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Have you ever been in labor, gotten checked after hours of challenging contractions, and heard the words, You're only two centimeters," or,"You're only four centimeters"?
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Or maybe you're even farther along in labor, but that number is the exact same as the last time you were checked Perhaps you've been having strong contractions and doing everything you know how to do to get labor to progress, and yet that dilation number still just does not seem to be changing.
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Something that most women have never heard during their birth preparation is that dilation is actually one of the last pieces of the puzzle.
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Your cervix is doing way, way more than just opening.
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Before your baby can move down and be born, your cervix actually has quite the job to do, and all those other things are happening concurrently and many times even before dilation.
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So today we're gonna talk about the three things your cervix must do beyond dilation before baby comes.
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Understanding this is going to completely change the way that you view labor progress, and my hope is that you walk away from this episode feeling way more confident when labor doesn't look exactly how you expected By the way, friend, if you have been around here for a while, I would love if you could do me a huge favor by leaving a rating and review on whatever platform you listen to this podcast.
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It is the number one thing that helps this show to grow and to get in the hands of other women like you preparing for a God-centered natural birth.
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It also means the absolute world to me, and I read every single review that I get, truly.
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I keep a tally of how many I have on my podcast, and it just, yeah, it means so, so much.
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I do want your review to be earnest, though, so if this is your first time listening, maybe stick around a little while, and hopefully I'll be lucky enough to earn that review from you at some point All righty, friend.
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Now with that out of the way, let's go ahead and dive in Okay, so I want to start off by telling you a story about a doula client that I supported one time.
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We had been going through labor for a super long time.
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She'd been laboring for hours and hours with consistent and strong contractions that she was really having to breathe and cope through.
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So it seemed like she was in active labor for a long time, I think probably, like, maybe close to 24 hours.
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During this 24-hour period, we went to the hospital several times, only to be told that she was two centimeters.
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The first time we
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went, she was two centimeters, which was surprising, because she seemed farther along than that.
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The next time we went, we were certain that she was gonna be farther along than two centimeters, and still, she was only two centimeters dilated.
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Now, as you can imagine, this was extremely discouraging for her Luckily, this particular mama was an absolute champ.
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She was so strong.
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We went home and labored for a considerable longer amount of time, and eventually got to the hospital when she was much closer to having her baby.
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She did have an unmedicated birth at the hospital.
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She did an amazing job.
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But it was a lot to be told that she was only two centimeters, quote unquote, time and time again, even though her contractions felt like she was progressing And I used to see this a lot as a labor and delivery nurse, right?
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Women would be checked and they would be having hours of what seemed like active labor.
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They'd be checked again only to hear that nothing much had changed with their dilation, and they would just feel super deflated that that was the case, which makes sense when dilation is the only thing that you're really basing labor progress off of.
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It can feel like the work you're doing in labor is not actually doing much But what a lot of women don't know or understand is that there is way more happening behind the scenes with your cervix than just dilation.
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In fact, there is one more metric that I think is a lot more important when we're talking about labor progress than dilation alone.
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All of those other jobs your cervix has to do really affects how quickly and easily you dilate, and it can be easy to hyper fixate on dilation because that's what we hear about most often.
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And many times providers don't even offer these other metrics during a cervical exam when they say, This is the result of the exam." They'll just often tell you how open your cervix is But what I want you to keep in mind before I get into the things your cervix actually has to do is that a cervical exam is really just a snapshot of what's happening in this given moment that you have the exam.
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So try to avoid overusing them.
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Okay, so the first thing that the cervix needs to do before it opens is efface So effacement actually means that the cervix is thinning and shortening.
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Before labor, the cervix is typically pretty long and thick, almost like kind of a funnel or a tube, and it's usually about the length of like three to four centimeters, so about half of your pointer finger So think from about the tip of
your pointer finger to your first knuckle.
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That's about the length of your cervix while you're pregnant for most people.
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And during labor and even before, it gradually becomes shorter and thinner until it is paper thin and ready for the baby to actually pass through.
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A cervix can be dilating and effacing at the same time, but in most women effacement has to happen significantly before major dilation.
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Your contractions often take your cervix from about that length of a few centimeters to, like, really, really paper thin.
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And if you can imagine paper thin is going to be way more stretchy and pliable.
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Imagine one of those rubber bracelets, the what would Jesus do bracelets, for example, that kids like to wear that you get free at, like, events and things like that.
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Think about stretching one of those versus stretching a really thin rubber band.
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One of those has way more elasticity because it's also thinner and more pliable, right?
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So the thicker the cervix is, the less pliable it's gonna be.
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Your cervix cannot effectively open if it is still really thick and firm So that cervix really has to thin out before it can fully open up around baby's head.
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That's why a woman might be, quote unquote, only two centimeters but have a cervix that's, like, 90% effaced, which is actually a huge amount of progress.
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If you go from two centimeters and 30% effaced to two centimeters and 90% effaced, that is significant, and your cervix is likely to open much quicker when it's that thin.
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Okay, the second thing that your cervix needs to do is to soften.
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It will usually go from feeling kind of like the tip of your nose during your pregnancy or when you're not pregnant especially.
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Usually, it feels hard like the tip of your nose.
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If you've ever felt your cervix for NFP reasons, then you might be familiar with the feeling of a fertile versus a non-fertile cervix.
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When you're not fertile, your cervix is kind of firm and hard, and when you are fertile, your cervix is kind of soft and squishy.
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And that also happens when you go into labor.
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Your cervix goes from firm and hard like the tip of your nose to soft and squishy like your lips.
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Now, this happens due to a hormone called prostaglandin, which if you are familiar with inductions at all, Prostaglandin is one of the medications that they give you for cervical ripening to start an induction process because they cannot start Pitocin to give you strong contractions before the cervix is adequately ready.
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You need to have a good Bishop score, which is essentially measuring these other metrics around your cervix.
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What is your cervix doing?
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What is it looking like?
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And is an induction likely to be successful because we're measuring more than just dilation, right?
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So it needs to be soft, and it needs to be thin, and prostaglandin is a natural hormone in the body that does this.
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In an induction, they give you an artificial form of prostaglandin It's actually in the form of pig semen, so pretty gross.
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But that is the same mechanism of action.
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A lot of the time, this is also why you will have loose stool or diarrhea during early labor, because prostaglandin also works on the GI tract.
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If you can imagine, your cervix is also going to have an easier time doing the point we last went over, which is thin out, when it's really soft.
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If it's really firm, it's unlikely to thin out, too.
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So all of these things are kind of working concurrently and end up helping your cervix to open up.
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So it's not like a, this thing happens, and this thing happens, and this thing happens.
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They're all kind of working together.
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But what I'm trying to get you to understand here is that dilation is really just a piece of the puzzle.
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In order to dilate and open, your cervix has to be soft and it has to be thin, those two things help one another along.
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One thing that you can do to help your cervix soften while you're still pregnant in the end of your pregnancy is to be intimate with your husband a lot, because that prostaglandin is found in semen.
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That's why they give pig semen for an induction.
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Sorry to be crass, but that's just the truth of it, right?
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And that will help your cervix to soften and get ready for labor.
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That's why they say that having sex is an induction method.
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Okay, the last thing, and in my opinion, the most important thing, which doesn't actually technically have to do with the cervix, but is something that's being measured during a cervical exam, and I think it is way more important than dilation, is station.
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Now, station refers to where a baby is in relation to your pelvis.
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Your pelvis has these things called the ischial spines, and they are two kinda little bony landmarks on the pelvis, and a provider should be able to
feel for those ischial spines and where your baby's head is in relation to those ischial spines.
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So if you've ever heard that phrase, baby is engaged, that really means that baby's head is lined up with those ischial spines at zero station.
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When a baby's head is floating between the hip bones above those ischial spines, that would be considered a negative station.
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So minus one, minus two, they're not yet engaged in the pelvis.
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And then when their head is coming down beyond those ischial spines into the outlet of the pelvis, that is a plus station.
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But essentially, a healthcare provider will measure that station based on how low baby's head has descended in the pelvis.
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Baby's descent is a really big part of cervical progress because baby's head provides pressure against that cervix.
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Your contractions could open your cervix to, you know, a considerable amount, eight centimeters, even nine centimeters, without baby's head really...
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Even 10 centimeters without baby's head being pressed on that cervix.
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And if you are 9, 10 centimeters without baby's head down low in your pelvis, you're likely not gonna feel an urge to push, which is a whole separate topic, but this will happen sometimes.
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Women will be fully dilated because their contractions have opened up that cervix, but they're not feeling the urge to push'cause baby's not low enough yet.
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In active labor, say maybe closer to five or six centimeters but baby's still up high, that is potentially going to stop you from dilating further because baby's head presses against that cervix and causes it to open around the head.
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Your baby is actually part of the dilation process.
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The uterus contracts, pushing baby downward.
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Baby's head applies pressure against the cervix.
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That pressure on your cervix from the head stimulates your body to release more oxytocin, which strengthens those contractions and helps the cervix continue changing.
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So as you can see, birth is not about this just, like, one metric of your cervix going from 0 to 10 centimeters, which I think is often how it's framed in the culture.
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Birth is like a partnership between your uterus, your cervix, your baby, your pelvis.
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Your hormones.
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There are so many facets, and this process is so complex, and we tend to really oversimplify it.
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So just know that how open your cervix is is not a complete picture One thing that you can do to help station is to move a lot.
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If you are moving on the outside, that's gonna help baby to navigate your pelvis on the inside.
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I actually have a free guide to labor positions.
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It's called the Speedy Birth Blueprint.
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You probably heard about it earlier in this episode, but you can find the link for that in the show notes.
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That's gonna help you know exactly how to move for each stage of labor to help your baby descend through the pelvis, okay?
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So basically, what I want you to take away from this episode is that dilation is only one measurement of labor progress.
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It is not the full picture.
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Two women can both be five centimeters dilated and have completely different labor situations, right?
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Like, One woman may have a thick, firm posterior cervix with baby still high in the pelvis, and another one might have a thin, forward, really effaced, really soft cervix with a baby that is low in her pelvis and ready to keep descending.
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That is two women with the same dilation but a completely different picture.
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So instead of asking,"How many centimeters am I?" I think you should start asking more complex questions if you're in labor and feeling discouraged by this, right?
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Like, is my cervix changing?
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Is my baby moving down?
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Is my cervix soft?
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Where, what is the position of my cervix?
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All these things matter, and all of these lend to the bigger picture.
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And I also just wanna encourage you, something that I like to tell to doula clients is that a cervical exam is truly just a snapshot of what's happening in the particular given moment that you get the exam.
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So try really hard to avoid overusing them, and if you do feel like it's necessary to be checked, my best piece of advice is tell them not to tell you your dilation It is so easy to get in our head about dilation, and that is not really good for our laboring brains.
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So instead, you can ask for other pieces of information like station and effacement because those are things that you can actually do something about.
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You can't force your cervix open, but if you know the baby's still high in the pelvis, well, you can pull out your Speedy Birth Blueprint and you can do some of those positions to help them descend, right?
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alrighty, my friend, that is it for today's podcast episode.
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I hope that you enjoyed and got something helpful from this episode today I know we're at the very end, so for those of you who are still with me, I just want to tell you something really exciting.
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I'm gonna just drop a little nugget.
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I'm not gonna tell you too many details.
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But if you have ever thought about becoming a doula yourself, right?
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If you've been interested in supporting women through birth, I am working on putting together something that is very special for you.
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So make sure that you keep listening to the podcast over these next couple of months, because I am going to release something that I've been working really hard on, and I'm really, really excited to bring you into it.
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Okay, my friend, I hope that you have a wonderful rest of your week.
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Know of my prayers for you as you prepare for this birth, over you and your baby, and I will see you back here next Monday.