I needed to dilate to 12!

14 Aug

There is a massive myth that when you reach 10cm, you are ready to push out baby.  Apparently all babies have the exact same size head!  Why else would everyone need to reach the same dilation!  My DS2’s head circumference was 37cm (15.4″), which meant I needed to dilate to 12cm to birth him (He was 8lb 10oz).  With my smaller (6lb 8oz) DS1’s head circumference of 34cm (13.3″), I still needed to dilate to 11cm .Thinking about this, I really do think it is important that women wait until their bodies start to push, and then work with it, rather than submit to promptings from caregivers!  I mean, you might have 2 more centimeters to dilate – and we all know how long that can take!

Anyway, here is an interesting article for you!

What You Don’t Know About Your Cervix Can Ruin Your Birth


How enviously I watched the rose bush bear her bud  ~

Such an easy, Lovely birth.

And at that moment I wished the sweet myth were true  ~

That I could pluck you, my child, from some green vine

But now as you breathe, through flesh that was mine

Gently in the small circle of my arms, I see the wisdom of investment

The easy gift is easy to forget.

But what is bought with coin of pain ~

Is dearly kept

~ Carol Lynn Pearson, Reprinted from Beginnings

What!?  Where?

Most women have no clue what their cervix is, where it is, its function or even what it looks like.  Well, here’s where it is:

And it looks like this (much like the head of a penis):

The first time I learned about basic reproductive anatomy, I was pregnant with my first child, and the only thing I really learned about the cervix is that it was at the bottom of my uterus (liking my cervix to the opening of a balloon and my uterus was the balloon part waiting to expand), and was supposed to dilate to from 0 to 10 during labor.  It was also supposed to thin out (efface) and go from what is like the tip of my nose to the web of skin between my index finger and thumb…melt away kind of like a lifesaver.  And that my cervix might need to be checked during labor to asses its progress.

But that was it.  It wasn’t until I was well into being a childbirth educator and a doula did I find out some other things about the cervix.  Things that would change how I forever approach supporting women in labor and birth.

Cervix Myth #1: 10 is the Magic Number

No, it is not.  Did you know that you can dilate past 10 cm? What?!  Now what are we all supposed to do?  That sounds horrific!  It IS horrific, right?

Not really.  Not any more so than dilating to 10 is.  I dilated well beyond 10 cm with my last birth, where my baby’s head measured at a whooping 14.75 inches.  That’s right, that’s 38 cm (circumference) of head coming through me, which means I would have had to have dilated to 11+ cm (diameter).  And guess what, I lived.  And guess what, too….it didn’t hurt any more than my other births where I dilated supposedly just went 10.  So, just because you are 10 cm doesn’t necessarily mean you are ready to push.  If you do not feel the urge to push at 10 cm and are instructed to do so, you will force the cervix open “against its will” and bruise the cervix.  And if you have an epidural and don’t feel the urge, you are at even higher risk of injuring yourself.

Cervix Myth #2: Your Cervix Dilates in a Nice, Neat Circle

Your cervix does not dilate in a nice, neat circle like all the dilation model depict.  It actually opens like an ellipse as depicted here


“It opens from the back to the front like an ellipse. The os (opening) is found tucked at the back of the vagina in early labour and opens forward. At some point in labour almost every woman will have an anterior lip (meaning the top of the cervix isn’t completely dilated) because this is the last part of the cervix to be pulled up over the baby’s head. Whether this lip is detected depends on whether/when a vaginal examination is performed. A posterior lip is almost unheard of because this part of the cervix disappears first. Or rather it becomes difficult to reach with fingers first.”

Cervix Myth #3: Vaginal Exams Do Not Harm the Cervix and/or Hinder Dilation

Midwife Carla Hartley at Ancient Art Midwifery puts it this way:

“The cervix is not meant to be touched, there is an inflammation response from the foreign material (glove) as well as the pressure, and a hormonal response. It may be confusing to the body that while it is trying to empty the uterus there is interference from the cervix being touched and manipulated in a way that it is not meant to have to deal with. VAGINAL EXAMS ARE NOT PHYSIOLOGICAL AND ARE AN INTERRUPTION TO THE NATURAL PROCESS OF BIRTH.

Here is the thing about pushing….DON’T….your body knows how to eject a baby without your help….it is a reflex. Don’t even expect an urge…..expect a sensation of your body taking over in a big way, getting that baby out… it is DESIGNED to do…

I talk a lot about digital and verbal abuse in labor and vaginal exams are an example of digital abuse.

Midwives [and OB’s and nurses] who think vaginal exams are a good thing or necessary do not have sufficient education or they have not kept up with emerging science that proves that birth is safer if left alone. Hanzoffa, hanzoutta, mouthshutta midwifery is the safest.”

Cervix Myth #4: Your Cervix is Different and Isolated From All Other Body Parts

Ina May Gaskin, the mother of modern midwifery, has coined a term called “The Sphincter Law”.  The Sphincter Law states:

Your sphincters (including your excretory, cervical and vaginal) are responsible for releasing your baby into this world.  If your sphincters are tight you may not progress, and you will probably experience more pain.

So what exactly is Ina May’s “Sphincter Law”?

1.  Excretory, cervical (your cervix), and vaginal sphincters function best in an atmosphere of intimacy and privacy.  For example, a bathroom with a locking door or a bedroom where interruption is unlikely or impossible.

2.  These sphincters cannot be opened at will and do not respond well to commands such as push or relax!

3.  When a person’s sphincter is in the process of opening, it may suddenly close down if that person becomes upset, frightened, humiliated, or self conscious.  Why?  High levels of adrenaline in the bloodstream do not favor (sometimes, they actually prevent) the opening of sphincters.  This inhibition factors is one important reason why women in traditional societies may have mostly chosen women, except in extraordinary circumstances, to attend  them in labor and birth.

4. The state of relaxation of the mouth and jaw is directly correlated to the ability of the cervix, the vagina, and the anus to open to full capacity

Did you catch that?  In other words,

Open Mouth=Open Cervix

Open Throat=Open Vagina

It is near impossible to birth effectively with tightly pursed lips and a closed off throat.  Go ahead, try it right now….when you relax your jaw, open your mouth and open your throat, your bottoms automatically relaxes and sinks into your chair.  Ina May talks about the benefits of kissing, and keeping the lips and mouth lose and open.  Kissing also releases oxytocin and other love hormones that raise your pain tolerance level and speeds labor along.

Please enjoy this short video of Ina May talking about The Sphincter Law


Further Reading:

Cervical scars – commonly stop dilation
Should you have a cervical exam?

Anterior Cervical Lip – something to avoid?

The truth about Dilation


Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: