Cervical Checks During Pregnancy & Labor: Are They Necessary?
Pregnancy and labor can be a rollercoaster of feelings and decisions. One of those decisions is whether to have cervical checks, a routine procedure that gives important info about how labor is progressing. But are they really needed? Knowing what cervical checks are all about can help moms-to-be make smart choices that fit their birth plan and comfort zone.
In this article, we'll dive into what cervical checks do during pregnancy and labor and look at the pros and cons so you can figure out what's best for you and your baby.
When is a Cervical Check Done?
A routine cervical check to see how your cervix is doing is usually done during your prenatal visits, usually when you're farther along in pregnancy, around 36 or 37 weeks. Assessing cervical dilation can give medical providers an idea of how close you might be to going into labor. As the pregnancy progresses, healthcare providers may opt to check your cervix more frequently since you're getting closer to laboring.
What Happens During a Cervical Check During Labor?
A cervix check is performed because your midwife or healthcare provider wants to see how dilated and effaced your cervix is. Simply put, it's kind of like a status check on your baby's eviction process. As for the process, you can expect a doctor or midwife to insert two gloved fingers into your vagina to check your cervix and determine your Bishop Score (more on that below). It might feel uncomfortable or even a bit painful, especially if you're not dilated yet.
If getting a cervical check is painful for you, it’s a good time to practice your Calm Breath and visualizations to help you cope with the sensations.
What's a Bishop Score?
The Bishop Score is a way to predict how ready a woman's body is to go into labor and give birth. It's determined by how soft and thin the cervix is, how dilated it is, and if the baby's head has yet dropped into the pelvis. Doctors use this information to determine whether or not an induction would be successful and what type of medications to use if you need to be induced.
Here's what these scores look like in the situation of preparing a woman for an induction:
Dilation of the Cervix (cm):
0 points: 0 cm
1 point: 1-2 cm
2 points: 3-4 cm
3 points: 5+ cm
Effacement of the Cervix (%):
0 points: 0-30%
1 point: 40-50%
2 points: 60-70%
3 points: 80+%
Consistency of the Cervix:
0 points: Firm
1 point: Medium
2 points: Soft
Position of the Cervix:
0 points: Posterior
1 point: Mid-position
2 points: Anterior
Station of the Fetus (relative to ischial spines):
0 points: -3
1 point: -2
2 points: -1 or 0
3 points: +1 or +2
Total Score Meanings:
0-3: Unfavorable for induction
4-6: Moderately favorable, may require additional interventions
7+: Favorable, likely to result in successful induction
It's like a little checklist to see if everything is lining up for labor to begin. So, when the doctor says a woman has a high Bishop Score, all the signs point to her body being ready to go into labor soon. And if it's low, it might be a little while before things get moving.
Cervical Check vs Membrane Sweep
Don’t get this confused with membrane sweeps. Cervical checks and membrane sweeps are pretty different things you might encounter during pregnancy. As mentioned earlier, a cervical check is when your doctor uses gloved fingers to see how much your cervix has dilated, usually around 36 weeks. On the other hand, a membrane sweep is a bit more intense; the doctor sweeps their fingers around your cervix to try and kickstart labor.
You can ask for a cervical check if you're around 37 weeks and curious about how things are progressing. But if you need a little push to get labor going, you might consider a membrane sweep. Just remember, both procedures carry a small risk of your water breaking accidentally, so chat with your doctor to figure out what’s best for you and your baby.
Pros and Cons of Cervical Exams During Pregnancy
When it comes down to it, you have to make the best decision for you and baby. So here's a pros and cons list to help you do so:
Pros:
Exams can tell doctors more about the status of the cervix, such as its dilation and effacement, so they can determine how far along you are in labor.
If you're planning for a labor induction, exams help monitor the effectiveness of medications.
Cervix checks can help determine the baby's placement to prepare for a safe delivery.
Cons:
Cervical exams can be uncomfortable or even painful for some women, leading to increased anxiety and stress during an already sensitive time.
An exam may accidentally break your water.
There is a risk of infection, especially if performed frequently or if proper sterile techniques are not followed.
Exams are not always accurate, which can lead to unnecessary interventions, inductions, or c-sections.
Beyond the pros and cons of cervical exams, research has shown that there's no significant benefit to having a cervical check during late pregnancy.
How to Decline a Cervical Check During Pregnancy
If you're feeling like you want to decline cervical checks, you totally can! You have every right to refuse any medical procedure you don't want. Be polite but firm when you tell your doctor you'd rather skip the cervical check. You can say, "I'm not interested in having a cervical check now, but thank you for offering." You can even simply keep your clothes on instead of changing into a gown. Either way, your healthcare provider should respect your decision and move on to the next topic.
Alternatives to Cervical Exams
Cervical checks can be uncomfortable and sometimes downright painful. But fear not; there are some alternatives you can consider during your pregnancy. Here are some options:
During labor, your behavior will give a good indication about how close you are to giving birth. If you’re talkative and up moving around between contractions, you’re likely not very dilated. If you’re focused inward, breathing deeply, making noise and wanting silence, you’re likely more dilated and getting closer to labor. If you want to learn more about this, be sure to take our online childbirth class!
Pay attention to your contractions and their strength and frequency. This can give you a good idea of where you are in the labor process without needing an internal exam.
You can always discuss using ultrasound technology with your healthcare provider to check on your baby’s position and progress.
So don’t stress about those cervical checks, mama; there are plenty of other ways to keep tabs on your pregnancy!
Conclusion
Ultimately, the cervix is not a crystal ball to tell you when labor will begin. There is no research-backed reason to receive cervical checks during pregnancy either. The only caveat would be if you are planning an induction and the doctor needs to know your Bishop Score. If you have any concerns or questions about cervical checks at the end of pregnancy, be sure to ask your provider. You have full rights to take charge of your plan of care!
