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Let's Talk About Cervical Checks

There's one thing I jokingly call "curiosity checks."

Cervical exams during pregnancy. That usually gets a laugh, but there's actually a reason behind it.

As you get closer to your due date, it's common for friends and family to ask, "So... are you dilated yet?" Somewhere along the way, we've been taught that knowing how many centimeters dilated we are tells us when labor is going to begin. I wish it were that simple.

Here's the thing... a cervical exam doesn't predict when labor is going to start.

Let's imagine two different scenarios.

You're 40 weeks pregnant. You haven't had a single contraction. We do a cervical exam, and I tell you your cervix is completely closed. Now what?

For a lot of moms, that information creates stress. Suddenly they're wondering if their body is doing what it's supposed to do or if they're "behind."

Now let's flip it around.

You're also 40 weeks. Still no contractions. This time I tell you you're already 5 centimeters dilated. Well... now you're wondering why you aren't in labor yet! Should you be timing every little cramp? Is baby coming today? Can you even go to sleep tonight?

See what happened? Neither answer actually told us when labor would begin.

Some women walk around several centimeters dilated for days or even weeks. Others go from completely closed to holding their baby just a few hours later.

That's why I don't recommend routine cervical exams during pregnancy without a good reason, like if you think your water has broken or there's another concern we need to evaluate.

My goal is never to create unnecessary anxiety just to satisfy our curiosity. Now, does that mean I won't do a cervical exam during pregnancy?

Not at all.

If we've talked through the pros and cons and you still feel like having one would be helpful, we'll absolutely have that conversation. This is your pregnancy, and shared decision-making is a huge part of how I practice. My job is to give you the information you need so you can decide what's best for you. Labor is a little different.

When I first arrive at your home, I usually recommend a cervical exam because it gives me a starting point. But even then, I'm not just trying to figure out how many centimeters you're dilated. I'm feeling how thin your cervix is. Where your cervix is positioned. Where baby's head is in relation to your pelvis. Whether there's any swelling.

All of those things help me understand how labor is progressing and guide any recommendations I make along the way. But even then... it's not black and white.

If I walk through your front door and you're grunting, your body is bearing down, and I'm seeing all the outward signs that your baby is making great progress, I may not recommend a cervical exam at all. Sometimes your body tells me everything I need to know.

As labor continues, I may offer another cervical exam every 4 to 6 hours if labor seems to be progressing more slowly than expected or if you're asking for one. Again, it's never about checking a box. It's about gathering information that helps us make good decisions together.

When it comes time to push, I don't automatically reach for a glove either. Most women experience what's called the fetal ejection reflex, that overwhelming urge to push that's almost impossible to ignore.

If I'm seeing your body opening beautifully, baby's head beginning to crown, or other outward signs that everything is progressing normally, another cervical exam usually isn't necessary.

If you've been pushing for a while without much progress, I'm seeing bleeding that concerns me, or something just doesn't seem to fit the picture, I'll recommend checking.

Sometimes babies are just a little too eager and trigger that urge to push before the cervix is completely dilated. A cervical exam in that situation can give us helpful information and guide our next steps.

One thing you'll probably notice if you choose me as your midwife is that I don't recommend procedures just because "that's what we always do." I like to know why we're doing something. More importantly, I want you to know why.

Sometimes a cervical exam gives us valuable information. Sometimes it simply satisfies our curiosity. Knowing the difference is part of good midwifery.

If you're considering a home birth and have questions about prenatal care, labor, or simply want a provider who takes the time to explain the "why" behind recommendations, I'd love to chat.

No pressure. No expectations. Just a conversation.

Learn more about Living Waters Midwifery or schedule a free consultation here:
https://www.livingwatersmidwiferyfl.com/contact