Following on from Ceri’s last blog post about your incredible uterus in all its glory, let us now marvel at the wonder of the cervix. Daisy teacher Chloe Sena says, “Let’s have a look at the remarkable journey your cervix goes on as your labour starts and progresses. It does so much more than just open, so during labour (as hard as it is!), try not to get too hung up on the number of centimetres dilated you are. Numbers are not everything. Anyone who has been to Daisy Birthing classes with me, will know how much love I have for the cervix. Honestly, I’m not a weirdo – hear me out ? ”
In Pregnancy
The cervix is without a doubt one of the most amazing features of the female body. One of its main jobs is to protect the development of the baby and the uterus during pregnancy by remaining closed and plugged with mucus. Then it has to to open and allow the body to birth your baby.
During pregnancy, it is like thick cartilage (a bit like the end of your nose), closed and plugged with mucus. It is about two and a half centimetres long and starts off pointing towards the back wall of your vagina. As your body starts getting ready for labour and birth, it will release hormones called ‘prostaglandins’. These will help it begin to soften, ripen and do its thing! As this starts, the mucus plug may also start to come away. Sometimes called a ‘show’, you may notice it in your pants, or when you wipe after going to the toilet. You may also not notice anything but it will come away at some point. Then it begins. Your cervix has one heck of a journey to go on and it will start before you even realise you are in labour!
So, what happens?
Firstly, the cervix will go from pointing backwards (posterior) to pointing forwards (anterior). This will bring it into line with the vagina to allow the baby to move through more easily. It also has to efface and soften. The contractions of the uterus draw the cervix up and cause it to shorten (from approximately two and a half centimetres) before any dilation can happen. This process is called effacement. It also has to soften, or ‘ripen’ and go from being hard cartilage like material to be soft and stretchy like the inside of your cheek, or ‘soft like butter.’ Pretty cool, hey?
Dilation of the Cervix
In addition to all of the above, the cervix also has to dilate or ‘open’ to approximately ten centimetres. In reality, the numbers mean very little and your cervix will get to a point of simply being ‘fully dilated’, whether that is 9, 10 or even 11cm. Dilation can not happen unless it has done all of its other jobs. So, if someone in labour is ‘stuck’ at say, 5cm – the other processes of thinning, effacing and ripening will be still going on. The important thing here is to not get disheartened if you are ‘only’ 3, 4, 5cm…. as your cervix is still doing its splendid thing and you will get there! And just to clarify, your cervix will not dilate to 10cm and leave a gaping hole just there, waiting for baby to come through. Rather, it peels back over baby’s head – a bit like a polo neck jumper. The dynamic movements, rotations, sways and rocks your body will instinctively do during labour all help aid this process of dilation, helping the cervix ease open over baby’s head with each contraction of the uterus.
It is Not a Crystal Ball
As we can see, the cervix has many jobs and every woman’s cervix will work differently. As Maria Pokluda says
“Let me let you in on a secret, your cervix is not a crystal ball. It cannot predict when labour will start. Nor can it predict if you will deliver before, after or even on your due date. The cervix can do many wonderful things, but let’s not give the cervix more credit than it is due. A cervix cannot predict the future.”
So, no your cervix can’t tell you when you are going to give birth, but you can see progress in many ways. When in labour, rather than thinking only in terms of numbers of dilation – ask your care provider to tell you if it is anterior, or how thin or effaced you are. This will mean you can see your progress and not be discouraged if on examination you are ‘only’ 4cm. Think instead – ‘Yeah! I’m 4cm – my body is awesome! Look what I’ve done already!’. Birth is different for everyone: a completely dynamic process that you can’t predict.
I hope you have enjoyed finding out more about your incredible cervix and that I have managed to show you of how truly tremendous it is. In my opinion, it is the most awesome part of the female anatomy.
Love Daisy x
Further reading:
http://www.mynovabirth.com/motherbaby-blog/2016/2/1/the-contracting-power-of-the-uterus