A cervical exam is a routine procedure in pregnancy where your healthcare provider inserts two fingers vaginally to assess various aspects of your cervix. These exams measure how many centimeters your cervix is dilated, how soft it is, how low your baby's head is, and whether your cervix is still about two inches thick or has thinned. While these exams can be useful in determining your readiness for induction, they don’t provide reliable information about the timing of labor or its progression.
Why Consider a Cervical Exam?
Before deciding whether to undergo a cervical exam, it’s crucial to understand why you’re getting one. Although cervical exams are common, they offer limited information that may not be as helpful as many people expect. For example, when I work with birthing clients, I always make it clear that a cervical exam is usually performed out of curiosity rather than necessity. In most cases, the results won’t provide crucial information before labor begins. While curiosity is a valid reason to request an exam, it’s important to know that the procedure has potential drawbacks, and the data obtained is often not as valuable as one might think.
Cervical exams can sometimes provide insights into the readiness of the cervix for labor, but they don't offer a clear prediction of when labor will start, how quickly it will progress, or when it will end. This means that, although a cervical exam can offer information, it doesn't necessarily make a significant difference in how you should prepare for labor.
Understanding the Risks of Cervical Exams
Like any medical procedure, cervical exams come with their own set of risks. The main concern with cervical exams is the risk of infection. If your water has not broken, the risk of infection is lower, but the likelihood of infection increases if cervical exams are performed frequently. The more exams you have, the higher the chance that bacteria could enter the birth canal and lead to infection.
Another risk is premature rupture of membranes (PROM), where the bag of water breaks before labor begins. Once the waters have broken, the birthing person is on a time clock, and the clock starts ticking for how long they have before the baby must be born. If the water breaks and remains broken for a long time without labor progressing, it increases the risk of infections, as the protective barrier around the baby is no longer intact.
Although these complications are rare, they are still worth considering before agreeing to a cervical exam. Some providers may suggest these exams routinely, but it’s important to weigh the risks and benefits. In many cases, cervical exams are given without much thought to the potential consequences, which is why it’s so important for patients to be informed and confident in their decision.
Considering Past Trauma and Emotional Responses
Another factor to consider when deciding whether to have a cervical exam is your personal history. If you are a survivor of trauma or have past experiences that might make this procedure uncomfortable, a cervical exam could be emotionally and mentally challenging. For many, the idea of having someone examine the cervix can be invasive and uncomfortable. In some cases, it can even trigger past trauma or create significant anxiety.
If you have any hesitation about getting a cervical exam, I would suggest that you listen to your body and your feelings. It’s completely okay to say no if the procedure feels wrong for you. The mental and emotional risks of cervical exams often outweigh the potential benefits, especially since the results do not provide any substantial guidance in preparing for birth. If you are feeling vulnerable, the procedure could lead to unnecessary stress, and that’s something worth considering.
My Perspective as a Midwife: What Cervical Exams Really Tell Us
As a midwife, I have a very specific perspective on cervical exams: they’re not the crystal ball that many people hope for. While they can tell you how many centimeters your cervix is dilated, this information does not provide a clear picture of when labor will start, how long it will take, or how difficult it will be. The cervix can feel different depending on its position or whether anyone is touching it, and pregnancy and birth are unpredictable.
In my experience, one of the most important things for expectant mothers to understand is that labor is not something that can be planned down to the smallest detail. Pregnancy and childbirth push us into the discomfort of uncertainty. We can’t know for sure when labor will start, how it will progress, or exactly when it will end. This uncertainty is a natural part of the birthing process.
So, in my opinion, the only valid reasons to consent to a cervical exam during pregnancy are as follows:
- To assess dilation and effacement (thinning): Some people may feel reassured by knowing whether the cervix is dilating, but keep in mind that this doesn’t predict the timing or intensity of labor.
- To decide on induction: If you’re considering induction, a cervical exam and the resulting Bishop’s Score can help guide that decision. The Bishop's Score is a system that evaluates the cervix’s readiness for labor. A cervix that’s not favorable may not respond well to induction techniques.
- For a membrane sweep: If you’re hoping to have a membrane sweep (a technique to help start labor), it requires a cervical exam. If you’re considering this method to encourage labor, be prepared that a cervical exam is a necessary part of the process.
Remember: Dilation Isn’t Everything
If you do decide to have a cervical exam, remember that dilation is just one aspect of your birth process. It doesn’t define how your labor will unfold. For example, I often see clients go from 1cm to 10cm in a very short time, while others stay at 6cm for days. The cervix will change at its own pace, and there’s no magic number that indicates when your baby will be born.
In fact, some signs of cervical change are more promising than others. For example, cervical position (whether it is anterior or posterior) and effacement (thinning) can offer more insight into the progression of labor than simple dilation. These factors indicate that your body is preparing for labor in a positive way, even if dilation has not yet advanced.
Your Body, Your Choice
Ultimately, the decision to have a cervical exam should be a personal one. It’s important to be empowered and confident in your choice. If a cervical exam doesn’t feel right for you, it’s okay to say no. Your birth journey is your own, and your body is in charge of how it will unfold. If you choose to skip the exam, trust that your choice is valid, and know that your body will guide you through the process of birth at its own pace.
About This Article
This article is brought to you by Momcozy in partnership with YourBabyClub, offering helpful tips and resources for expectant mothers navigating the challenges of pregnancy. For more practical solutions and expert advice, visit Momcozy.
