A cervical check is a manual, internal examination performed by a healthcare provider to assess the status of the cervix during late pregnancy and throughout labor. This procedure involves the provider inserting one or two gloved fingers into the vagina to physically feel the cervix. The examination provides a snapshot of how the cervix is changing in preparation for childbirth. The information gathered helps the medical team make decisions regarding the next steps in the birthing process.
What Cervical Checks Measure
The examination gathers data on three specific measurements that indicate the progression toward birth.
Cervical dilation quantifies how open the cervix is, measured in centimeters (cm) from closed (0 cm) to fully open (10 cm). Full dilation means the opening is wide enough for the baby to pass through the birth canal.
Effacement describes how thin the cervix has become. During pregnancy, the cervix is typically long and thick, but labor preparation causes it to shorten and soften, a process measured as a percentage. A cervix that is 100% effaced is completely thinned out.
Fetal station indicates the baby’s head position relative to the mother’s pelvis. This is measured using a numbered scale from -5 to +5. Zero station means the baby’s head is engaged in the pelvis at the level of the ischial spines. Negative numbers indicate the head is higher, while positive numbers mean the baby has descended lower.
Routine Checks During Late Pregnancy
Cervical checks are often introduced during routine prenatal appointments as the pregnancy nears its end. Many providers may begin offering this examination around 36 or 37 weeks of gestation. The primary purpose of these late-pregnancy checks is to establish a baseline of the cervix’s condition and determine if the body is beginning to prepare for labor.
These checks can contribute to a Bishop Score, which is a system used to predict the likelihood of a successful labor induction. However, finding out the cervix is dilated or effaced does not reliably predict when labor will begin. A person can be several centimeters dilated for weeks without going into active labor, and conversely, a closed cervix can progress to birth within hours.
These checks before active labor begins are generally optional for the patient. Unless there are specific medical concerns, like signs of premature labor or a planned induction, the results of a routine check often do not change the immediate care plan. Patients are fully within their rights to decline the examination during these weekly appointments.
Monitoring Progress During Active Labor
Once a patient is admitted to a hospital or birthing center with regular contractions, cervical checks become an integrated part of monitoring labor progress. A check is typically performed upon admission to determine if the patient has reached active labor and is eligible for hospital admission. This initial measurement of dilation, effacement, and station guides the immediate care plan.
During active labor, checks are performed less frequently, often every two to four hours, or when a change in the patient’s condition suggests progression. Common triggers include a patient requesting pain medication, particularly an epidural, as minimum dilation is sometimes required for administration. A check is also performed if the patient feels a strong urge to push, to confirm that the cervix is fully dilated to 10 cm.
A cervical check is also performed immediately if the patient’s amniotic sac ruptures, or “water breaks,” especially if the baby is not yet engaged. This check is performed quickly to rule out umbilical cord prolapse, a rare complication where the cord slips out before the baby. Limiting the total number of checks is recommended after the membranes have ruptured, because each examination carries a slight risk of infection.
Patient Consent and Physical Experience
Every cervical check requires informed consent; the patient has the right to decline the procedure at any point. Even during active labor, a patient can refuse an examination, unless a severe medical emergency makes the information essential for life-saving intervention. The medical team should explain the reason for the check and how the results will impact the care plan before proceeding.
The physical experience can range from mild pressure to being uncomfortable or painful. Discomfort is sometimes more pronounced if the cervix is high, firm, or difficult for the provider to reach. Patients can request the check be performed between contractions or stop the examination if the sensation is overwhelming.
Following a cervical check, minor and temporary side effects are common. Patients may notice light vaginal spotting or cramping for 24 to 48 hours. This is normal and short-lived, resulting from the physical manipulation of the cervix.