Pregnancy has several important stages, but the most important is labor, the stage that is just before delivery. Moms-to-be learn about this stage, which includes their water breaking (rupture of the amniotic sac), and the breathing exercises to do while in labor. But dilation in pregnancy is discussed less often. During labor, your cervix will dilate to open up the birth canal. This cervical ripening can begin days or weeks before your due date. Once your cervix opens to 10 centimeters, it’s time to push and deliver your baby.
Here, with the help of some awesome experts (including three OB-GYNs and a certified nurse midwife), we’ll break down what dilation is, how you’ll feel once it begins, and the next steps after dilation.
Dr. Tamika K. Cross is a popular OB-GYN based in Houston, Texas. She's a partner in a medical practice, Serenity Women's Health & Med Spa, led by her and another physician, Dr. Peace Nwegbo-Banks, who also just gave birth a few months ago.
P. Fadwah Halaby is an Advanced Practice Registered Nurse, Certified Nurse Midwife/National Birth Coach and the founder of Midwife360.
Dr. Lucky Sekhon is a reproductive endocrinologist and infertility specialist and board-certified obstetrician and gynecologist who cares for patients at Reproductive Medicine Associates of New York’s Manhattan and Downtown (SoHo) Offices.
What Is Dilation?
"Dilation is when the cervix opens to allow passage of the baby through the birth canal," Dr. Peace Nwegbo-Banks tells CafeMom. "10 cm is the goal dilation. The cervix is composed of tissue that can accommodate labor and open as needed."
When the cervix begins to dilate too early in pregnancy, this can cause pregnancy loss and preterm labor. This is one of the reasons that early prenatal care is so important.
What Moms-to-Be Need to Know About Dilation in Pregnancy
"Dilation of the cervix is required to deliver a baby vaginally … Uterine contractions and the release of factors that temporarily break down and soften the cervix lead to cervical dilation," Dr. Lucky Sekhon explains. "It is possible to be a little dilated prior to labor starting, especially towards the end of pregnancy as your body prepares for labor and delivery and in women who have had a prior vaginal delivery."
What Is the Difference Between Dilation and Effacement?
Dr. Tamika Cross explains that "dilation is when the cervix opens up. Effacement is when the cervix thins out." She adds: "The cervix needs to thin out and open for the baby to come through. A non-laboring cervix is usually thick, similar to a donut. It then gets thinner and thinner as labor progresses."
To get a better understanding, P. Fadwah Halaby elaborates: "Imagine that the uterus and cervix looks like a light bulb — the uterus is the bulb part, and the cervix is the part that screws into the socket. The cervix extends into the back of the vagina, and the uterus is above the vagina in the pelvis. When a person is pregnant, the bulb part, or uterus, is what holds the baby and grows up into the belly. The screw part is what is thinning and essentially becomes part of the body of the uterus during labor, once a person has achieved complete effacement."
"In first time moms, usually the cervix effaces and thins out and then begins to dilate, adds Sekhon. "When a doctor does a cervical exam, they not only note how dilated the cervix is (the diameter of the actual opening) but they also will note how effaced, or thin, the cervical canal feels and will describe this usually as a percent (i.e. 50% effaced, or 100%/full effaced meaning the cervix feels almost paper thin)."
What Are the Symptoms of Cervix Dilation Early in Pregnancy?
"Cervix dilation early in pregnancy can be painless with some women only noticing discharge and bleeding," says Nwegbo-Banks. "Other women can feel pelvic pressure and the need to push or bear down. Others can experience painful contractions. It is important to notify your OB if you are preterm and having any of these symptoms."
What Are the Signs of Dilation in Labor?
According to Cross, signs of dilation in labor include regular, painful contractions. Contractions every two to five minutes are consistent with active labor.
Halaby notes that one sign of dilation is also the loss of the mucus plug, which may or may not be accompanied by blood (commonly referred to as 'bloody show'). So if the mom-to-be does see some light blood around go-time, that is likely what it is — but always check with the doctor to be sure.
Sekhon also offers that dilation can also be detected on a pelvic exam when gloved fingers palpate and detect the size of the cervical opening. This exam done in a serial fashion, over time, will help to determine if the cervix is opening, or dilating, over time.
What To Do Once the Cervix Starts To Dilate?
Of course for anyone who is in preterm labor, notify the OB so things can be immediately evaluated.
However, if full term, notify the OB when contractions become more painful and regular, advises Cross. "It may be time to visit the hospital or birthing center."
Halaby advises moms-to-be to contact the care provider. "The doula will be helpful in knowing when to either go to the hospital or birth center, or call the midwife to come to the home," she notes.
"It is important to keep track of how often you are feeling contractions," says Sekhon. "That will be the best DIY indicator of whether you could be going into labor. Regular, strong contractions occurring every five minutes or more frequently are a sign you could be in labor and you should consult your doctor … I do not advise that women try to examine themselves to determine if they are dilated."
For more information about Dr. Cross and Dr. Nwegbo-Bank's visit the Serenity Women’s Health & Med Spa's website.
For more information about Midwife360, visit Facebook and Instagram.
For more information about Dr. Lucky Sekhon, visit her website, The Lucky Egg.
*Disclaimer: The advice on CafeMom.com is not a substitute for consultation with a medical professional or treatment for a specific condition. You should not use this information to diagnose or treat a health problem without consulting a qualified professional. Please contact your health-care provider with questions and concerns.
