Cervical checks are a component of prenatal care during pregnancy, serving to monitor the health and progression of both the mother and the developing baby. These examinations provide healthcare providers with information about the cervix, which undergoes significant changes throughout pregnancy. The frequency and necessity of these checks can vary based on individual circumstances and the stage of pregnancy.
Why Cervical Checks Are Performed
Cervical checks gather information about the cervix, a muscular structure that acts as a protective barrier for the uterus. A primary reason for these checks is to assess cervical length, which indicates the risk of preterm birth. A shorter length, especially between 20 and 24 weeks, can indicate an increased likelihood of preterm delivery.
These examinations also evaluate for cervical dilation and effacement. Dilation, measured in centimeters, refers to the opening of the cervix, while effacement describes its thinning and shortening, expressed as a percentage. As pregnancy progresses and labor nears, the cervix naturally begins to soften, thin, and open. Monitoring these changes provides insights into the body’s readiness for labor and its progression. Providers also check the cervix’s position, consistency, and the baby’s station, indicating its position in the pelvis.
Standard Schedule for Checks
During an uncomplicated pregnancy, cervical checks begin at specific points. An initial pelvic exam, potentially including a cervical check, is often performed during the first prenatal visit to assess reproductive organ health. Checks become more common as pregnancy advances, especially in later stages.
Routine manual cervical checks often begin around 36 or 37 weeks of gestation and may continue weekly until labor. However, some providers omit routine late-pregnancy checks unless concerns arise, as these exams do not reliably predict labor onset. During active labor, checks occur more frequently, often every two to three hours, to monitor dilation and effacement progression. This helps providers assess labor advancement and determine next steps.
When Extra Checks Are Necessary
Additional cervical checks may be necessary beyond the standard schedule if specific situations or symptoms arise. Concerns about preterm labor, such as contractions, spotting, or pressure, may prompt an earlier cervical check to detect early labor changes. Infection signs or premature rupture of membranes are other reasons for non-routine examinations.
A history of cervical insufficiency, where the cervix shortens or opens too soon, requires closer monitoring, often via transvaginal ultrasound. If a short cervix is identified, further monitoring or interventions, like a cervical stitch, may be recommended to reduce preterm birth risk. Cervical checks also determine the Bishop score, especially when considering labor induction, as this score guides the process.
What Happens During a Cervical Check
A cervical check involves a manual examination by a healthcare provider. The patient lies on an exam table with feet in stirrups. The provider inserts one or two gloved, lubricated fingers into the vagina to reach the cervix. During this manual assessment, the provider evaluates several characteristics:
Cervical dilation (how open the cervix is in centimeters)
Effacement (how thin the cervix has become)
Its position (whether it is facing forward or backward)
Its consistency (softness)
The baby’s station, indicating its position in the pelvis, may also be assessed.
While a speculum is commonly used for visual inspection during a general pelvic exam or Pap test, it is generally not used for routine manual cervical checks in pregnancy unless visualization is needed (e.g., for a Pap smear or discharge investigation). In some cases, particularly for cervical length measurement, a transvaginal ultrasound may be used. This involves inserting a small ultrasound probe into the vagina for a clear, precise cervical measurement. The examination typically lasts 30 seconds to a few minutes.