This exam—during which a provider inserts a gloved hand into the vagina to check the cervix—can be especially uncomfortable in the final weeks of pregnancy because there's increased blood flow and swelling in the vagina.
Ask your doctor if you can take an over-the-counter pain medication such as Tylenol an hour before the exam to reduce discomfort. Deep breathing can help you stay calm and relax your pelvic muscles. If you feel pain, tell your doctor.
So does it hurt when they check for dilation? If you have a care provider that cares about your comfort and wellbeing, then it should not hurt when they check for dilation and many people don't experience pain during their exam.
Second Stage or Active Labor
The second stage is the most painful stage of labor. The baby passes through the cervix, through the pelvis and birth canal, and out through the vaginal opening. On average, it takes one to three hours from the time that the cervix becomes fully dilated to the birth of the baby.
Cervical dilation does not predict when labor will begin, nor how it will progress.
Similarly at 40 weeks, 81.0% of women who had a cervical exam the previous week of greater than 1 cm went into spontaneous labor, as compared to 45.1% with an exam less than 1 cm (aHR of 2.4; 95% CI 1.6-3.6).
Why does a speculum hurt so much? Pain may be a sign that your muscles are overly tense or that you have a condition that's making the experience painful. To prevent pain, communicate your concerns and relevant health information to your provider. Let them know at any point if you're experiencing pain.
Practice slow, deep breathing. Try to relax your shoulders, your stomach muscles and the muscles between your legs. Your provider should already be describing each step of the exam, but you can ask for more explanation or for them to go more slowly.
You can expect to feel a little discomfort, but you should not feel pain during a pelvic exam. Take slow, deep breaths and urinate before the exam to help with any discomfort. If you feel pain or discomfort during your exam, tell your doctor.
If the cervix is not immediately visible, don't withdraw immediately: Consider angling the blades of the speculum (anteriorly or posteriorly) until it comes into view. If it is partially concealed, a swab may be used to bring it fully out (it is essential to be able to see its entire circumference).
Sometimes the nurse may not be able to see your cervix. This could be because you have a tilted cervix, cervical stenosis (where the vagina narrows) or something else. It does not mean there is anything to worry about.
The time between dilating to 1 cm and giving birth varies from woman to woman. One woman may go from having a closed cervix to giving birth in a matter of hours, while another is 1–2 cm dilated for days or weeks. Some women do not experience any dilation until they go into active labor.
So why all the fuss about declining this procedure? Well, for starters, it's uncomfortable! Toward the end of pregnancy, vaginal tissue becomes more sensitive, so a cervical exam (which is not known for being gentle) can feel uncomfortable or even painful.
Sitting on the toilet or squatting or standing with one leg on the edge of the bathtub are good positions. Use the same position each time you check your cervix. Gently insert one or two fingers into the vagina. Feel for the cervix – located in the upper front or top.
What are the risks? They can be extremely uncomfortable, especially in the weeks leading up to your birthing time when the cervix is supposed to be high, firm, closed, and posterior. They can give us an unnecessary, false sense of hope or discouragement. An increased risk of infection.
It is not a requirement. Agreeing to a cervical exam at any point during pregnancy or labor is an extremely personal decision. No one can force you to have a cervical check.
Reasons Your Cervix Isn't Dilating
It's possible your contractions just aren't strong enough to pull the cervix open. If things aren't happening naturally, your doctor may want to induce labor.
The knock-on effects are the slowing down, or even stalling of contractions, and more pain. Remember, cervical checks can provide information about how dilated your cervix is at the moment the check is done.
The cervix generally needs to be dilated to 10 centimeters before it's ready for the baby to pass through. Your cervix can be dilated to a couple of centimeters for a few weeks before delivery. This softening can cause the mucus plug to be dislodged and come out.
A bloody show is a common symptom during late pregnancy when a small amount of blood and mucus is released from the vagina. A bloody show occurs because the cervix starts to soften and thin (efface) and widen (dilate) in preparation for labor. When your cervix dilates, it's making room for your baby to pass through.
Clear and stretchy — This is “fertile” mucous and means you're ovulating. Clear and watery — This occurs at different times of your cycle and can be particularly heavy after exercising. Yellow or green — May indicate an infection, especially if it's thick or clumpy like cottage cheese or has a foul odor.
You can feel your cervix by gently putting one or two clean or gloved fingers deep into your vagina (make sure you don't have any sharp or jagged edges on your nails). Using lube may make this more comfortable. Seeing your cervix can be a little trickier, but it's possible.
A cervical polyp may be found when a doctor does a pelvic exam and Pap test. Cervical polyps don't usually need to be treated. Polyps that are large, are bleeding or look abnormal can be removed, usually during a pelvic exam.