A cervical check, or digital vaginal examination, is a standard procedure performed by a healthcare provider late in pregnancy or during labor. The examination involves inserting gloved fingers into the vagina to assess the condition of the cervix. A frequent concern is whether this routine procedure might inadvertently cause the membranes to rupture, commonly referred to as the water breaking.
Understanding the Cervical Check Procedure
A cervical check is a manual assessment performed by a clinician to gain a snapshot of the body’s readiness for delivery. The primary purpose is to determine how much the cervix has changed in preparation for labor or to monitor labor progression.
The examination involves taking three key measurements: dilation, effacement, and fetal station. Dilation refers to how open the cervical opening is, measured in centimeters from zero to ten. Effacement is a measure of how thin the cervix has become, expressed as a percentage. Fetal station indicates how far the baby’s presenting part has descended into the pelvis in relation to the mother’s ischial spines.
The Role of the Amniotic Sac
The amniotic sac is a thin, tough membrane that envelops the developing fetus and is filled with amniotic fluid, commonly referred to as “the water.” This fluid-filled sac serves a protective function, cushioning the baby and maintaining a constant temperature. The part of the sac that bulges through the opening cervix ahead of the baby’s head is called the forebag of waters, which is directly accessible during a vaginal examination.
Assessing the Risk: Can the Examination Induce Rupture?
It is possible, though uncommon, for a cervical check to inadvertently cause the amniotic sac to rupture. The membranes may be more vulnerable if they are already thinned, weakened, or bulging low into the cervical opening. The physical pressure from the examining finger, particularly when the cervix is dilated and the forebag is prominent, can be enough to break the membrane.
This accidental rupture is different from an intentional procedure called Artificial Rupture of Membranes (AROM), or amniotomy. AROM is a deliberate medical intervention performed with a specialized, sterile tool called an amnihook to break the waters in a controlled manner, typically to speed up labor.
Expected Side Effects Following the Examination
The most common side effect following a cervical check is light vaginal bleeding, often appearing as pink, brown, or light red spotting. This spotting occurs because the cervix is highly vascular during pregnancy, and physical contact can irritate the delicate capillaries on its surface. Mild cramping or increased pelvic pressure is also frequently reported, caused by the mechanical stimulation of the cervix triggering mild uterine contractions. Contact a healthcare provider if the bleeding becomes heavy like a menstrual period, or if there is a sudden gush of fluid, as these symptoms may indicate a more significant event.