What You Should Know About Cervical Exams During Pregnancy

What’s the deal with cervical exams during pregnancy?

Note: We are talking here about full-term pregnancies where there are no additional symptoms like bleeding or signs of premature labor.

Also called pelvic exams or vaginal exams, cervical exams during pregnancy are offered as a routine part of care for many OBs and hospital-based midwives (some home birth and birth center midwives too). That often looks like one exam each week beginning around 36 weeks gestation until labor begins.

Even though there are no studies demonstrating clinical benefits to routine cervical exams before labor, many providers still consider them a normal part of prenatal care.

What’s involved with a cervical exam?

During a prenatal office visit, a provider may ask you to undress from the waist down so they can check your cervix. You will be asked to lie back on the exam table with your feet in the stirrups and knees wide. This exam is performed manually with a gloved hand using lubricating gel. The provider inserts two gloved fingers into the vagina (no speculum is used) and reaches up toward the cervix. They cannot visually see the cervix and are relying on touch alone. Prenatal cervical exams usually last between 30 seconds to a few minutes.

A cervical exam late in pregnancy usually involves evaluating:

• the position of the cervix (whether it is still in the pregnancy position facing your lower back, or has moved to face in a more forward direction toward your pubic bone)

• the consistency of the cervix. The cervix changes from firm during pregnancy to very soft during labor. Sometimes that change begins to happen prior to labor beginning. (This is not a measurement, but an adjective describing the consistency of the cervix as your provider perceives it with their fingers.)

• whether the cervix is dilated (open), and if so how much. During pregnancy it’s normal and healthy for the cervix to be tightly closed, keeping your baby protected from things on the outside. During labor, the body uses contractions to open the cervix. Sometimes, the cervix starts to dilate a centimeter or two (or sometimes more) late in pregnancy, before contractions begin.

• whether the cervix has started to efface (thin), and if so how much. Late in pregnancy, the cervix can start to thin out in preparation for labor. Labor contractions are really helpful in creating this change, but sometimes the body can start moving in this direction beforehand.

• the baby’s station (one aspect of their position in the pelvis). Some babies begin to move lower into the pelvis late in pregnancy (you may have heard this referred to as the baby “dropping”). Labor contractions are the primary way that babies move down through the pelvis, so this measurement doesn’t mean very much prior to labor.

Remember - the answers to all these questions just tell us what is happening right now.