Pregnancy and you blog
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.
Aug. 14, 2010