D is for Dilation

It’s more than just 10 centimeters.

The dilation of your cervix tells your care provider a lot when you are preparing for or going into labor. It certainly cannot predict the future, but it is a great indicator of where your body is at in that moment.

Some care providers will check your cervix starting at 37 weeks to see if you are dilated or if your cervix is “ripe”. Other providers will delay a cervical exam until your 40th week or until you are in labor. Checking cervical dilation does not tell your provider when you are going into labor, but it gives them an idea of its readiness.

The cervix is the neck of the uterus and is about 4 centimeters long. It is the part of your body that opens during labor to allow your baby to move into the birth canal. Cervical dilation takes time and this snapshot of your cervix is a starting point. Only time will tell if you will have a short or long labor.

Your cervix does 4 things as your body prepares for labor.
  1. The cervix moves from a posterior position (pointing towards the back of your pelvis) to an anterior position (pointing toward the front of your pelvis).  If this does not happen before labor begins, it generally happens during early labor.
  2. The cervix becomes soft, or “ripens”, which means it is softer and a bit more stretchy. This usually happens in the days leading up to labor, but can also happen during the early part of labor. A softer cervix means it will dilate and efface more easily.
  3. The cervix shortens and thins out, or effaces, going from 0% effaced to 100% effaced before you are ready to push your baby out. Effacement may happen before labor, but it usually works in conjunction with dilation.
  4. The cervix opens, or dilates, to 10 centimeters in order for baby to be born.This part takes the longest and happens over the course of the labor. Most pregnant persons start labor at 0 – 1 centimeters dilated and with contractions, progress to 10 centimeters dilation.
Is your cervix ready?

In order to assess cervical readiness, your provider may use the Bishop’s Score. It can also be used to indicate how successful an induction would be. A higher score indicates the cervix would respond well to inductions methods. A lower score would indicate the cervix is not quite ready for labor or an induction. If you are preparing for labor or need an induction, ask your provider about your Bishop’s Score and what it means for you.

Does knowing your dilation help?

Dilation is an important indicator of how well your labor is progressing. Most likely, you will receive a cervical exam when you get to labor and delivery, and then periodically until you are ready to push your baby out. Some laboring persons find this information to be motivating and they love hearing the status check. Others prefer not to know if or how much their cervix has changed, choosing to wait to see other signs of labor progression. Talk with your provider about your preferences and know you can always change you mind if you decide you do or do not want this info.

Things to remember…

If you are preparing to have your baby or you are in labor, keep in mind that dilation is just one part of the whole picture. We expect your cervix to be ready around 40 weeks of pregnancy, and for it to start making changes just before or during early labor. Whether you practice the art patient waiting or decide to get things moving with an induction, having this information in your toolbox can help you make great decisions for you and your birth.

By: Lois Perks

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