
- With Mayo Clinic certified nurse-midwife
Mary M. Murry, R.N., C.N.M.
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Mary M. Murry, R.N., C.N.M.
Mary M. Murry, R.N., C.N.M.
Mary Murry is a certified nurse-midwife in the Department of Obstetrics & Gynecology at Mayo Clinic, Rochester, Minn.
Murry, a Cincinnati native, has been a nurse-midwife practitioner for more than 20 years and is an instructor at the College of Medicine, Mayo Clinic. She was a contributing reviewer and writer of the "Mayo Clinic Guide to a Healthy Pregnancy" book.
Her research interests include adult female survivors of sexual abuse, women's perception of pain in labor, and obesity in pregnancy.
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Pregnancy and you blog
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Aug. 14, 2010
Cervical exam: What can it tell you?
By Mary M. Murry, R.N., C.N.M.
If you're like most pregnant women, you've been showered with questions and comments from well-meaning family members, friends and strangers. Still, I find it amazing when someone asks a pregnant woman, "Are you dilated?" I'm not sure there's any other time in your life when someone would feel free to question the state of your cervix. Still, the question comes up fairly often.
As you near your due date, your health care provider may do a vaginal exam to determine your baby's position inside your uterus. If there's any question about what part of your baby is coming first and its relation to your pelvis, your health care provider may confirm the baby's position with ultrasound. He or she may also do a cervical exam to check whether your cervix has begun to open (dilate) or soften (efface) in preparation for birth.
It's easy to pin your hopes on the results of a cervical exam, but the information you get from a cervical exam is limited at best. The measurements from a cervical exam are only estimations, so two different health care providers could have different results. In addition, the results don't predict when you'll go into labor. You could be dilated 2 to 3 centimeters and 30 percent effaced for days or even weeks before labor actually begins. Also, a cervical exam can be uncomfortable and may cause spotting or increased vaginal discharge for the day. Sometimes the information isn't worth the trouble.
One of my colleagues describes the cervical exam as a disappointment: You're disappointed if you learn that you're not dilated, and you're disappointed if you're dilated but still pregnant the next day.
In my own practice, I don't do routine cervical exams if I can be sure of the presenting part from a tummy check. If a woman wants to know what her cervix is doing, however, I'm happy to do the exam — and if a stranger wants to know the state of your cervix, you can always say that your cervix is fine and then ask kindly how theirs is doing.
6 comments posted
July 30, 2011 6:50 p.m.
When I was pregnant with my first daughter, at my 34 week checkup they told me I was 2 cm dilated and 60% effaced....I stayed 2 cm until they induced me(fluid level dropped due to bad sinus infection) at 38 weeks 2 days. I did continue to soften as when I was induced I was 90% effaced. With this my second baby I am 1cm dilated and hope that at my next apointment its progressing even though I know from past experience that even if I dilate further its not indicative of labor being really soon.
- Sarah
April 8, 2011 12:29 p.m.
I was told at my 38 wk check by one dr, I was 0 dilated, but 80% effaced. At my 39 wk check (w/my dr)I was told 0 dilated, 60% effaced. Obviously, the "results" of the internal exam depends on the practioner. At 40 wks (my dr) said that I hadn't changed from the wk before. I'm now 41 wks dilated 1, but no mention of effacement was made this time. My dr wants to schedule me for an induction in a few days, with more "unnecessary" testing between now and then. I just had the Bio-fetal profile/stress test done yesterday and it was absolutely normal (per my dr's own words "perfect")-NO ISSUES! But he wants me to have another one today and he also did not like me questioning him for the reason to have another done. Too bad! Doctors need to learn to listen to their patients as we also have some say in the care we receive and are capable of educationing ourselves on childbirth. I hope my little man comes soon on his own. Fingers crossed!
- Leanne
October 19, 2010 11:11 p.m.
I was dilated to 2cm for about 2 weeks prior to going into labor with my second daughter. During that time I also had several bouts of false labor. This was good news to me anyway, because with my first daughter I wouldn't dilate even though I was in labor.
- Skye
September 29, 2010 9:45 p.m.
I agree the cervix check is just weird. It never seems to tell anyone anything. There were 5 of us pregnant at the same time. This was the results #1 - Dilated 2 effaced 40% for 2 weeks - C-section #2 - Never dilated or effaced C-section #3 - Dilated 8 for 6 hours effaced from 0% to 100% for about 15 minutes #4 - Dilated 2 for a few hours with no efface. Then went from 2 to birth in 15 minutes. #5 - Dilated 3 for the last trimester. what to eat while pregnant
- Ana
September 13, 2010 9:12 a.m.
When I reached about 36 weeks, I seemed to get a check every time I went in, and each time I heard "Nada. Your cervix is hard as a rock." This was what I heard from 36 weeks until the Cervadil kicked in at the hospital. After 48 hours of very painful Pitocin-induced contractions (my blood pressure had spiked due to the pain of being in LABOR, go figure!), I had still not dilated beyond 2 cm and ended up having a c-section. There were about eight total cervical checks and each time my husband and I got our hopes up and each time they were dashed in about 30 seconds. Although emotionally it truely is lose-lose when you don't get the news you want, medically the check still has value, and it's only a few uncomfortable seconds out of many more to come in a woman's life and when it comes down to it, the baby will be born one way or another. Without the check, my sister in law would've had no idea she was dilated to five cm halfway through through her pregnancy with multiples and could have created complications for no good reason.
- Laura
August 25, 2010 6:34 p.m.
I had my 38 week appt yesterday and declined the exams. I was basically told that "well it's your body but you're not making the right choice" The doc was just upset that someone told him no. I did tell him why. The reasons they aren't a good idea. he said I was making things up. Good riddance!
- Amber
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