The method used by midwives and doctors to measure dilation in the active phase of labor is through vaginal examination . This procedure makes it possible to assess the state of the cervix -or cervix- and thus be able to know the position, consistency, length and dilation of the cervix and the descent and rotation of the fetal head.
This practice is essential in recognizing the onset and progress of labor, but it should only be carried out by expert personnel, with clean hands covered by sterile gloves.
How is a vaginal examination performed?
With the woman lying on her back and her legs spread, the midwife inserts her index and middle fingers into the vagina until she reaches the cervix. They open them as if it were a compass and determine in a few seconds how many centimeters we have of dilation. Although they are not exact centimeters, -it is not measured with a ruler-, with the help of practice, they can know “firsthand” the progress of the dilation.
It is not a painful procedure, but it can be uncomfortable . Some women feel violated when they consider that their intimacy and privacy is invaded. They must always be performed with the consent of the woman, explaining beforehand what the procedure consists of.
How many vaginal exams can I have?
In addition to discomfort, vaginal examination is considered a potential risk factor for infections, so the ideal is to minimize the number of times this procedure is performed. According to the WHO recommendations, doing it every four hours should be enough.
Generally, the midwife will do an examination on admission, to assess the state of dilation at that time, and towards the end of the progress of labor, when the contractions are more frequent and intense and you are close to full dilation.
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The first three to four centimeters of dilation are the ones that take the most time. Even in many cases, especially if it is not the first delivery, the dilation can begin a few days before.
Once the three centimeters are exceeded, in what is known as the active dilation phase, dilation accelerates rapidly to 10 or 12 cm to allow the baby’s head to pass.
In the second phase of dilation, the bag usually ruptures, if it has not happened before. But in some cases it can go whole to full dilation.
Do you have any contraindications?
Vaginal examinations are contraindicated in pregnancies with placenta previa, because it could cause bleeding that could put the mother and the baby at risk.
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