Understanding Cervix Checks in Pregnancy: A Guide for Tree of Life Birth Center Clients
As you embark on your beautiful journey of pregnancy, you may have questions about the procedures and examinations your midwife will use to monitor your health and your baby’s development. One important aspect of prenatal care is the pelvic exam, which includes assessing the vagina and tissues, pelvic bones, cervix, and station of the baby in the pelvis. Understanding when and why midwives offer pelvic exams and cervix checks in pregnancy can empower you as a birthing individual and help you make informed decisions about your care.
What are Cervix Checks in Pregnancy?
Cervical exams involve a healthcare provider such as your midwife assessing the cervix to determine its status—specifically, its dilation (how open it is), effacement (how thin it has become), and the position of the cervix from posterior (towards spine) to anterior (towards pubic bone). These exams can provide valuable insights into labor progress and help inform your birth plan. They do not predict when labor will start. As midwives, we also perform Pap Smears when indicated during pregnancy. This involves a speculum to visualize your cervix for polyps, cysts, and inflammation, and then using a broom to collect cervical cells to evaluate for cancer cells.
Timing of Cervix Checks: Why We Wait Until 39 Weeks at Tree of Life Birth Center
In our midwifery care at Tree of Life Birth and GYN, we typically do not perform routine cervical exams before 39 weeks of gestation. Here are a few reasons why:
- Avoiding Unnecessary Stress: Early cervix checks can lead to anxiety or concern about your progress. The cervix can change in response to various factors, and early checks may not provide a clear picture of your labor’s timing or nature.
- Natural Progression: Every pregnancy is unique, and the body has its own timeline for preparing for labor. We believe in giving your body the space it needs to naturally progress toward labor without unnecessary intervention.
- Reducing Risks: Frequent cervical examinations can introduce risks, such as increased infections or irritation. By waiting until 39 weeks, we can minimize these risks while still providing the necessary assessments as you approach your due date.
If you are having signs of labor or think you are leaking fluid, your midwife will do a pelvic exam to diagnose labor, regardless of your gestational age, or send you to the hospital for evaluation of preterm labor (before 37 weeks).
The Role of Cervix Checks After 39 Weeks of Pregnancy
Once you reach 39 weeks, cervical exams can serve as a useful tool in your plan of care at Tree of Life Birth and GYN. Birth Center protocol allows births in our center between 37weeks and 42 weeks. If you get to 42 weeks gestation and you are not in active labor, our protocol is to transfer you to the hospital for medical induction with prostaglandins or Pitocin.
Here’s how cervical exams can help:
Assessing Your Cervix’s Readiness for Labor:
Cervical exams in pregnancy can provide insights into how your body is preparing for labor. Knowing the degree of dilation and effacement can help you and your midwife discuss the next steps, including adding herbs, homeopathic remedies, pregnancy chiropractic care, and acupuncture. Some studies show that touching the cervix helps release prostaglandins in the body, which encourages labor to start.
Planning for Herbs and Natural Remedies to Support Cervical Ripeness:
As a Tree of Life midwifery client, you will receive recommendations for “priming” herbs such as Red Raspberry Leaf and Evening Primrose Oil at your 36-week appointment. These are natural ways to support cervical “readiness” and help initiate contractions when used appropriately. If you are past your due date or approaching it, cervical exams can guide discussions about which herbs to encourage prepping the cervix versus herbs to induce labor naturally.
Certain herbs like Blue and Black Cohosh cause uterine contractions and increase the release of hormones to kick labor in. For some women, these herbs are contraindicated, so always check with your midwife or prenatal care provider before starting.
Monitoring Cervical Changes:
After 39 weeks, if your exams can help our midwives know which herbs and homeopathies to use. If your cervix needs more softening, we may recommend homeopathies. If you have already used homeopathy, we may switch to an herbal tincture. Cervical exams after 40 weeks can facilitate discussions about alternative options and care plans, ensuring you feel supported in your decisions
What is a Membrane Sweep of your Cervix?
A membrane sweep is NOT part of a pelvic or cervical exam. A membrane sweep or stretch is a separate procedure that has pros and cons that you should be asked if you want done and consent to having done. A cervical or membrane sweep is when you are already 1-2cm dilated and the midwife is able to use her finger to “sweep” between the head and lower segment of the uterus. This separates the amniotic sac, or bag of waters from the uterus and releases a cascade of hormones that encourages the start of labor.
A membrane sweep can be the start of a natural induction process. Because birth centers have protocols specifying gestational age between 37-42 weeks, a membrane sweep after 41 weeks can increase your chances of starting labor before 42 weeks at the center
What is Pelvimetry during Pregnancy?
Another aspect of the pelvic exam is assessing the shape and diameter of the pelvic bones and arch of the symphysis pubis , your pubic bone. As Midwives, we never say “baby is too big” or “your pelvis is too small’. Midwives honor the process of birth where the bones open and the head molds to fit your pelvis. However, if we assess a short diameter of the pelvis or a flat pubic bone, we will encourage certain positions to help the molding and opening.
Frequently Asked Questions about Cervix Checks in Pregnancy
A cervical check is a vaginal exam used to feel the cervix. Your midwife may check if it is soft, closed, or starting to open. During pregnancy, it does not predict exactly when labor will start but can give some clues as to how close you are.
No. Cervical checks and pelvic exams are optional. They are not required in a healthy pregnancy. You always have the right to say yes, no, or not right now. Informed consent is important to us here at Tree of Life Birth and Gynecology.
It can be uncomfortable. Some people feel pressure. Others experience pain. How it feels depends on the provider’s technique, your body, and how relaxed you are. You can ask to pause or stop at any point.
You can decline the exam. You can ask why it is being suggested and what decisions would change based on the results. You can also choose to wait until labor is active or ask about other ways to assess how things are going.
Final Thoughts
Pelvic exams and evaluating the cervix at 39 weeks and after can play a significant role in helping you navigate the transition to labor while respecting your body’s natural processes. At Tree of Life Birth and GYN, our midwives use herbs, homeopathies, teas, and meditation exercises with Hypnobirthing to help encourage labor by 42 weeks. Open communication with your midwife is key. We will be there to support you with knowledge and personalized care throughout your journey. Ultimately, it is your body and your choice.
If you have any questions or concerns about cervical exams or your midwifery care plan during pregnancy, don’t hesitate to reach out to your care team at Tree of Life Birth and GYN. We are here to help you feel empowered and informed every step of the way!
Tree of Life Birth Center is a nationally accredited facility offering holistic prenatal, birth, and postpartum care and well-woman gynecology with the highest standards of the midwifery model of care. We help Florida families who are struggling with the standard maternity care model to achieve their ideal birth & wellness experience and feel heard, respected, and safe. Book your free consult today.