Cervical Dilation

Let's talk: Cervical Dilation

Written by One Mama Midwife

Comfort Items From Birth and The Dummy Debate

What is your cervix?

Your cervix is the ‘neck’ of your uterus (womb) that joins the top of your vagina. If you picture a balloon, the cervix is the long tube that you tie to keep all the air in. The cervix irresponsible for staying closed during pregnancy and then opening during labour to allow a passage from your uterus through to the birth canal for the baby to be born. The process of your cervix beginning to open is called cervical dilation. Your cervix must open to 10cm dilated before the baby is able to pass through… so how big is that really? The cervix starts out the size of a blueberry and becomes the size of a melon at 10cm dilated!!! If you’re a visual learner, click this link to visit our reel on cervical dilation sizes.

What causes the cervix to dilate?

Dilation is usually caused by the contraction of the uterus, pushing baby’s head onto the cervix along with hormonal changes causing it to become soft (effacement) and open(dilation). This process is different for everyone and that is normal.

Phases of the first stage of labour:

The early phase of labour occurs from 0cm-4cm and it is during this time that most women are encouraged to stay home (provided they have no medical contraindications). The early phase of labour is usually the longest phase of labour, this is because the cervix has a lot of work to do. In early labour, the cervix not only has to dilate (open) but it has to become soft, thin (effacement) and move from the back (posterior) to the front (anterior). During this early phase of labour, contractions and progress are variable and can take anywhere from a few hours to a few days. It can be helpful during this time to try to rest, relax and distract yourself as best as you can. You do not want to use up all of your energy during this stage. Anytime that you have concerns it is best to talk to your healthcare professional. Once you are in established labour, which is anywhere from 4-6cm onwards, you will notice that the contractions become more regular and are stronger. During established labour, contractions are usually every 3-4 minutes and last approximately 40-60 seconds. During established labour, it will become impossible to ignore the contractions and you will struggle to talk through them. It is now when it is important to stay upright to help baby move further down into the pelvis and to focus on your breathing, making sure that you are taking deep, slow breaths. In established labour, most women will dilate 1cm every 1-2hours however, every woman and pregnancy are different. A delay in labour progress is usually diagnosed if the woman has dilated less than 0.5cm per hour over a four-hour period. It is important that the clinical picture is considered when determining delays to progress in labour.

The transition phase of labour occurs from approximately 8-10cm and is the period where you may feel and often say “I can’t do this anymore” - this means that you are so close!! In transition, the contractions are again stronger and often closer together. During the transition phase, try to stay in your zone, listen to your body, focus on your breathing and picture meeting your baby very soon.

Tips to help you progress in labour:

As you can see there is a wide range of “normal” when it comes to labour and labour progress. Every woman and pregnancy are different and should be treated individually. My tips to help you promote physiological labour include:

- Staying at home as long as you feel comfortable (provided there are no contraindications)
- Creating an atmosphere of calm, privacy, and safety to reduce adrenaline (aka – the fight or flight response).
- Having a trusted healthcare professional with continuity of care if possible- Having a supportive birth partner/team- Ensuring that you’re listened to, this can be from your partner advocating for you or through your birth plan
- Change positions regularly, making sure that your pelvis moves at different angles to help baby move down into the pelvis.
- Use water for pain relief.

So, remember that everyone is different and labours differently. Meaning that you maydilate slower during some phases and faster during others and this is completely normal.Understanding each phase of labour can really help you stay focused and in control.Knowledge is power!!