, but I am easily able to put a finger in the end of it. I am quite worried, but I always think things are wrong when they arent. Do you think I should be worried or schedule an earlier appointment with my doctor, or just wait until the 10th?

Nicole, I think you should at least call your doctor’s office and see what they say. They may have you go in just to get checked out or maybe have you wait. Either way, that call will put your mind at ease. Are you still having the green color discharge? That would be cause for concern. ~blessings, Guinever

15. Bree - March 12, 2010

Im at least 39wks along, maybe more? I just had an ultrasound done its showing Im over 40.5wks with a 9lb er~~. Anyway, I was just cheked today and Im at least 5-5.5 cm dilated and 80%effaced. My Doctor said the baby still needed to come down a little bit, but she can feel babys head&my water bag. I have had irregular contrx up until this point. Doc says she would be suprsied if I make it another 4 days. But of course anything is possible. What do you think? Also even with me being over 5cm the hospital wont keep me until Im in “active labor” Im so ready for my little girl to be born!!

Bree, I think it’s just a matter of time before your labor starts and I think it will be very soon. ~birthing blessings, Guinever

16. Annabell - March 12, 2010

i was taking evening primrose oil gel 2 orally by mouth 2 times a day an 2 gel at night right befour i go to bed. this time after i layed down even flat on my back 2-3 mins later they leaked out. i m 41 weeks pregnant.my question is,am i fully effaced because the oil just leaaked out?
or did i not insert it correctly?
i am 3 cm dialated since 38 weeks an 40 percent effaced since then. i hope you can answer my question thnak you
2 gels at night inserted intra vaginally right befour i go to bed**

Annabell, I don’t think the state of your cervix has anything to do with why the oil leaked out. It’s probably because the gel cap melted and you changed position so it leaked. ~blessings, Guinever