Cervical checks are physical or procedural examinations of the cervix, the lower, narrow part of the uterus that opens into the vagina. These examinations serve distinct purposes depending on the context. The term generally refers to two applications: routine preventative screening for cell changes, and manual assessment during late pregnancy and labor.
Cervical Checks for Routine Health Screening
The most common reason for a cervical check outside of pregnancy is to screen for precancerous or cancerous cells. This is primarily done through the Papanicolaou test, commonly known as a Pap smear. The provider uses a speculum to visualize the cervix, then gently collects a cell sample using a small brush or spatula.
These collected cells are sent to a laboratory for cytology, where they are examined under a microscope for abnormalities. The goal is to detect cell changes that could develop into cervical cancer; early detection significantly increases successful intervention. The Pap test is often paired with or replaced by a Human Papillomavirus (HPV) test, which detects the virus that causes nearly all cervical cancers.
The HPV test identifies high-risk strains of the virus, which cause abnormal cell growth. This dual approach, known as co-testing, provides a comprehensive assessment of cervical cancer risk. Screening is recommended to begin at age 21, with frequency ranging from every three to five years depending on the patient’s age and the tests used. The routine screening check is purely diagnostic, focusing on cellular health rather than physical dimensions.
The Role of Checks in Late Pregnancy Assessment
Cervical checks take on a different function when performed in the final weeks of pregnancy, usually beginning around 36 weeks gestation. These checks are manual examinations, where the provider uses gloved fingers to assess the physical state of the cervix. The primary point of these assessments is to establish a baseline and gain information about the body’s readiness for labor.
The provider measures three parameters: effacement, dilation, and fetal station. Effacement is the thinning of the cervix, measured in a percentage from 0% (thick) to 100% (paper-thin). Dilation is the opening of the cervix, measured in centimeters from 0 to 10. Fetal station indicates how far the baby’s head has descended into the pelvis, measured in relation to the mother’s ischial spines. Zero means the head is engaged.
These combined measurements contribute to a Bishop Score, a system used to predict the likelihood of a successful labor induction. While they offer a snapshot of progress, these checks are not reliable predictors of when spontaneous labor will begin, as a person can be partially dilated for weeks before active labor starts. The information is primarily used to inform conversations about upcoming delivery, especially when medical induction is being considered.
Monitoring Progress During Active Labor
Once a patient is admitted to a hospital or birthing center with confirmed active labor, the purpose of cervical checks shifts from baseline assessment to real-time monitoring of labor progression. These manual examinations are performed periodically to track the speed and efficiency of the labor process. Dilation is the most frequently cited measurement, which must reach 10 centimeters before the second, or pushing, stage of labor can begin.
Monitoring the rate of change is necessary to ensure the labor is following expected timelines. If the cervix is not progressing, the check results help the medical team determine if interventions, such as administering medications to augment contractions, are needed. The information also guides the timing of pain relief methods, which may be administered once the patient reaches a certain dilation.
The fetal station is also monitored during active labor to confirm the baby is moving down through the birth canal. This is important for guiding pushing efforts; if the baby is still high in the pelvis, delaying pushing may conserve the patient’s energy. Checks during active labor provide objective data to inform moment-to-moment decisions affecting the safety and progression of the birth.
Patient Concerns and Informed Consent
Cervical checks, particularly the manual exams during late pregnancy and labor, can cause discomfort and may be painful. The physical nature of the examination, which involves fingers reaching the cervix, can be a source of anxiety. In late pregnancy, many routine checks are optional and can be declined by the patient.
Patient autonomy dictates that informed consent should be obtained before any medical procedure, including a cervical check. The provider should explain the reason for the check, the information they hope to gain, and any potential risks, such as an increased infection risk if membranes have ruptured.
The right to refuse an examination remains even during labor. However, checks become more medically necessary in certain situations, such as when monitoring a labor induction or if there is concern about fetal distress. Open communication with the care team about comfort level and the necessity of the procedure is encouraged.