As a doula, you will be asked about signs of cervical dilation. Your clients will want to know when to contact you, when to call their midwife or doctor, and when to head to their birthing location. While you cannot perform cervical dilations, you can help your clients (and yourself) by understanding signs of dilation.
Every labor is unique, and signs can vary. However, there are several signs that indicate cervical dilation is likely occurring. You can use this information to help educate your clients. They can use this information to make informed decisions about their care.
Signs of Cervical Dilation
As mentioned, every labor is unique. This means that even if one has birthed before, the signs can vary. Some people have every symptom and labor stages are quite noticeable. Others have subtle or harder to detect signs and symptoms leaving them wondering whether they are even dilated or if they could be fully dilated.
Here are 6 signs of cervical dilation
#1: “Lightening Crotch” or Vaginal Pain
Termed lightening crotch because it feels like a sudden shooting pain, this vaginal pain sometimes occurs due to pressure on nerves. As baby engages lower into the pelvis, they are likely to apply pressure to the cervix. While this can occur long before labor, sometimes it is a sign of early dilation.
#2: Backache and Menstrual Like Cramps
Like lightening crotch which can occur throughout pregnancy, backache and cramps can simply be pregnancy or dilation. As baby descends and applies pressure to the cervix, back pain can begin or worsen.
Early dilation often feels like menstrual cramps as the cervical changes cause pain and cramping noticed in the lower part of the uterus. It is the same sensation and location as menstrual cramps. Active labor tends to be felt in a larger area but can be a similar sensation as cramping (with more intensity of course).
While both backaches and cramping can occur during pregnancy, when they are signs of cervical dilation, the intensity, frequency, and exact feel tend to change.
#3: Bloody Show – A Sign of Cervical Dilation
Not the loveliest term, but it accurately describes a small amount of blood showing cervical changes. Some notice this, others do not. Often this is like spotting, occasionally a brief light flow, and mixed with mucus.
The mucus plug is releasing and the slight cervical changes with dilation can cause this light bleeding.
Anytime a client experiences spotting or bleeding, they should contact their midwife or doctor for appropriate instructions.
Generally, if they are term, their provider will describe at prenatal appointments if they need to let them know about spotting, bleeding, etc. In some cases, a provider will let them know what bloody show looks like and whether or not they need to contact immediately or wait for more symptoms.
If your client is less than 37 weeks, has any symptoms of infection, or it is a flow without any mucus, they should contact their provider immediately.
Bleeding and spotting can be symptoms of other things besides dilation. Any concerns should be directed to their provider.
#4: Less Talking, But Possibly More Noise
During active labor, speaking during a contraction becomes quite difficult if not impossible. This does not mean not wanting to talk, this is an inability to speak through the contraction.
However, at the same time, clients might begin to moan or vocalize, often involuntarily. This vocalizing is a way to cope with the increasing intensity of contractions. When a client is unable to speak through a contraction it is often a sign of active labor and thus they are likely dilated beyond 3-5 centimeters.
#5: Intuition
While our modern lifestyle does not always require us to pay attention and trust our instincts, our bodies are still quite instinctual. Many are able to know they are in labor and progressing or may sense labor is imminent.
As doulas, we can encourage our clients to trust their instincts. When we educate prenatally about signs of dilation, signs of labor, etc., we can help remind them of their natural instincts.
#6: Less ‘Politeness’ – a Sign of Cervical Dilation
It is quite likely your client will be pleasant, conversational, and generally polite during your consults, prenatal visits, etc. When you arrive for labor, if you notice changes in their personality, being short with partner, you or staff, there is a good likelihood labor is progressing.
The intensity of contractions combined with heightened hormones can understandably make many less polite. From language to stripping nude, these typical birth behaviors would otherwise be seen as impolite.
As a certified doula, understanding signs of cervical dilation will help you educate your clients and be a good support.
Author: Aliza Juliette Bancoff
Aliza Juliette Bancoff is a well-known doula and doula trainer who has been providing doula services to families for over a decade. She is the founder of Main Line Doulas, a doula group providing doula support in the great Philadelphia area for the last decade, the International Doula Institute, which provides online doula training and lactation training and certification programs and the International Breastfeeding Institute which provides lactation training and certification. She is the co-founder of United Birth, a company devoted to increasing access to doulas across the country to make the perinatal time safer both physically and emotionally. “Every birthing person deserves access to quality doula support. And we are working to make that a reality across the country. The work we are doing to get doulas to every birthing person will decrease the black infant and maternal mortality rate significantly by 2030.” Says Bancoff. Aliza is known for her compassionate and empowering approach to doula work, and she has been featured in numerous media outlets, including United Nations Maternal Health Report, Parent Magazine, CafeMom, theBump and many more. Aliza's journey into doula work began when she gave birth to her first child and felt a strong calling...