A cervix check is a medical procedure where a healthcare provider assesses the condition of the cervix, the lower, narrow part of the uterus that connects to the vagina. It is a common physical examination used to gather information about the cervix’s readiness for various stages of pregnancy or for general gynecological health.
Why Cervix Checks Are Performed
Cervix checks are performed for several medical reasons, primarily in the context of pregnancy and labor. During late pregnancy, starting around 36 to 37 weeks, these checks help determine if the cervix is beginning to prepare for labor by assessing its thinning and opening.
During active labor, cervix checks are routinely conducted to monitor the progression of labor. By examining the cervix, healthcare providers can assess how far along a person is in labor and track the effectiveness of contractions in dilating and effacing the cervix. This information helps guide decisions about labor management, including when interventions might be necessary or when it’s appropriate to begin pushing. A cervical check might also be performed before a planned labor induction to help determine the likelihood of a successful induction and guide the choice of induction methods.
How the Examination is Conducted
A manual cervix check, also known as a digital exam, involves a healthcare provider inserting gloved fingers into the vagina to physically assess the cervix. The patient lies on an examination table with their feet in stirrups, a position that allows the provider clear access. The provider will use one or two lubricated, gloved fingers to reach the cervix.
The provider relies on touch to evaluate several characteristics of the cervix. They feel for its position, which can shift from being posterior (towards the back) to a more anterior (forward) position as labor progresses. They also assess the cervix’s consistency, noting if it is firm or has softened in preparation for birth. The primary assessments made during this manual check are dilation, effacement, and fetal station. While the manual check is the most common, a speculum may be used for visual inspection, especially if there are concerns like a ruptured membrane, to reduce the risk of infection.
Patient Experience During a Cervix Check
Patients describe the sensation of a cervix check as pressure or discomfort, rather than sharp pain. The level of discomfort can vary significantly among individuals and even between different checks for the same person. Some may experience brief, cramp-like feelings similar to menstrual cramps, while others report little to no sensation. The sensitivity of the cervix increases during pregnancy due to increased blood flow, which can contribute to the discomfort.
The procedure is very quick, lasting only 30 seconds to a few minutes. To help manage discomfort, patients can practice deep breathing techniques, focusing on slow, steady breaths to promote relaxation. Communicating any pain or anxiety to the healthcare provider can also be beneficial, as they may offer guidance or adjust their technique. Gently coughing or bearing down during the check can help alleviate sensations of pressure.
Interpreting the Results
After a cervix check, the healthcare provider communicates findings using three main measurements: dilation, effacement, and fetal station. Dilation refers to how open the cervix has become, measured in centimeters. A cervix is considered fully dilated at 10 centimeters, which indicates readiness for the pushing stage of labor.
Effacement describes the thinning of the cervix, expressed as a percentage. During pregnancy, the cervix is thick, around 2 to 3 centimeters in length, and is considered 0% effaced. As labor approaches or progresses, the cervix thins out, reaching 100% effacement when it becomes as thin as paper. Fetal station indicates how far the baby’s presenting part has descended into the pelvis relative to the mother’s ischial spines. This measurement is expressed as a number from -5 to +5, with 0 station meaning the baby’s head is aligned with the ischial spines, and positive numbers indicating further descent into the birth canal. These measurements together provide important information about labor progression.