As pregnancy nears its end, many wonder about cervical exams, especially when a healthcare provider mentions feeling the baby’s head. This observation often leads to wondering if it directly indicates cervical effacement, a key step in preparing for birth.
Key Measurements in Late Pregnancy
During late pregnancy, healthcare providers conduct cervical exams to assess three primary measurements: effacement, dilation, and fetal station.
Effacement
Effacement refers to the thinning and shortening of the cervix. Before effacement begins, the cervix is firm, closed, and approximately 3 to 4 centimeters long, resembling a bottleneck. As the body prepares for birth, the cervix softens, thins, and shortens, eventually becoming as thin as paper when fully effaced. Effacement is measured in percentages, ranging from 0% (no thinning) to 100% (completely thinned).
Dilation
Dilation describes the opening of the cervix. It is measured in centimeters, from 0 centimeters (closed) to 10 centimeters (fully open). For a vaginal delivery, the cervix must dilate to 10 centimeters, which is approximately the width of a newborn’s head. Effacement and dilation often occur together, though they may not progress at the same rate.
Fetal Station
Fetal station indicates how far the baby’s head has descended into the pelvis relative to the ischial spines, which are bony protrusions within the pelvis. This measurement uses a numerical scale from -5 to +5. A negative number, such as -5, means the baby’s head is high above the pelvis, sometimes described as “floating.” A station of 0 means the baby’s head is level with the ischial spines, indicating engagement. Positive numbers, like +1 or +2, signify that the baby’s head has moved past the ischial spines and is deeper into the birth canal, with +5 indicating crowning.
Connecting Fetal Descent and Cervical Readiness
Feeling the baby’s head during a cervical exam means the baby has descended into the pelvis, a process known as engagement. However, the baby’s head being felt does not directly translate to a specific percentage of cervical effacement.
Fetal descent and cervical changes are interconnected. The pressure exerted by the baby’s head on the cervix can contribute to both effacement and dilation over time. As contractions begin, they help push the baby’s head downward, which in turn stretches and thins the cervix.
For individuals experiencing their first pregnancy, effacement often precedes dilation. For those who have given birth before, dilation might occur before or at the same time as effacement, as the cervix may have been stretched previously. This pressure, combined with uterine contractions, aids in cervical ripening, making it soft, thin, and open for birth.
Interpreting Your Cervical Exam Results
Healthcare providers interpret the combination of effacement, dilation, and fetal station to assess a pregnant individual’s progress toward labor. These measurements offer a snapshot of cervical readiness, but they are not absolute predictors of when labor will begin. A cervix that is effacing and dilating, even minimally, along with a descending fetal station, indicates that the body is undergoing changes in preparation for birth.
A doctor feeling the baby’s head confirms engagement, a positive step toward labor. This finding suggests that the baby is in a good position to move through the birth canal. Even if effacement or dilation is not yet significant, the baby’s low position can be a reassuring sign of progress. The interplay of these measurements helps healthcare providers understand the overall readiness of the cervix for labor.
Next Steps and Signs of Labor
Even with favorable cervical findings, labor may still be days or weeks away. The body’s preparation for labor is a gradual process, and changes in effacement or dilation can occur slowly over time. It is important to continue monitoring for definitive signs of labor.
Key signs to watch for include regular and increasingly strong contractions that do not subside with rest or position changes. Rupture of membranes, commonly known as your “water breaking,” can be a gush or a trickle of fluid. The loss of the mucus plug, often appearing as a thick, sometimes blood-tinged discharge, can also indicate that the cervix is changing, though labor may not be immediate. Contact your healthcare provider if you experience regular contractions, your water breaks, or if you have any concerns about your symptoms. They can provide guidance on when to go to the hospital or birthing center.