What is cervical effacement? What is the difference between dilation and effacement? What are the symptoms and how do you measure it?
Having a baby is a magical thing. Numerous things happen to our bodies, almost simultaneously, close to birth to get us, and baby, ready for the big debut. One of those things is effacement, not to be confused with dilation. Effacement is a natural process in the cervix that assists in the delivery of your baby.
What is Cervical Effacement?
Cervical effacement, also known as ‘cervical ripening’, is your bodies natural way of preparing to give birth. The cervix recedes into itself, becoming shorter and softer so that the baby has an easier time coming through the birth canal. When you experience cervical effacement, your baby will be in the birth position (head down) most of the time and your cervix will be shortening, making it a shorter journey for your baby to travel.
Many women are disheartened when their doctor checks them and tells them that they are 100% effaced, and then a different doctor or nurse checks them a week later and tells them that they are only 25% effaced. This happens because checking for effacement depends on the person’s finger length and size. Someone whose fingers are long and narrow will probably tell you that you are close to 100% when someone who had short, wide fingers will tell you that you are not effaced at all. Effacement judged solely by the ‘finger check’ is actually quite inaccurate. The best way for you to really know how effaced your cervix is is to have an ultrasound of cervical length and thickness done.
Another common misconception about effacement is that, once you are 100% effaced, you are ready for labor. This is not true. Effacement is undoubtedly necessary to give birth. However, you still need to dilate to 10 cm and the baby needs to travel further down the birth canal, going through the birth stages, in order to give birth.
What is the Difference Between Dilation and Effacement?
Dilation is the process in which the cervix and hips actually widen in order for the baby to fit through the birth canal. This process happens after cervical effacement.
Cervical effacement is where the cervix softens and thins out from its normal thickness, rather than open up.
When you are finally 100% effaced, your cervix will kick in to dilation mode and start to open in to get ready for birth. These are two essential parts of the stages of labor.
What are the Stages of Birth?
There are three, crucial stages to labor. The first stage has three phases: early, active, and transition. These stages are what encompass cervical effacement and dilation.
The First Stage
- Early Phase
In the early stage of labor, contractions pull the cervix in. Your cervix, which is roughly 3 – 4 cm long, ‘thins out’ or shortens, seems to become a part of the lower uterus by the end of effacement, making it as thin as a piece of paper. Effacement can happen any time between a few weeks before labor starts (mainly caused by Braxton Hicks Contractions), to hours before giving birth.
- Active Phase
The active stage of labor is after effacement has occurred. This is where the contractions come in more frequently and for longer intervals. These contractions are necessary to keep your cervix dilating in order to give birth. This is the main stage of giving birth. On the contrary to the belief that, ‘pushing’ is the main stage, the key to a successful birth is coping with the active stage contractions.
Try and find ways to cope with them, whatever works best for you. It’s been found that moving, chanting, and swaying help immensely with these contractions, so try and wait on your epidural as long as possible. After you get an epidural, you are not allowed to move around.
- Transition Phase
The last stage of birth is the transition stage. This stage is where the last two centimeters needed to dilate so that you can get ready to bear down and have your baby.
The Second Stage
The second stage of labor is pushing your baby through the birth canal. It may seem easy considering how thin the cervix has become over the phases of the first stage of labor. However, it still requires a of energy for you and baby. Your baby needs to ‘turn’ through the birth canal so that he/she can fit.
Concentrate on staying relaxed. If you stress yourself out, your baby will stress out, making this stage last longer than it needs to.
The third stage of birth comes after your baby has been born. Another common misconception is that as soon as you’ve given birth to your baby, you’re done. However, this is not the case. The placenta (your baby’s temporary home and nutrition source) now needs to be delivered as well. Not delivering the placenta can cause hemorrhaging, as your body is continuously trying to expel everything foreign to the uterine space. This is a simple process and is the shortest stage in the birth process.
What are the Symptoms of Cervical Effacement?
Though there are no actual symptoms for cervical effacement, there are changes that you will experience when it occurs. Such as:
- ‘Lightening’ – the feeling of being able to breath again. This is caused by your baby dropping lower into the birth canal and getting ready for labor.
- Loss of mucus plug – this is the plug of mucus that blocks the cervical canal from expelling anything before it is time. This not the best way to tell if your effacing, however. Not everyone loses their mucus plug in one chuck. Sometimes, it happens over a series of days (or even weeks) so that it is hardly noticeable.
- Contractions – contractions are what cause dilation and effacement in the first place. If you are unsure of what a contraction feels like, here is an example: Say you are sitting on the couch and you have a sudden cramping in your stomach, almost as if you need to use the bathroom. This ‘cramping’ is a contraction. All people feel contractions differently, so the pain may be more centered in your back, sides, or stomach. One common thing with all contractions, though, is the pressure that you feel in your bottom. It seems that more women feel pressure in their bottom than in their pelvic region during birth.
How to Measure Cervical Effacement
Most people go to their OB/Gyn to be checked for cervical effacement. However, there are ways for you to check in the comfort of your own home.
Firstly, make sure your hands are clean and your nails are trimmed. You don’t want to give yourself an infection or cut yourself during such a delicate process.
Secondly, find a position that is most comfortable for you and allows you full access to the vaginal area. A lot of women find the squatting position to be easiest because it is an easy position for a pregnant woman and allows you complete access to the cervix, which should be very high up.
Third, insert your finger as far as your cervix will allow. If your finger can be inserted to the second knuckle, then there has been no effacement. You will know that you are effacing when your reach gets shorter each time you insert your finger.
However, asking your midwife or doctor is the safest way to ensure that you are effacing. To avoid different answers, try and keep the same person checking you at each appointment. This eliminates the possibility of different answers from different people.
Don’t put too much stock in how quickly you are effacing. Some woman take weeks to efface 100%. Other woman can go from 0 – 100% in a matter of hours. It all depends on the person. Either way, focus on the positives, be excited, and your little one will arrive when he/she is ready!