Wednesday, December 14, 2011

{Ottawa Doula} Can I Check My Own Cervix?

I have a habit of writing posts on issues that are somewhat counterculture...I can't help it! I love learning about things that are not mainstream, especially when it comes to women's health. So read on, but be warned....this may not appeal to you :)

If your care provider is a doctor or an OB, there is no way of knowing how dilated you might be without heading into the hospital and getting a cervical exam. If you have a midwife, they will often come to your home and do a check, which will tell you if it's time to head into the hospital or not.

I would first like to point out that dilation is not the primary indicator that labour is progressing. Penny Simkin (my doula guru) teaches that there are 6 ways to progress in labour:

1) The cervix moves forward - it faces your birth canal, instead of your bum!

2) The cervix softens and gets squishy

3) The cervix thins (effacement, in %)

4) The cervix dilates (from 1-10 cm)

4) The baby moves down the birth canal (station, from -4 to +4)

5) The baby rotates

For a lot of women, long early labours (24+ hours) are doing a number of things - the cervix is moving forward, softening and effacing. Dilation may happen during this time, but it's common for effacement to take place to a greater degree. So women arrive at the hospital, find out they're 3-4cm, and feel extremely disappointed. But if effacement is 90-100% then dilation can occur rapidly after this point. Or, if baby's head is sitting very low (say, +2 station), then the pressure may spontaneously break your waters, and you are soon pushing!

However, it's also possible that you may find yourself at 2cm, with little effacement. You then receive the disappointing news - they're sending you home.

So clients often ask me: how do you know when it's time to go to the hospital?

Personally, I like to confer with astrological charts and assess my client's aura for signs....

....kidding! But sometimes I am definitely unsure as to whether my client is dilated enough, and find myself holding my breath during the exam. There are plenty of signs, but women's bodies can sometimes mimic active labour when they are in early labour.

So during prenatal appointments, I half-jokingly inform them that some women check their own cervix at home. I'm generally met with nervous laughter (they're probably wondering whether they hired the doula who does use astrological charting and auras), but I secretly hope that one day, someone will take me up on the suggestion.

Because, let's be real....this is your body we're talking about. When you get to the hospital in labour, many different people repeatedly stick their fingers inside your vagina. Yes they wear gloves, but like condoms, there's no 100% guaranteed protection. Personally, I like the idea of using my own bacteria-ridden hands to do the job. But clearly this is a very personal choice, and who knows whether I'll actually do it myself if I'm ever in labour again!

{Before you read on, please note that this is not medical advice. It is simply some observations I have made about the cervix, in addition to my own experience!!}

For interest's sake, I thought I would provide some information on how to check your cervix....if you so wish! It might be a good idea to check your cervix once or twice during pregnany, just to get a sense of how it feels during non-labour (also, some women are dilated 1 or 2cm throughout their entire pregnancies):
  • Wash your hands well with warm, soapy water. Make sure your nails are clipped - nicking yourself on the cervix would not be pleasant during labour. You also need to be sure you're not going to break your bag of waters by accident.
  • In between a contraction (please don't do this during a contraction), have your partner or doula help you get into a squatting position
  • Insert your middle finger into your vagina, and go all the way back until you run into the cervix.
  • When you're not in labour, the cervix will feel "tough"....probably as tough or hard as your forehead feels. As things start getting softer, it will kind of feel like the tip of your nose. Once your cervix is very soft, it will feel like your lips
  • When you're not in labour (and not ovulating), your cervix looks and feels like a puckered kiss. If you are 1cm dilated, you will be able to slip your finger into the cervix (through the puckered kiss!) Basically, the more fingers you can get in there, the more dilated you are. Most nurses will insert 2 fingers, and then will stretch them out to see how wide the cervix is stretched out (keep in mind though, if you're manually stretching your cervix, it's gonna hurt! This is not a good idea - just stretch them out as far as you think the cervix is stretched)
  • Once your fingers are in the cervix, you will feel the bag of waters. If you press on the bag, you'll feel a hard head. If your bag has broken, you'll obviously just run into your baby's head at some point.
Given that checking dilation is an art (and takes some practice), keep in mind that you may be off by 1 or 2 centimetres. But, if you definitely feel some dilation (for example, 2 fingers are inserted and stretch out a bit), AND the cervix feels very soft and thin, you can be pretty sure that you're in active labour. Especially if you're also exhibiting other signs of "labourland."

Bottom line - if labouring at home for a long time is really important to you, consider learning how to check your cervix. You may save yourself a wasted trip to the hospital.


  1. long before I had done any work as a doula I checked my cervix during my labour with my third baby. I could not only feel a nice mushy thin cervix but bulging membranes poking through. Good time to call my midwife I surmised!Elijah arrived about 90 minutes later, my first home birthed baby.17+ years ago.
    I often now even in my non-pregnant state check my cervix. I can tell by it's position if I am ovulating or close to my period by it's position. Hey it is my body ( as you so nicely pointed out!) and getting aquainted with all its parts and changes only seems to make sense to me

  2. I often get confused I've been contracting a lot and when I feel my cervix its very soft but I'm confused because when I stick my fingers in there its like a soft kind of long stretchy tunnel so am I dialated or just soft confused

  3. I often get confused I've been contracting a lot and when I feel my cervix its very soft but I'm confused because when I stick my fingers in there its like a soft kind of long stretchy tunnel so am I dialated or just soft confused


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