Going Into Labor Can Be A Scary Thing: Here Is What Soon-To-Be Mothers Can Expect During Examination

When soon-to-be mothers are about to give birth they often wonder what their hospital or birth center’s patient care procedures are. If you’ve found yourself tossing and turning in the days and weeks leading up to your due date, pondering what the examination will be like throughout labor – you’re not alone!

I was terrified at the thought of how labor was going to turn out, mostly how this little being was coming out! 

Going into labor is actually unique for every woman, but the procedures for it are fairly standard and the events experienced are likely to also be fairly standard.

For instance…

While how you go into labor can differ, a fairly standard procedure to have once you’re in labor is to have a nurse or doctor do an internal examination to determine if the cervix has dilated. 

 

 

Going Into Labor: Cervical Exams, Medical Terms and What to Expect

If you’re curious about the labor process – how it’s assessed and what you can possibly anticipate from the experience – we’re going to give you all the information we can based on our collective experiences and research about giving birth. 

To answer as many of  your burning questions as possible, this post will be in a Q&A style – where I pose a question and then give the most straight forward (and honest) answer as possible.

I hope you find some answers (and relief to your worries) here. If you have any questions – feel free to drop us a line in the comments below! We’d love to hear your story!

Is A Cervical Exam Uncomfortable?

The majority of moms, at the end of their pregnancy, need to undergo a cervical exam (or pelvic exam).
Labor cervical exams are typically done with the woman laying down on the bed, on her back with her knees bent and legs permitted to relax.
While prenatal exams tend to include stirrup use, a laboring woman can generally put her feet on the bed, close to her bottom.

The exam could be either extremely painful or just uncomfortable – this depends on the woman, the stage of labor she’s in, etc. Me, well – I screamed bloody murder when my OB tried to do a exam on me during labor and she walked out saying, “get the epidural!“

Since we want to be able to share our experiences so that you can have a great birthing experience, here are some things I learned during my cervical exam. 

Tips for conquering a cervical exam without freaking out: 

• When an internal examination is being done, it’s important to take slow, deep breaths so the vaginal muscles are relaxed.
  The more relaxed a woman is, the easier it is for her doctor to get to the cervix.
  The cervix is high up in the vagina, especially during early labor.
• I found that keeping myself cool (not being covered with a blanket) was helpful – I’m a person who gets warm easily and once I get warm, I can tend to get anxious even easier. And while you’re in labor, your anxiety may already be at a high due to nerves. While this was the case for me, some people prefer to be covered for warmth and privacy – so what I suggest is just to do whatever you can before the cervical exam starts to make sure you’re comfortable.

If you’re interested in hearing some explanation and tips for vaginal exams from a professional, watch the video below where Sarah Lavonne (a down-to-earth and relatable registered nurse and birthing coach) explains what she looks for during a vaginal exam and some general tips on how to stay comfortable. 

 

Medical Terminology…What Are They Saying!?
4 Common Words Said During A Cervical Exam

While in labor, your doctor will do an exam and give you an update, using some very big and scary words. While some doctors will be able to take the time to explain things, others do not for various reasons. 

So, what are some common terms you’ll hear your doctor say?

“Cervical Ripening“

During the early stages of labor, possibly even in a late prenatal visit, your doctor may say your cervix is ripening, which means it’s softened and potentially a little dilated.

Ripeness just means your body is getting himself ready for the labor process.

“Dilation“

This is the width of the cervix when it’s open.

Dilation will start before the labor process does and is measured in centimeters. In the majority of deliveries, the cervix has to dilate to 10 centimeters before a woman can start pushing and the baby is delivered.

Why 10 centimeters?
That’s usually because a full-term baby’s head is roughly 10 centimeters across.

“Effacement“

This is the shortening of the cervix.

It’s similar to dilation, beginning before or during the early labor.

Before this process can occur, the cervix is a bottleneck, typically around four centimeters.
When it begin, the cervix will shorten, drawing up into the uterus to become a part of the lower uterine wall.

Effacement is measured in percentages… all the way up to 100 percent (paper-thin cervix).

“Station“

This is the description of the baby’s head and where it’s located in the pelvis.

This is important information because doctors need to know how far the baby is in the birth canal.

This is done by feeling where the baby is lying to in relation to the ischial spines, which protrude slightly in the birth canal and is felt within the vagina.

Station is done in a measurement range of minus five to plus five. When a baby is at minus five station, it means the baby is located above the pelvis. At zero station, the baby is engaged in the pelvis and the head is laying at the level of the ischial spines.

At a plus five, the baby head can be seen at the vagina opening (called crowning).

Understanding How Our Bodies Change During Labor 

Understanding the changes our bodies undergo through the duration of our labor and delivery is so crucial (in my opinion) because it helps you understand how you’re progressing, where you’re at, what to expect and most importantly during labor – how close you are to meeting the little bundle of joy you’ve been pining for. 

So, let’s talk about what happens to the cervix in the various stages of labor.

What Happens To The Cervix In The “Latent Phase” of Labor

At the beginning of your labor, a cervical exam is going to be a little more uncomfortable than they are when the labor progresses.

That’s because the practitioner will need to reach high up in the vagina to determine where the cervix is.

In the latent phase, the baby’s head hasn’t yet gotten down into the pelvis.
A baby’s head will cause the cervix to drop closer to the opening of the vagina.

As the labor continues, the cervix moves to the front and is far more accessible, which should make for more comfortable exams.

During this phase, the cervix will dilate from one to four centimeters.
By the time this phase ends, the effacement is 100 percent.

What Happens To The Cervix In The “Active Phase” of Labor

In the active phase, the cervix has a typical dilation of four to five centimeters.
And, for each hour of labor, the cervix will dilate even more, and it continues until it finally hits 10 centimeters.

In this time, there is a small amount of bleeding from the cervix, known as the bloody show.

At this point, the mother may feel some pelvic pressure and an urge the push as the baby gets into her pelvis.

If a woman isn’t completely dilated, she shouldn’t push because it can cause the cervix to rip open.

What Happens To The Cervix In The “Transition Phase” of Labor

The active labor phase also includes the transition phase, which starts when the cervix has dilated to around seven to eight centimeters and occurs until it’s fully dilated at 10 centimeter.

When full dilation has been reached, the action to bear down and push a baby out begins.
(Read more on my personal labor and delivery story here!)

I’d love to hear in the comments below your experiences with labor and delivery – how did you welcome your little one into the world?
If you’re still pregnant (and willing to share) – let us know the name you’ve picked out for your sweet little one!