Navigating Cervical Checks: A Doula's Perspective on the Risks & Benefits

Photo Credit: Erin Heuser Photography

As a birth doula, my role is to provide support and guidance to expectant parents throughout their childbirth journey. One common topic that comes up during pregnancy and labor is cervical checks. These checks are routine in many medical settings, but they come with their own set of pros and cons. In this post, we’ll explore both sides to help you feel informed and empowered when making decisions that fit your birth plan.

What Are Cervical Checks?

Cervical checks involve a healthcare provider inserting gloved fingers into the vagina to assess how dilated, effaced (thinned), and positioned the cervix is. These checks typically happen during late pregnancy and throughout labor to monitor how labor is progressing.

Pros of Cervical Checks

1. Tracking Progress: One of the main reasons for cervical checks is to see how labor is progressing. This can provide valuable information about how far along things are and help guide decisions during labor.

2. Informed Choices: With more insight into how your body is progressing, you can make informed decisions about pain management or interventions, if needed.

3. Reassurance: Seeing measurable progress can give a sense of reassurance and help ease any anxiety about labor’s progress.

4. Spotting Potential Issues: Sometimes cervical checks can reveal complications, like a baby in a less-than-ideal position or other factors that may need attention. Addressing these early can help adjust the birth plan as needed.

Cons of Cervical Checks

1. Discomfort and Invasiveness: For many, cervical checks can be uncomfortable or even distressing. This discomfort may make it harder to stay relaxed, which is important during labor.

2. Risk of Infection: Each cervical check comes with a slight risk of introducing bacteria into the vaginal area, which can increase the risk of infection, even with precautions in place.

3. Labor Progression Isn’t Always Predictable: Cervical dilation isn’t always a reliable indicator of how fast labor will progress. Sometimes labor stalls or moves slower than expected, which can lead to unnecessary interventions or frustration.

4. Loss of Privacy and Autonomy: Frequent cervical checks can feel invasive and may affect your sense of control or privacy during labor, especially if you prefer a hands-off approach.

It’s important to remember that cervical checks, while helpful, don’t tell us everything. A common misconception is that dilation gives a clear picture of how much longer labor will take—but your cervix isn’t a crystal ball! You could be a few centimeters dilated for days or even weeks without much change, and then suddenly go into active labor. On the flip side, you could be very close to fully dilated, and labor may still take longer than expected.

Cervical dilation is just one piece of the puzzle when it comes to labor progress. Each person’s body works at its own pace, and labor can unfold in ways that can’t always be predicted by a single check. So while cervical checks provide useful information, they’re not a perfect predictor of what’s to come.

How to Approach the Decision

When it comes to deciding whether or not to have cervical checks, here are some steps to consider:

1. Learn the Facts: The more you know about cervical checks—why they’re done, their benefits, and their risks—the easier it will be to make an informed choice that feels right for you.

2. Talk to Your Provider: Don’t hesitate to have an open conversation with your healthcare provider about your preferences. Discuss your comfort level with cervical checks and ask about alternatives if needed.

3. Advocate for Your Comfort: Remember, you always have the right to give or withhold consent for cervical checks. If you feel uncomfortable or prefer to have fewer checks, communicate that with your care team.

4. Trust Your Intuition: You know your body best. If something doesn’t feel right or if you feel that the checks are excessive, speak up. Your preferences and comfort should be respected throughout your birth experience.

Cervical checks can offer valuable insight into labor progress, but they also come with potential drawbacks like discomfort or loss of privacy. And remember, your cervix isn’t a crystal ball—it can’t predict how long labor will take. By weighing the pros and cons and having open discussions with your healthcare provider, you can feel confident in making the decision that best aligns with your birth goals. Every birth journey is unique, and the most important thing is that you feel informed, empowered, and supported in your decisions.