One of the more painful aspects of labor and late pregnancy can be the cervical exam. I have performed innumerable cervical exams as an OB-GYN both during my training and in private practice, and I have seen a wide range of reactions. The exam is only a passing event for some folks. But, for many others who are already experiencing a great lot of discomfort due to pregnancy, it is stressful to have to deal with it.
In light of this, why even do OB-GYNs perform cervical checks in the latter weeks of pregnancy? Some of our mentors during my training years engaged in it since it was how they had always operated. But, a lot of OB-GYNs who treat pregnant women today, including myself, have come to the conclusion that while there are situations where a cervical exam.
Cervical exams are performed to determine how dilated or open the cervix is, to put it simply. In the past, many OB-GYNs frequently performed cervical examinations in the latter weeks of pregnancy to look for changes in the cervix that would signal the beginning of labor. Together with dilation, other changes that occur during pregnancy include effacement (how thin the cervix feels) and location in the pelvis (how close or far away the cervix is from the pelvic bones and the baby’s head).
Even though these indications can occasionally help us estimate how close someone is to going into labor, they are ultimately simply educated estimates. I once saw a patient with a closed cervix in my own clinic who gave birth the next day, while another patient walked around with a 5 centimeter cervix for over a month before going into labor! There are many other factors that we have yet to understand about what kick starts labor and unfortunately, the cervical exam is just one part of that equation.
