On my local mommy message board, there is much talk about dilation and effacement. Around here, doctors start checking you at 36 weeks. Why? Who knows. The information is not beneficial to anyone from what I can see. It seems to only serve to make the mom anxious.
There are women who actually believe that they have "undilated"....meaning they were told they were a certain number of cm's, and then at the next visit told they were less. So just for my own peace of mind, I explain the art of checking dilation from my perspective.
When I first began checking dilation, one of my mentor midwives showed me how to get a good feel for the cervix, then withdraw your fingers and actually check on a tape measure to see how many centimeters it was. Now this is still tricky as you must visualize in your head how far apart your fingers are since you can't see them. And you can't withdraw your two fingers and keep them apart as that would be uncomfortable for the mother. So you can get my drift here that this is NOT an exact science.
Now, when a cervix is almost closed, or one fingertip....that is usually 1cm. But as you get into 2-7cm....it is very tricky. And everyone is a little different. Sometimes a practitioner will stretch the cervix a bit and be generous with their cm's, whereas my midwife wants to know the dilation without any stretching. So if you are checked by two people, one who interprets with a stretch and one who doesn't, you may get two very different results. Also, since perception plays such a big role, this can cause discrepancy between two different cervical exams. My vision in my head of how far apart my fingers are may be innacurate by a cm or so. This is why I always call a cervix about 1cm less that what I think it really is. I would rather underestimat than over...then have a devastated mom if someone else checks and she has appeared to "go backwards."
There is usually no question at 8, 9, and 10cm as these are not hard to assess. But no one ever thinks to ask their nurse how long they have been checking cervixes. You may have the newest nurse on the L&D floor and she may not have really gotten adept at cervical checks yet. She has to feel as insecure as I did those first few times. And out of those first few times, I was off a bit according to my midwife.
It is an art....not a science. And just when I think I have mastered it after a year of working in the birth biz, I will check a cervix that makes me go, "huh?" becuase it is so puzzling.
So the fact is, if your doctor or nurse says you're 8, 9 or 10cm..do the happy dance and get ready to push out a baby. If its somewhere between 2 and 7...take it with a grain of salt, keep breathing and know that the baby will come. And those routine checks at the dr's office.....a simple no thank you will keep you from letting those numbers transform in your brain to crazy thoughts such as, "This baby is never going to come!" or "I'm 3cm, I will go into labor tonight!" only to go another week.
