Cervical checks are a routine part of late pregnancy care, often sparking questions about their role in initiating labor. This article aims to provide clear, evidence-based information regarding cervical checks and their potential, or lack thereof, to induce labor.
Understanding Cervical Checks
A cervical check involves a healthcare provider manually examining the cervix, typically using one or two gloved fingers inserted into the vagina. This internal examination assesses several factors related to the cervix’s readiness for labor. Providers evaluate the cervix for dilation (how open it is, 0-10 cm) and effacement (thinning, 0-100%).
The examination also includes assessing the cervix’s position, as it moves from a posterior (backward-facing) to an anterior (forward-facing) position closer to labor, and its consistency, changing from firm to soft. Additionally, the fetal station, which indicates how low the baby’s head is in the pelvis, is determined during this check. These checks are often performed starting around 36 to 37 weeks of pregnancy and throughout labor to monitor progress or for signs of early labor.
How Labor Naturally Begins
Labor is a complex physiological process orchestrated by a delicate interplay of maternal and fetal factors. It typically begins when both the body and the baby are physiologically ready, usually between 37 and 42 weeks of pregnancy. Key hormonal shifts drive this process.
Oxytocin, often called the “love hormone,” stimulates uterine contractions that help to thin and open the cervix. Prostaglandins, hormone-like substances produced by uterine cells, also help to ripen (soften and thin) the cervix and initiate contractions. The baby’s readiness, signaled by substances released as its lungs mature, contributes to the cascade of events that trigger labor.
The Link Between Cervical Checks and Labor Onset
Routine cervical checks, when performed solely to assess the cervix, are not considered direct inducers of labor. While the physical manipulation of the cervix can sometimes lead to mild cramping or spotting, this does not initiate true labor. Labor may begin shortly after a cervical check because the examination is performed when the body is already preparing for birth. This creates a correlation, where the check happens close to labor onset, but it is not necessarily the cause.
A standard cervical check differs from a “membrane sweep” (also known as “stripping the membranes”), a separate intervention performed during a cervical examination. A membrane sweep involves the healthcare provider sweeping a gloved finger around the amniotic sac to separate it from the lower uterine segment. This separation stimulates the release of natural prostaglandins, which can help to soften the cervix and encourage the onset of contractions, potentially initiating labor. A membrane sweep intentionally encourages labor, unlike a routine cervical check, which is purely diagnostic.
What to Expect After a Cervical Check
Following a cervical check, it is common to experience sensations that are normal and temporary. Many individuals report light spotting, as pinkish or brownish discharge, for 24 to 48 hours after the examination. This occurs due to irritation of sensitive cervical tissues during the examination.
Mild cramping or irregular contractions are frequently reported after a cervical check. These sensations resolve within a few hours, though some might experience them for up to 31 hours. These temporary symptoms do not indicate that labor has been induced but rather reflect the cervix’s response to the physical manipulation. However, if heavy bleeding (requiring more than one pad an hour), severe and persistent pain, or signs of true labor (regular, intense contractions increasing in frequency and duration) occur, it is important to contact a healthcare provider for further evaluation.