A student in my childbirth class a couple of weeks ago asked, somewhat shyly, if a woman can check her own cervix at home in early labor. The class looked a little startled, and all eyes turned to me.
It’s funny. The way books are written, you’d think no woman has ever or would ever put her finger in her own vagina. But the truth is. you can absolutely check your own cervix. The more familiar you are with how it feels before the early signs of labor, the more likely you are to notice any changes such as effacing (or softening) of the cervix and dilating (or opening.)
Checking yourself for signs of softening and dilating isn’t necessary, however, nor is it a substitute for the assessment of your trained care-provider, but as long as the amniotic sac hasn’t ruptured there’s no medical reason not to do it.
As Canadian midwife Gloria Lemay puts it, “I think it’s a good and empowering thing for a woman to check her own cervix for dilation. This is not rocket science, and you hardly need a medical degree or years of training to do it. Your vagina is a lot like your nose — other people may do harm if they put fingers or instruments up there, but you have a greater sensitivity and will not do yourself any harm.”
Here are tips for figuring out what’s going on:
1. Where is it?
The cervix is the opening of the uterus and it sits at the top of the birth canal/vagina. During pregnancy, it feels like the tip of your nose. During labor it becomes softer, like puckered lips. Eventually it becomes so soft and thins out so much, you can’t feel it.
2. What does it feel like?
During pregnancy the cervix is high, long, and firm; as labor nears/starts, it moves down and becomes softer and shorter. Sometimes the cervix can be a little out of reach. Usually be the time labor starts all women can reach it. You can try sitting on the toilet with one foot up on the seat to see if that helps you reach it. Some women ask partners to try checking the cervix and find that’s easier.
3. How can you tell if it’s dilating?
During labor the cervix also opens. This is what contractions do: they tighten the uterine muscle and pull that tight, closed cervix open and open and open until it’s all the way open at about 10 centimeters. This is called dilating. Sometimes women are one, two, three, or even more centimeters dilated before labor even starts.
When the cervix is open a couple of centimeters, you can easily slip your finger into the opening — it’s like putting your finger between soft, puckered lips. If you do this, you’ll probably feel the shape of your baby’s head, safely encased in the amniotic sac. When the cervix is entirely opened and you’re pushing or close to pushing, you can really feel the head. Women who have done this often describe the head as having an amazing, “velvety” soft texture. Feeling the head can be inspiring and may help with the pushing phase.
4. Is it risky to check?
Once the amniotic sac has ruptured (85% rupture during labor at some point), the sterile environment of the womb has been opened to the world and there’s the risk of bacteria getting in there and causing infection. This is pretty unlikely, but there are things we do to minimize risk, such as reduced internal exams. If your water breaks early in labor or before labor has started, the recommendation is to avoid putting anything into the vagina to prevent infection. If your water has broken and you want to feel your baby’s head during pushing, that should be perfectly fine but lots of self-exams in earlier phases of labor or pre-labor might push bacteria up towards the cervix.
5. Is it useful to check it?
If you do check your cervix before labor has started to see if there has been any softening or dilation, keep in mind that whatever you discover doesn’t have much bearing on how the labor will go or whether it will start. Internal exams have been called “overrated” and “unnecessary” for this reason. You could be 40% effaced (with a cervix that feels like very mushy soft lips) and 2 cm dilated (with enough space to actually feel the opening) and not necessarily have a faster or easier labor than a woman whose cervix is 0% effaced and sealed tight, nor would you be able to tell from this exam exactly when you’ll go into labor. Still, knowing your body and being aware of changes is something you might be interested in.
6. Can I get more information?
There’s an incredibly detailed website called The Beautiful Cervix Project with tons of pictures of the cervix at various stages in a woman’s cycle and during pregnancy. It’s actually more fascinating and potentially useful for women trying to conceive than those about to give birth, but pretty rad regardless.