Cervical exams occur when your provider places two fingers vaginally and feels to see how many centimeters your cervix is dilated, how soft your cervix is, how low your baby’s head is, and if your cervix is still about two inches thick or if it has gotten thinner.
This information can be helpful when considering whether or not your body is ready for an induction (The Bishop’s Score) but does not give much information about how soon labor will occur, how fast labor will be, or anything else.
Things to Consider
Why Are You Getting This?
When considering a cervical exam, the first thing to consider is why you are getting it. Cervical exams do not give us much information, yet many care providers request them. When people are birthing with me, I always tell them that if they want a cervical exam, it would be out of their curiosity and that I do not need that information, especially before labor. Curiosity is a valid reason for getting a cervical exam, as long as you know all possible risks and that it has no benefits.
What Are the Risks?
The risks of a cervical exam are mainly the risk of infection. If the waters are intact, you are much less likely to develop an infection, but the more frequently cervical exams are given, the higher the likelihood of infection. Another risk would be premature rupture of membranes or the bag of water breaking early. If this occurs, it puts the birthing parents on a timer for how long they have before the baby is born. Waters being broken for an extended period also increases the opportunity for infections to occur. These complications are rare, so cervical exams are given pretty thoughtlessly, but they are something to consider.
Do You Have Past Trauma?
Another thing to consider is if you are a survivor or have a history of trauma. For many, cervical exams can feel highly uncomfortable, and in some cases, they can be very mentally and emotionally challenging. If you have any hesitation about getting a cervical exam, the answer should be no. The triggers are not worth getting the exam, especially when the information is often less than helpful.
My Thoughts, as a Midwife
My favorite thing to tell people when they are asking about cervical exams is this: Our cervix is not a crystal ball. We cannot determine any factual information based on a cervical exam. Your cervix might feel different in a different position or without someone’s fingers. Pregnancy and birth are meant to push us into the discomfort of uncertainty. We don’t get to know how our journey through childbirth will go, let alone how it will begin and when it might end. That is a part of the journey itself, the unknown.
In my opinion, the only reason to consent to a cervical exam during pregnancy would be for one of three reasons. The first is your desire to know if dilation is occurring or not occurring. The second is if you are trying to decide whether or not to try for induction. In this circumstance, getting a cervical exam with a Bishop’s Score can help with that decision-making process, as an unfavorable cervix might not be a good one for induction techniques. The third reason would be similar to the second, but if you wanted a membrane sweep. These sweeps cannot be done without getting a cervical exam in tandem, so if a membrane sweep is something you are desiring, be prepared that it comes with a cervical exam as well.
If you decide to get a cervical exam, remember that we do not give birth by numbers and that we cannot obtain any information about pregnancy or birth from this exam. If your mental health is in a shaky spot, it might be a good idea to forego hearing any of the numbers, as dilation less than you were hoping can feel devastating. And like I tell all of my clients, people can go from 1cm to 10cm in an hour or hang out at 6cm for days. Dilation occurs at its own pace and isn’t even the most challenging part of cervical change. I often have more cervical hope if it has moved from posterior to anterior or effaced (thinned) a decent amount than when dilation changes have occurred.
Your body and your choice come into play when considering a cervical exam. If a cervical exam is not in the cards for you today, say no confidently, and know your choice is good.
