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 that I found 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 just to a 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

Source: MidwifeThinking.com

“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…..as 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 adn 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

(source: MidwifeThinking.com)

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12 Responses to “What You Don’t Know About Your Cervix Can Ruin Your Birth”

  1. Lisa says:

    They don’t actually measure 10cm. They say you’re 10 when they can’t feel cervix anymore. Your cervix dilates the same amount for each birth. Some women have full dilation at less than 10cm & some have it at more.

    Also, Carla is wrong about pushing. SOME women (including me, which is how I know she’s wrong) do NOT get a pushing urge, do not have our bodies push. I had unassisted births, so I know it had nothing to do with being told to push “too soon”. The only thing I get is increasing, excruciating pain if I’m not pushing. Pushing has been a conscious choice in my births in order to make the pain stop and it was the right choice. I wish I got a pushing urge/reflex. It would make my births less unpleasant at that point.

  2. Theresa says:

    LOVED this. I just wish more women would read and believe it!

  3. doulapam says:

    Your facts in #1 might need a little revision. No, not all women dilate to “10″. When a care provider is checking a cervix in early labor, they are feeling for how big the opening is. Later in labor, after about 5 cm, the are checking for how much is left. So if there is 2 cm of cervix left, you are at 8cm. So 10cm just means the cervix is completely gone, not that it’s dilated to exactly 10 cm. Being told to push without an urge is not going to force the cervix open prematurely, because it’s already gone if you are at 10cm. Not that I would advocate pushing without an urge, but you have the mechanics wrong here. Ideally, we wouldn’t know dilation because the body would just begin pushing when the baby is in a good position and the body is ready but I think we all know how common that is in hospital births.

  4. Great post! I’m going to share it with my readers :)

  5. KF says:

    Please add to this the normalcy of the cervix “reverse dilating” in response to change of head position as the baby’s head rotates and flexes inside. I can’t stand constantly hearing about swollen cervices and how the mom suddenly back-tracked…if we didn’t have our hands inside we’d never know in the first place and her baby would likely be born fine all the same.

  6. Jami says:

    Thank you for posting that! So informative and Ina May is fantastic!

  7. the knowledge that I think is most significant is…the cervix dilates UP not out….it is pulled UP into the body of the uterus and then into the fundus and becomes the piston….. that makes leaving it alone all the more important!…Carla

  8. Tipper says:

    Great post! About “10″ not being the magic number… you can have the urge to push, and it is *okay* to push, before you reach 10 cm.

  9. Amanda says:

    Right on about the amount the cervix can – needs to – dilate. I still remember giving birth to my first child and hearing the mid-wife pronounce my having reached 10 centimeters (five “fingers”, right?)

    “So I can push now?” I asked wearily.

    “No!” I was disappointed to hear. At which I protested that I’d “learned” that ten was adequate. I should have expected the reply – that my baby’s head was extra large and I needed to wait.

    Leaping ahead to the fear that he was abnormal somehow, I plugged away and thank God he was born in fairly short order for a first birth – and without any analgesics.

    That is, except for a shot of novocaine before the machete chop – oops, I mean, episiotomy. Actually they did it with something like heavy kitchen shears. That lovely crunching sound as the tissue was being cut through!

    Important (I think) digression.

    Now – much later – I am beginning to suffer not only from urinary but also [UGH!] fecal incontinence. Ladies, those peri-birth traumas ARE “paid for” in later life. Yet one more reason to educate yourselves well – along with choosing your birthing assistants with great care!

    Anyhow, resounding agreement with your comments about the “magic number” for cervical dilation!

  10. Theresa McHale says:

    This is an awesome article, a must-read for all women who have given or will give birth; I’ve had 7 children, 5 of whom were born @ home, on purpose, w/no professional help. By the time I was having my 3rd I was totally confident that my body indeed knew what to do during labor and birth (and I was only 23 yrs old!)


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  2. Home Birthers & Hopefuls! - Home & Natural Birthing Forum (Page 721) - 08. Jun, 2011

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