Cervical dilation and effacement
As you get closer to labour, the lower part of your womb called the cervix will begin to thin or stretch (efface) and open (dilate). Effacement and dilation prepare the cervix for vaginal delivery.
Effacement: Thinning of the cervix
Before your labour begins, the cervix is long, firm, and tightly closed. As labour begins, your cervix shortens, softens, and begins to thin out. It is referred to as cervical effacement or thinning of the cervix. During this phase, you might feel uncomfortable and experience irregular but not very painful contractions, or you might feel nothing at all.
Cervical effacement is often measured in percentages. At 0 percent effacement, there is no shortening or thinning of the cervix. At 50 percent effacement, your cervix has thinned to half of its original thickness. At 100 percent effacement, your cervix is completely thinned out.3,
Dilation: Opening of the cervix
After the cervix begins to thin out, it will also start to open. It is referred to as cervical dilation.
Cervical dilation is expressed in centimetres from 0 to 10. 0 means your cervix is closed, and 10 means it is completely dilated. Your cervix needs to be 10 centimetres dilated (completely dilated) before you can start the pushing stage.
How quickly the cervix thins and opens is different for each woman. In some women, the cervix may start to efface and dilate slowly over a few weeks.1,
In case this is your first pregnancy, you may not dilate until active labour begins. Active labour is when contractions become stronger, closer together, and regular.
It is difficult to predict when active labour will begin as each woman is different. For some women, it may only take a few hours, and for others, it may take several days. Therefore, you must look after yourself during this phase. The following tips may be helpful:2,
- Continue with your day to day activities
- Watch TV or listen to your favourite tunes to distract your thoughts from the pains of early labour
- Practice your breathing techniques – Inhale and exhale slowly
- Use a hot water bottle or a cold face towel on areas that ache; for instance, your lower back, under your bump, and in between your thighs
- Have a warm bath or shower
- Take a walk
- Remember to eat and drink in small amounts
- Rest well- avoid exhaustion and conserve your energy for when labour establishes
Call your doctor if you're not sure about whether you're in labour or if you are concerned about how you are feeling.
You may even arrive at the hospital only to be told that it was a false alarm. Don't be embarrassed! Instead, consider it a practice run.
1. Government of Alberta. Cervical Effacement and Dilatation [Internet]. Available at: https://myhealth.alberta.ca/Health/Pages/conditions.aspx?hwid=zx3441&lang=en-ca. Accessed on Aug 17, 2020.
2. Blackpool Teaching Hospital, NHS Foundation Trust. Coping with the Latent Phase of Labour [Internet]. Available at: https://www.bfwh.nhs.uk/wp-content/uploads/2015/08/PL824.pdf. Accessed on Aug 17, 2020.
3. Mayo Clinic. Signs of labor: Know what to expect [Internet]. Available at: https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth...'t%20wear%20yourself%20out. Accessed on Aug 17, 2020.
4. Winchester Hospital. The Signs and Stages of Labor [Internet]. Available at: https://www.winchesterhospital.org/health-library/article?id=101232. Accessed on Aug 17, 2020.
5. HealthLink BC. Cervical Effacement and Dilatation [Internet]. Available at: https://www.healthlinkbc.ca/health-topics/zx3441#:~:text=Effacement%20an...,)%20and%20open%20(dilate). Accessed on Aug 17, 2020.
6. Mayo Clinic. Stages of labor and birth: Baby, it's time! [Internet]. Available at: https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth.... Accessed on Aug 17, 2020.
7. Southend University Hospital, NHS Foundation Trust. Latent phase of labour [Internet]. Available at: http://www.southend.nhs.uk/media/172700/latent_phase_sou4059_041963_1115_v1.pdf. Accessed on Aug 17, 2020.