The Four Types of Cervical Change You Need to Know About

By Doulas of Shanghai

When I say cervical change, what comes to mind?

Most people can quickly name dilation, or the opening of the cervix, and the main type of cervical change. It’s a big one!

But did you know there are three more changes your cervix will make? They not as dramatic and don’t get as much attention, but they are vital to the birth progress.

For most people, there is some level of fear or anxiety that you feel when thinking about and anticipating birth and the big changes your cervix will make. If that rings true to you, contact us about a childbirth education class or book your free consultation to talk with our doulas and learn how we can help reduce that fear and anxiety.

What is the cervix?

The cervix is the doorway to your uterus. It’s located at the base of the uterus, between the uterus and your vagina.

One day, you get the good news… You’re pregnant! For the next 40 (or so) weeks, your cervix stays tightly closed. It develops a mucous plug, keeping bacteria, sperm, and germs out, and holding your baby and everything else in.

A few weeks before your due date, your doctor may ask to do vaginal exams. One reason she does this is to check if your cervix has started changing in preparation for birth. It can be one indication that labor is coming soon.

(Note: If you are not comfortable with vaginal exams, talk to your doctor and work together to make an alternate plan. Cervical checks are not required, and your doctor should have your consent before doing one.)

What are the four types of cervical change I need to know?

Every cervix goes through the following cervical changes during labor before a vaginal birth.

Dilation

This type of cervical change is one of the most commonly referred to. Over the course of late pregnancy and labor, your cervix will go from totally shut to 10 cm dilated. Your doctor measures your dilation with her fingers through a vaginal exam. Once 10 cm dilated, your cervix is fully pulled back and open, ready for you to push.  

For most people, the first 4-6 cm of dilation take the longest, and your cervix is going through additional changes during that time. Once you reach 4-6 cm, dilation often speeds up.

Effacement

This refers to how thin your cervix is. During pregnancy, your cervix is 3-4 cm long. It will then efface, or thin, eventually becoming as thin as paper. It’s going to be a lot easier and faster for your cervix to dilate after it’s thin. Effacement is definitely a big change to celebrate!   

Firmness

Your cervix will go from being hard and stiff to soft and flexible. Before labor starts, your cervix will feel similar to the tip of your nose. Go ahead, give it a poke. It then softens to the point where it feels more like the bottom tip of your ear. Can you feel the difference?

A soft and flexible cervix will have an easier time thinning out and opening up. Your doctor may also refer to this as “cervical ripening.”  

Position

Your cervix is well practiced in changing positions. It changed position during each of your menstrual cycles, and it’s going to do the same thing during labor. During most of pregnancy, your cervix is posterior, or facing backwards toward your tailbone. During labor, it will move to a more forward-facing position. This puts it directly under your baby’s head, and is going to make contractions more effective for dilation and effacement as there is more direct pressure on it.

What order does cervical change usually happen in?

There is no set order for cervical change to happen in.

Too often we get caught up in focusing only on dilation to know if labor is progressing. Each body and birth is different, so the most important thing is to note your progress from day to day, or hour to hour. Is there change in one or more area? Celebrate that progress! You’re on your way, baby.

Why is it important to know about the different types of cervical change?

During late pregnancy and in labor, knowing about the four types of cervical change give indications about how labor is progressing. Dilation is NOT the only sign of progress, and noting when progress is happening in other areas is very encouraging. Cervical change in other areas are all signs of progress.

For example: You’ve been in labor for 6 hours, and you’ve dilated to 2 cm. When the doctor checks your cervix two hours later, you may still be at 2 cm. Some people will feel discouraged, and feel like there hasn’t been any progress, or all of these contractions were for nothing.

Then you ask your doctor what other changes there have been to your cervix. She may tell you that your cervix has changed position, becoming softer, and is thinner. All of these contractions you’ve been having are working! You are making progress, and you’re getting closer to meeting your baby.

Not sure if you’re feeling Braxton Hicks or true labor contractions? Read more here.

Want to learn more? Join one of our childbirth education workshops or contact us to set up a private class in the comfort of your own home.

Your birth doula will also teach you about cervical change during your prenatal meetings with her, and will encourage you and remind you of your progress during labor when times get tough.

Contact us today to learn more or set up your free in-person consultation.

WeChat: DoulasofShanghai

Email: info@doulasofshanghai.com

Instagram: DoulasofShanghai

Phone: 135-2491-8954

Published by Doulas of Shanghai

Doulas of Shanghai is providing the leading care for families throughout pregnancy, labor, and the postpartum period.

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