If you’re among the first-time mothers or you just don’t have an understanding of the medical terms, it’s okay. Terms like dilatation, effacement are crucial when around the 37th week, when it’s almost the end of pregnancy period. It is the time when the doctor and the midwife check the cervix for this parameters. They are important signs in the last few days which tell us how much you are left till the most important part, the actual act of labor. It is necessary for this actions to happen in order for the baby to come out of the cervix into the outside world. Let’s elaborate on those.
The sign of effacement means the act of thinning the surface of the cervix or effacing. It happens during the third trimester of the pregnancy when the baby comes to a position where it’s closer to “the exit”. When not in pregnancy, the cervix is 3-5cm long and it is thick. When the pregnancy comes to an end, it starts to shorten and it gets thinner. As it gets more and more effaced, it actually looks like the uterus disappears inside the walls of the pelvis and it appears as if it is the opening of the vagina. When you’re in the last days of pregnancy, your doctor checks for the effacement where it is expressed in percentage and it goes up to 100% when the labor begins. It is measured along with dilatation where it goes from 1 to 10 cm in wide and the percentage of effacement goes from 0% to 50% and lastly, 100%. As the thinning process is evolving, the mucous plug, as it is called, “unplugs” from the cervix opening which can be followed up with some bloody showers. This can also pass without you even noticing. Before the dilatation and late contraction, there are early signs called Braxton Hicks contractions. They occur when the baby’s head goes down to the uterus and it causes cramps and contractions. But these are not yet active labor, they represent the “false labor” preparing the body for the pushing phase. They are still irregular and you should get relaxation after drinking some water as the dehydration can be the cause of these contractions. The contractions get stronger by the time and progresses to the final stage when they become regular and don’t subside.
After the thinning and effacement stage, the cervix starts to stretch as well, where it gets ready for the baby’s body which has to go all the way from the uterus to the vaginal canal. The dilatation is measured in centimeters. In the early stages, it is usually zero centimeters. In the last week of pregnancy, the doctor may check for the dilatation stage to determine the size of widening. Since it’s measured by the finger technique, it can be expressed in “finger size” such as “she is 3 fingers dilated”. 0-4 cm is considered an early stage of labor. 4-7 cm is the dilatation in the active stage of labor, where the last 7-10 cm represent the transition phase or the phase when the active labor goes into the delivery phase. When the cervix is 10 cm dilated, it is ready for the baby’s head and you are prepared to give birth.
There is another sign which is important and it is being observed in the late stages of pregnancy, or in early stages of labor. This is the station terminology, which refers to the baby’s location of the head in relation to the pelvis. It is measured by the numbers from -5 to +5. When the number is in negative section of the scale, it means that it has not yet entered the pelvis. When the number goes to zero, it is the first stage of the baby’s head entering the pelvis. When the baby’s head engages more into the pelvis indent, it reaches the positive numbers. Even if you’re dilated to the maximum, you should not push until the station indicates that the baby’s head is close to the pelvic opening.
Other Signs Of Labor
- Water Breaking. As your baby goes into the pelvis, it makes pressure to the surrounding sac called amniotic sac. This sac is filled with fluid which gives the baby the needed nutrients. When at the end of labor, the sac will rupture and this phase is called water breaking. It is almost always at the start of labor, but there are cases where it can happen before that, which is called premature rupture of membranes. You can experience wetness and fluid going against your legs. Not everyone senses the breakage of the amniotic sac.
- Mucous Plug. This is the mucous membrane which protects the baby and uterus from possible infection during the pregnancy period. It comes out at the early labor stage when it looks like gelatinous plug which can also be accompanied with a bloody It can fall off in little pieces and one big swoop, so it is called the rush or the flush type.
- Bloody Show. This usually happens when the mucous plug is lost as it can cause the capillaries to rupture. You can spot it as a bloody wipe after the use of the toilet and it will look like a small bloody spot. It can be heavy or hemorrhage so badly that you have to wear a pad or even change it often. That’s when you should seek for medical attention due to possible complications. It should not be followed by heavy bleeding by any means.
Stages Of Labor
There are three stages of labor, were the first one is the longest one and the hardest one for the future mothers:
- Early Labor Phase. It is the phase when the cervix is dilated up to 3 cm and the labor is not yet to come.
- Active Labor Phase. It is the next stage when the dilatation goes from 3 cm to 7 cm.
- Transition Phase. It is the last stage of the labor and the actual delivery when the dilatation goes from 7 to the full dilation of 10 cm.