How Dilated Should I Be Before Labor Begins?
So many times when anticipating a ‘fast moving’ labor, I encounter a client who is stuck up on the amount of dilation their cervix is during vaginal exams. They really want to see dilation move quickly, and almost always have certain feelings about having a baby emerge quickly after they reach the coveted ’10 centimeters’.
I like to think about labor progress as an iceberg. What you can view from the surface, the smallest part of the iceberg, is cervical dilation. Below the water, an enormous rest of the iceberg comes into play, as do lots of other factors in the position and readiness of the cervix and baby for labor beginning and its progress.
One of the ways you can determine your cervical change during labor, and also your readiness for labor or how well an induction method might go, is a score you can discuss with your care provider called the Bishop score.
Developed by Dr. Edward Bishop (hence the name) in 1964, The Bishop score assigns numbers to each variable of your cervix to determine readiness for labor, odds of a successful induction, and progress during labor. It divides cervical changes into these categories:
Movement of cervix
The cervix prior to readiness for labor is shifted back away from the entrance to the vagina, or posterior. As the body begins to ready for labor, the cervix moves forward and into an anterior position, aligning it closer to the vaginal cavity. This can encourage a baby to align in the pelvis and allow engagement.
Cervical Ripening
During pregnancy, the cervix is kind of like a fruit that isn’t just yet ready for the picking. It is harder and tough; when it ripens, it feels softer and more pliable, which is important for the next piece:
Effacement
The cervix during pregnancy is usually 1/12 inches thick, keeping it closed and protecting your baby. Before and during labor, it thins out to the thickness of a sheet of paper, making it very pliable and easy to dilate. The amount is measured in percentages with 0% equating to no thinning and 100% being fully thinned and ready to help open the cervix.
Dilation
This is that part we all get so stuck on! Dilation is the opening of the cervix, from closed fully to 10 centimeters to allow a baby through. Dilation occurs most rapidly with the presence of consistent contractions and after a great deal of the ripening, effacement and positioning of the cervix needed to help the baby engage. Many women dilate up to 3 centimeters or even more prior to labor even beginning - this doesn’t tell us when you’ll have a baby or go into labor, or even how LONG labor might be! It’s a stage of body readiness for when labor begins.
Station
Believe it or not, your baby has a big part to play in the performance! A baby needs to perform their own movements and help position their bodies to engage, or fit, into the brim of the pelvis. When engagement happens, a baby can descend and emerge from the cervix, or put pressure on the cervix to aid dilation.
During or prior to labor, a cervical check can tell you all of these factors and help you assess your progression. When done prior to labor, they can’t really tell you when labor will begin, but give you reassurance that your body is beginning to ready itself for the big day!
In labor, this can clue you in to how your body is working to move your baby through the stages of labor and into your arms! Remember, dilation is just one small part of a larger picture. Knowing the full picture can help you feel accomplished as you move around and help your body and your baby during labor preparations.
Want to know more about the importance of and anatomy workings in labor? Our custom, in home private childbirth education, and prenatal visits with your labor doula, can help you gain knowledge about the incredible work your body achieves and can help ready you for staying calm and confident on the big day!
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