Cervical Dilation/Effacement – Conscious Birth and Wellness

Cervical Dilation/Effacement

How to optimize it!
As the body prepares for birth, the cervix undergoes a series of changes known as effacement and dilation. Effacement refers to the thinning of the cervix, while dilation involves the opening of the cervix.
Effacement is measured as a percentage, representing how much the cervix has thinned. Dilation is measured in centimeters, indicating the width of the cervical opening. The cervix typically needs to efface and dilate to certain extent for a safe and smooth delivery. Each time your uterus contracts it is pulling the cervix thinner and then eventually open. It is the rate of this opening that determines the length of your labour.

Some can be dilated a fair bit before labour even begins -Bonus!
That is usually due to effective fetal head placement and gravity. 
The cervix is very sensitive and has plenty of nerve endings I think for many what is perceived as pain in labour is the cervical changes.
The uterus is a muscle and is designed to contract and like your bicep, a muscle contracting isn’t in itself painful (unless you worked out too hard!) and labour is a workout x10 for some.

We can override the discomfort of these changes by riding the hormonal tide. (A topic for another day) One thing to be clear on Cervical changes DO NOT serve as a reliable predictor of when birth will occur!! You can go from 3cm dilated to 10 cm in 20 minutes or 20 hours. There is no linear progression. Your cervix is not a crystal ball. 

**Factors that Support Cervical Dilation:**

1. **Hormonal Changes:**
– The release of hormones such as oxytocin helps stimulate contractions and cervical dilation. Prostaglandins – cervadil used in inductions is a concentrate of this- to soften and ripen the cervix. Prostaglandins naturally occur in semen which is why sex  (and its oxytocin/endorphins) can help you go into or progress labour. 

2. **Fetal Position:**
– The baby’s position in the uterus can affect cervical dilation. An optimal fetal position of head-down, facing the back (Occiput Anterior) is typically the best. The head’s pressure on the cervix helps to facilitate dilation. Varying your position so they head isn’t always pressing on one side in labour is helpful. We can help baby get into position and help your body to release its holding that can restrict baby well in advance to optimize this. 

3. **Uterine Contractions:**
– Strong, effective contractions help thin and open the cervix. The uterus is muscle and like other muscles it can only do its job effectively when it has adequate energy/fuel. Rest, hydration and nutrition help here. Red raspberry leaf tea and other uterine tonics are commonly used in later pregnancy. Look and see if its right for you or not. 

4. **Maternal Relaxation:**
– Stress and tension can release hormones that may hinder the progression of labour. Safety, intimacy, security are key to effective dilation.  Quiet, dark and private is ideal. Fear, anxiety, previous traumas, resistance by both you and baby is all stuff we can work on prenatally and help you get the right birth environment to support you. 

5. **Pelvic Structure:**
– The shape and flexibility of the maternal pelvis can influence the ease of passage for the baby. A well-matched fetal head and maternal pelvis contribute to successful cervical dilation. The pelvis is flexible and its shape can be influenced by your connective tissues, fascia, muscle tension etc all  area which like to hold our emotions and experiences in them. Emotional release work and daily selfcare practice can help. 

6. **Previous Pregnancies:**
– Women who have had previous pregnancies may experience more efficient cervical dilation as the body has muscle memory and already knows what to do. Unless there was trauma in that case, the fear can inhibit. Have you taken the time to truly release the previous birth? The experiences are held in the body. 

7. **Positioning and Movement:**
– Certain maternal positions, such as upright positions and movement, may facilitate cervical dilation. Gravity can play a role in helping the baby descend and rotate as needed. Lying on one side for hours on end can lead to a cervical lip as baby’s head is only pressing on the one side. Changing positions regularly even if its just the other side is key.

 **** When you change positions your uterus will be able to contract in a different manner, this leads to  a very intense contraction or 2. It can feel easier to not move but that will limit your progression. Know that after moving you will have a really intense contraction but then your body will soon catch up again with its supportive hormones. It is like a stair step, they contractions increases and the body catches up. Just trust your body will catch up and cope again quickly! The intensity is bringing you closer to being dilated and your baby! ****

8. **Supportive Environment:**
–  Feeling safe and supported will contribute to a more relaxed state and better progression. Your choice of birth location, people present can all be factors that support or negate your progress.  You can have a physiological normal undisturbed birth in the hospital with the right preparation (that is our next topic) if that is what supports you best or you can stay home. The choice is yours. I’m here to help with whatever you choose. 

– Some medical interventions, such as induction  or epidural may influence the natural progression of labour and cervical dilation or in some cases help you to relax enough to get there. With the Conscious Birth Approach  it is my goal to help you to be informed, empowered and trusting of birth and your body. Helping you to have the birth experience that aligns with your values. To feel safe, supported and able to relax into the altered states of conscious needed for a blissful (not painful) birth. Your body has built this baby and knows how to birth it. Wisdom of the body is amazing when we allow it to unfold naturally, without disruptions… 
Which brings us to our next topic Cervical checks and how to avoid them and any or all medical intervention/assessment! With a special new Guide download. 

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