As your due date approaches, your body goes through a lot of changes, right? Another important thing that happens when your body is preparing for the arrival of your baby is the thinning of your cervix. You may have heard this word from your doctor. We call this ``effacement'' in English. This is also one of the signs that you are about to have a baby. So, let's talk about this very simply and in a friendly way today.
What is simply cervical effacement?
Simply put, effacement is the process by which your cervix gradually softens, thins, and shortens in preparation for labor. This happens toward the end of your pregnancy. Eventually, your cervix should be thin enough to open (dilate) so your baby can pass through your vagina.
To understand this better, let's think about the cervix. Throughout your pregnancy, your cervix is like a tight, long bottle neck. It's at the bottom of your uterus. The baby is inside your uterus. So this "bottle neck" of your cervix is what keeps the baby from coming down and protects it from infection. The cervix is usually about 4 centimeters long during pregnancy.
Now, as you get closer to delivery, the muscles in your uterus start to contract, which means they tighten. This pushing forces the baby's head down into your pelvis. This pressure causes your cervix to soften and shorten. Eventually, when your cervix is 100% dilated, it will become as thin as paper. There is no longer that bottle-shaped opening. Instead, your cervix is shortened and pulled up, which means your uterus is pulled to the side.
Your doctor, around 37 weeks into your pregnancy, can use gloved fingers to feel your cervix and measure how far along this effacement is. This can give your doctor an idea of what stage of labor you are in. However, it cannot tell you exactly when your baby will be born.
What is the difference between effacement and dilation?
Although both are related to childbirth, these are two different processes. Many people confuse the two. Let's see what the difference is between the two.
| Characteristic | Cervical effacement | Dilation of the cervix |
|---|---|---|
| What is happening? | Thinning and shortening of the cervix. | The cervix dilates or opens. |
| How to measure | In percentages (%). (Example: 0% to 100%) | In centimeters (cm). (Example: 0 cm to 10 cm) |
| Completion | Complete at 100%. (Thin as paper) | Complete at 10 cm. (Opens to the size of a small papaya) |
Both of these processes are caused by uterine contractions. Before the pushing stage of normal labor begins, your cervix should be 100% effaced and 10 centimeters dilated.
The important thing is that the speed at which both of these things happen varies from person to person. For some, the cervix first thins and then opens. For others, both happen at the same time.
How do you know when the cervix is starting to thin?
Most of the time, you won't feel this happening, but you can anticipate it along with other signs that you're getting closer to labor.
- Braxton Hicks contractions: These are not like real labor, but they are also a sign that your body is preparing.
- Mucus plug: The mucus plug that has been covering the cervix throughout pregnancy can loosen and come out of the vagina as the cervix thins.
- Bloody Show: A few small drops of blood may come out along with the mucus plug. This is normal.
- Baby Dropping: When the baby's head enters the pelvis, the pressure in the rib cage is relieved, and instead, you may feel pressure in the lower abdomen.
- Increased vaginal discharge: You may experience more vaginal discharge than usual.
All of these signs mean that labor is near. But some people experience them and some don't. Only your doctor can tell you for sure whether effacement has begun. Trying to test yourself can be dangerous.
What time should I call the doctor?
Cervical thinning is not a reason to call the doctor. It is a natural process that should occur before labor. However, if you feel like you are in labor, then you should definitely call the doctor.
Also, the symptoms below may be a sign of a complication, so inform your doctor or go to the hospital immediately.
| Emergencies that require attention | |
|---|---|
| 🔴 | If you are bleeding heavily from your vagina, it is important to go to the hospital's emergency department (ETU) immediately. |
| 🔴 | If you have unbearable, continuous pain (contractions). |
| 🔴 | If you think your water bag has broken (water breaks). |
| 🔴 | If you don't feel your baby's movements. |
What problems can arise in this process?
Yes, sometimes certain complications can occur that slow down or speed up the rate of cervical effacement.
Reasons why cervical thinning occurs slowly:
Sometimes this process can be slow. Activities like walking can help speed it up a bit.
- Weakening of contractions.
- The baby's size is getting bigger.
- Your pelvis is small.
- The baby's head is not facing down.
Premature thinning of the cervix (premature birth):
Some women's cervix begins to thin out prematurely, which can lead to premature birth.
- Incompetent cervix.
- Shortened cervix.
- Some accident to the cervix.
- Having had previous cervical surgery.
Your doctor will monitor these situations and provide the necessary advice.
Remember, every pregnancy is unique. You don't have to go through the same thing that happened to your friend. So don't compare yourself to others and worry about it.
Take-Home Message
- Cervical effacement is a completely natural and necessary process by which the body prepares for childbirth.
- This is measured in percentages (from 0% to 100%). 100% means that the cervix is completely dilated.
- Effacement and dilation are two processes that must occur for a normal delivery.
- Although this is a sign that labor is near, there is no way to tell exactly when the baby will be born. So don't worry if your due date is approaching but you are still 0% effaced.
- If you have symptoms such as heavy vaginal bleeding, unbearable pain, ruptured waters, or not feeling the baby's movements, call your doctor or go to the hospital immediately.
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