Before a woman get's pregnant, she probably never gave her cervix a second thought. It never played a prominent role in her life, as least not that she knew of. But, once she got that positive test, everything changed. Just like the vast majority of us, the first trimester was associated with a huge dose of medical terminology and anatomy jargon. Once all of the curiosities and necessities were addressed; your uterus, placenta and of course the baby took over the stage.
All the way through the center stretch of the pregnancy, you were concerned over more prominent things. Like the baby’s heart beat and kick counts, and estimated gestational age. You’re rapidly growing belly….and boobs…and feet, too! You counted down the days until your ultrasound and spent endless moments dreaming about what your baby might look like.
Fast forward to the third trimester: the ninth month to be exact. All of sudden the whole world is obsessed with what is happening down there. You know, way down south where the baby actually comes out! Cervix this and cervix that! Poking and prodding; and discussing all this stuff about a mucus plug, effacement and dilation. Wait a minute! Dilation? Did someone just say 10 centimeters?! 10 centimeters? How BIG is that? How does it happen? Does it hurt? Is that big enough to get the baby out?
Don’t worry if you’re behind, you can catch up here! Everything about your cervix that you never knew you needed to know!
16 The Baby’s Noggin Is Knockin’
Towards the end of pregnancy, the baby’s head puts pressure on the cervix. The constant pressure releases the hormone Oxytocin which causes contractions and dilation. When labor is active your birth assistant will be keeping measurements of your cervical dilation. When you reach 10 centimeters; delivery is imminent. This makes sense, as 10 cm is also the approximate size of the newborn´s head. As delivery progresses, the head puts pressure on the cervix forcing it to spread and thin out in preparation for crowning. The sensation that is felt as the head pushes through the vagina is often referred to as “the ring of fire. The finally stretching of the cervix is typically followed by delivery of the head and the body, and the afterbirth. Without the pressure from the baby’s head, full dilation without medication would not be possible. This is why the size of the cervix returns to its previous size soon after delivery.
15 That Loving Feeling
This love hormone is most often recognized for its link to bonding and motherhood. It is released both during orgasm and during childbirth. A huge flood of the hormone rushes through the body when the cervix is fully ripe for delivery. It literally becomes responsible for ejection of the baby as it produces regular and frequent contractions. Oxytocin is released by the baby himself, when the brain has finished developing. It literally gives the signal that the time is now! You can also naturally induce your Oxytocin production via cuddling, light nipple and body massage, or orgasm. Or you can just eat some dark chocolate. If you are not progressing through labor naturally or quickly enough, this hormone in its artificial form might be given to you as a means to start the process. The release of the hormone stimulates contractions and suppresses the stress hormone, while offering a sense of euphoria to Mom just as baby enters the world.
14 Let The Baby Get Well-Done
This hormone Relaxin first rages in early pregnancy and is responsible for causing achy backs and loose ligaments in the first trimester. The hormone resurfaces in late pregnancy. Relaxin levels rapidly increase throughout labor to help both Mom and baby adapt for impending delivery. The hormone softens all of the ligaments and cartilage of the pelvis to allow it to open up. It also loosens and softens the cervix, allowing it to thin and dilate. Relaxin also smoothes out the vagina and perineum making them stretchier for labor. The same hormone floods through the baby too, allowing the body to mold and literally squish through the birth canal. The best way to achieve high levels of relaxin is to let the baby “cook”. The more weeks pregnant you are, the higher your levels rise. If you feel like you need an extra dose, sex will provide an extra supplement of the hormone.
13 Indulge In Intimacy And Good Food
If you have ever been induced for labor, you have probably heard of prostaglandins. These hormones are responsible for contracting the smooth muscle of the uterus. This contraction stimulates the series of events that lead to cervical ripening and the onset of labor. But, if you aren’t planning an induction, there are a few natural sources of prostaglandins that can promote the onset of labor. Semen is the most notable one, and for that reason, sex is often recommended for couples who wish to induce labor naturally. If you’re not really in the mood, you could also indulge in the hypothetical last supper before labor. If you didn’t know, once you are in active labor- your doctors will not allow to eat until after delivery. But, before that happens, feel free to indulge in black licorice, fresh pineapple, or spicy takeout to get things moving. And last but not least, a brisk walk can also stimulate the production of prostaglandin and with it the much desired onset of labor.
12 A Rocking Cervix
As the body prepares for labor the cervix moves forward and tilts. When contractions begin, the cervix literally retracts into the uterus and then becomes thinner and opens up. It is too subtle for you to feel it, but the cervix is actually rocking itself into position. Some women might experience backache or stomach upset while this is happening. Other women are completely unaware that the process is underway. When the transition is complete, the cervix has indeed tipped itself into position and is now pointing towards the front. While this is happening, most women make the transition from a closed cervix to around 4 centimeter dilated. Often during this movement, the mucus plug is released. This is the first sign that labor is imminent. It gives your body the signal to continue dilating in preparation for labor. The duration varies between every woman, it can takes anywhere from hours to weeks for the process to complete.
11 The Braxton Bumfuzzles
Late in pregnancy, we hear the terms dilation and effacement bunched together as our pending labor is discussed. But, it is important to understand that they are not the same thing. If you are effaced but not dilated yet or dilated but not effaced, labor is not happening yet. The two happen together. During labor, the cervix changes from long and firm to soft and thin, it quite literally stretches out. Through the whole phase of labor your cervix will change from the thickness of a credit card to the thinness of paper. When your doctor checks to see how dilated you are, she will also be checking for effacement. Many women can and do fill the process happening with pressure and cramps. It not uncommon for this phase to be confused with active labor and that is why it is often referred to as false labor. Another name for the symptoms is the Braxton Hicks Contractions.
10 The Arrival Of The Real McCoy
Once contractions really begin, the baby’s head moves further into the cervix causing it to dilate or to open up. It is possible to being having contractions without realizing it as many as several weeks before labor. This means that you can also be dilating without noticing. This is why in the final month of pregnancy your doctor will usually check your cervix for dilation at every visit. The results of the check can be tricky and confusing. Some women can walk around comfortably for weeks as many as a few cm dilated. Others can leave the office with a closed cervix and still show up in labor and delivery later that day, ready to have a baby! Some women prefer to skip the readings for this reason. During the active phase of labor when contractions become the strongest and most frequent, the cervix dilates from 4 cm to 10 cm.
9 Adrenaline Junkie
When labor is impending the body releases natural pain relief through the release of endorphins. This comes in the form of hormones known as beta-endorphins. The effects are similar to when a person takes morphine. They stimulate certain receptors in the brain that offer pain numbing affects as well as feelings of overwhelming happiness. A big rush of this good stuff comes flooding through to Mom in the final moments of labor, creating a surge of energy and contractions for the big push. Both adrenaline and noradrenaline are responsible for this. They are often referred to as the “flight or fight” hormones that just won’t allow Mom to give up. The endorphins can often be coaxed out to bring on labor. Laughter, light massage, exercise, relaxation, a warm bath, and once again, sex, can all be used to give the baby a friendly nudge. In some cases, acupuncture and acupressure are approved to help release the endorphins that bring on labor.
8 Premeditated Prolactin
Most of the times when we hear a word like Prolactin, we think of lactose…milk, breast milk to be exact. So what does this have to do with labor, you might ask, doesn’t that come after? The truth is, we just aren’t sure yet but researchers are on the brink of understanding it. Prolactin is a hormone that is known for inducing the mothering instinct and has always been thought to increase in the final moments of labor, as the body prepares for breastfeeding. But, some scientists suspect that prolactin surges may begin sooner, acting as yet another signal to let the body know it’s time for delivery. It is possible that it can promote ripening of the cervix. The best way to increase prolactin production during and after labor is to go about the routine naturally. It is unclear why, but induced and stressful labors are both linked with an interruption in the hormonal surges.
7 Operation Deactivate: Hormone P
Did you know that the baby itself gives off chemical signals to communicate with the mother’s body? The messages are passed via hormones. In the earliest stages of preparation for labor, the baby sends out a signal to let mom’s body know it’s time to back off. On progesterone production that is. During pregnancy, high levels of progesterone help prevent contractions and premature delivery. This happens while the baby is still developing to ensure that she stays in utero as long as is necessary. But, progesterone can cause problems and get in the way of effective labor when the time it’s time to deliver. It’s pretty amazing that the baby gives this command when he’s good and ready. Deactivate! Once the progesterone has been inhibited, the muscles of the uterus regain their ability to contract. Now that the presence of progesterone is out the way, other hormones that promote labor can take over and dilation can begin.
6 On The Good Ship Estriol
As the baby reaches maximum capacity, he starts to get cramped and uncomfortable. But, the uterus is at its limit too! This starts to put physical strain and even distress to the baby and the organ. This causes the release of several stress hormones that gradually climb in the final weeks or days of pregnancy. The elevation of stress levels gives a nudge to the natural hormone called Estriol. It is a type of Estrogen that dominates the birthing process. It collectively prevents absorption of progesterone into the placenta. It also gets credit for enhancing the sensitivity of the uterine muscles. All of this hormonal juggling is responsible for the initiation and regulation of contractions. Through this chain of events the uterus works to prepare itself for labor in the final stretch of pregnancy. Eventually the message passed down the line, and the cervix gets the clue that it’s time for effacement and dilation.
5 A Secret Extension
We hear so much about the cervix and how it changes to accommodate the delivery of our baby, and we should! Going from closed to the size of a bagel is a notable achievement for sure. But, in some ways it takes all the credit when other areas deserve some recognition, too. There is an area of skin and muscle located between the vagina and anus that you probably have not given much thought to before. It is called the perineum and it is mostly only mentioned in reference to tears that happen during childbirth. But, the area has a bit of a bad reputation. Its function in childbirth is actually to give you an extra edge, a childbirth extension. It stretches to allow the baby just a tad bid more room to get out. In addition, if the cervix hasn’t stretched enough, the perineum lends some skin that doctors can cut to expand the opening a little more.
4 Who Cut The Collagen?
If you noticed an increase in the plumpness of your face during pregnancy, you might like to pretend that the baby is giving you a good collagen boost! All jokes aside, many women would be fascinated to know that the opposite is actually true! Particularly in the final weeks of pregnancy, both the uterus and the cervix, reduce their concentration of collagen. We all associate collagen as fluffy and round and youthful, which could be a big hindrance when a baby is trying to pass through! There needs to be as little friction as possible, so as part of the ripening ritual, our nether regions toss the collagen to the curb. Not to worry though, giving birth does not mean instant aging. There is no indication that the collagen in the rest of the body is affected. In fact, we hope that it means it resumes its normal function soon after delivery.
3 Say What?
You might be wondering, what is the cervix anyway? The cervix is officially referred to as the neck of the uterus. It connects the uterus to the vagina. Part of its purpose is to protect the fetus during pregnancy and to aid in delivery at the time of childbirth. Prior to pregnancy, it acts a doorway, either blocking or allowing substances to enter or exit the uterus. During ovulation, it allows the passage of sperm at the optimal time for pregnancy. At the time of menstruation, it dilates slightly to allow for the release of the menstrual flow. Even in these times of minimal dilation, it is not uncommon for women to experience cramping or nausea, just like in pregnancy. Some women notice the sensation when the opening expands during ovulation. Other women complain of pain and nausea with the menstrual cycle, often referred to as cramps. Some can feel both and sensitivity may vary from month to month.
2 The Long Haul
Every woman and every pregnancy is different, short and long labor/deliveries can range from extremes on either end. The process is typically the longest with your first child, and subsequently speeds up with each additional child. The first stage of labor is the longest and most women dilate around .5 cm per hour but the pattern can be irregular until the sixth centimeter is reached. Some women can walk around stuck at 1-3 cm for several weeks. Most women will not know that they are in labor until they are 4-5 cm dilated. At this rate, full dilation at 10 cm might not be achieved for another 12 hours. Even if you are fully dilated, the baby may not be far enough down in the birth canal for delivery. You must wait for the baby to enter the optimal position before you can begin pushing. The length of time needed for pushing until delivery varies widely. It can take minutes or hours more until the baby is born.
1 Shrink Therapy
So now that your cervix has expanded to the size of a bagel, probably in less than a day; how long it does take to recover? When does it return to its pre-delivery state? If you have had a baby before, you already know that your doctor will recommend that you abstain from sex for at least 6 weeks. This is partially to allow your body to recover from the relative physical trauma of child birth. This is also to reduce your chances of infection and repeat pregnancy while your cervix is still open. Remember that this is the door to your uterus, but after delivery it remains propped open for around a month and a half. It is important to take precautionary measures to prevent infection and accidental pregnancy. Keep in mind that it is very likely that you will experiencing heavy bleeding during this time that will gradually slow down to a period like flow before it ceases.
Sources: Adventures of a Labor Nurse, Your Childbirth Guide, Your Hormones, National Library of Medicine, Hypo Birthing Utah ,Parents, Baby Centre, Just Mommies, Study.com, Pregnancy, Health Line, Inner Body, Zoc Doc