You know you’re a Midwife when you see this image and the first thing you think is “6cm dilated” haha!
Which leads me into the topic of vaginal examinations (aka VE or internals) in labour. Did you know that vaginal examinations have NO predictive value in determining how long your labour will last? Or when you will give birth?
I have cared for women who have gone from 3cm dilated to a baby in their arms within an hour to 9cm dilated and a baby hours later. This is because labour variations in pattern and strength can differ from one woman to the next and even between each labour a woman has (whether her first, second or third etc) as every labour and birth is unique.
Did you know there are so many other important and exciting changes to your cervix – so much more than “just a number”. We should all be more interested in:
- The position: has it moved toward your front (anterior position) in readiness for labour as typically your cervix points towards your back (posterior)
- The consistency: is it firm/rigid like the tip of your nose or soft like your lips?
- The length: has it begun to shorten in length? It is usually around 3-4cm long before labour changes occur
- Effacement: Has your cervix begun to “ripen” or thin out in preparation for labour?
- Dilation: Has your cervix begun to open/stretch? then high-five! The number is less important here as your body has already done so much work!
- Application: Is baby’s head/bottom well applied on the cervix? Generally speaking, the more well applied the presenting part is to the cervix the more effective dilation (opening of the door) will be.
While yes, VE’s can have their place (for instance when determining an unusual presenting part like a shoulder/face/brow or a cord prolapse) there is no evidence to support routine vaginal examinations in labour.
So if you are offered an internal ask yourself what information do you hope to learn from it? If it is simply to know a number because you are wondering about how your labour is progressing then there are many other encouraging cues which can indicate to your health care providers how things are tracking (or cracking along).
These are just some of the wonderful topics we discuss at Calmbirth so check my profile on the Calmbirth Website and for my upcoming Calmbirth course dates.