have you ever felt when you're speaking to healthcare professionals that they're
speaking another language that medical speak and the terminology just goes over your head well in
childbirth it's important to understand the terminology and be on the same page as your
healthcare provider so that you can make the best decisions for you and your family and in
this video i want to break down the concept of how a cervix changes in labor and we're also
going to cover an important concept called the bishop score that can come into play if you are
up against the decision about an induction so in order to make this happen i am going to use
my trusty bullet journal and we're going to break it down that way now if we haven't met
in real life my name is alice turner i'm a doula a childbirth educator with an engineering background
and i'm here to help you be ready to have a positive birth experience so let's do it
so the cervix of course is one of the most important parts of our anatomy when we're talking
about birth i like to think of the cervix as really the exit and with the cervix there are two
ways that the cervix changes that most people talk about and the first one is dilation which is also
known as opening now with dilation a totally closed cervix is considered zero centimeters
dilated to a fully open cervix and that would be 10 centimeters dilated so halfway through we've
got five centimeters and then other points to note are our six centimeter dilation and our eight
centimeter dilation now the time between zero and six centimeters is called early labor and then
once we get to six centimeters that is when our labor is considered to be active labor
and then at eight centimeters is when we are considered to be in transition
now when we think about the other way that the cervix changes that we talk about
a lot and that is the effacement effacement is also known as the thinning of the cervix
so when you're pregnant and when the service is at its thickest point it is considered zero percent
effaced when you are at your thinnest point it is considered a hundred percent of phase
halfway through would be fifty percent of phased now if you're ten centimeters dilated a hundred
percent of faced usually that is when your cervix is called complete but there are actually four
ways that the cervix changes two of them aren't talked about as much but i think it's important
for you to know especially if we talk about induction so we have the cervical position
and the cervical position starts where the cervix is pointed in a posterior fashion which means it's
pointed towards the back of your body as the cervix changes in labor it is pointed finally
anterior and that's pointed to the front of your body and halfway through the positional change
is considered either a midline cervix or you might hear called a middle cervix so along with position
the cervix also changes in its consistency so how the cervix actually feels to the touch
so in pregnancy the cervix feels firm and if we're halfway through our cervical change as
far as consistency it's called medium and then when it's totally changed it's called soft
now firm we like to say feels kind of like your forehead so if you touch your forehead
feels a bit like that a medium cervix feels a little bit like the tip of your nose
so a little bit more give and a soft cervix feels more like your lips
completely soft so four ways the cervix can change
in addition to cervical change another way to know that we are progressing in labor
is to find out our baby's station so station is how the baby is in relation to the pelvis
and this is measured by looking at where the top of the baby's head is in relation to the pelvis
so here i'm drawing a quick pelvis use your imagination right at the ischial spines in the
middle of the pelvis it would be zero station above that the baby would be a negative one
negative two or negative three and then below that would be a positive one two or three so as
the baby leaves the middle of the pelvis we see the numbers becoming positive of course not drawn
to scale now we take these pieces of information both the cervical change and the station and if
we can map that on something called a bishop's score it gives us somewhat a v of a prediction
of the success of an induction so if you find yourself with an induction in the future you can
ask what your bishop score is or you can ask about each of the pieces of your cervix each of the
the measurements of your cervix and your station put those together to get your bishop's score and
i'll draw a quick table for you here just so that you can see what that looks like you can also find
more information online they do vary a little bit on the scoring but all of them of course take in
account the position of your cervix if you are posterior zero score middle one anterior two and
then three would also you wouldn't get a three for your position consistency if your cervix is still
firm then a zero score if it's middle medium you get a one and then it's soft already you get two
now with the effacement if your cervix is completely thick uh zero percent of face to
thirty percent you get a zero if your cervix has been thinning a little bit more you 40 to halfway
thinned it's one 60 to 70 is two and then 80 and above would be three points on the bishop score
now when we look at dilation if it's zero completely closed we've got a score of zero
one to two centimeters gets us a one score three to four gets it's just two and then if we're over
five centimeters we get a three score finally the station if we are in a negative three station
zero negative two one point one or zero gets our two points and then for three
for three points you have to be plus one or plus two the other things to keep in mind that if you
have given birth you get a plus one to your score for each previous vaginal birth that you have had
but if it is your first time birthing you have to subtract
a point from your total score so you find out all of this information you add up all
of your numbers and then what we do is look at the results greater than an 8 that will
predict or indicate that you your induction will likely be successful but if your score
is less than five it is an indication that your induction will likely be unsuccessful so an
unsuccessful induction is one that will not lead to a vaginal birth so again getting all
this information from your care provider can help you make decisions about your induction
you