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When Do Cervical Checks Start In Pregnancy? [2022 Guide]

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Here’s when cervical checks start during pregnancy, what to expect, and other helpful pregnancy and labor tips for new moms!

If you’re a first time mom you’ll likely have lots of questions about your pregnancy journey.

And one thing many new moms want to know is when cervical checks start.

Whether you’re apprehensive about these exams or are simply curious, we’re providing all the information expectant mothers should know.

Below you’ll learn what cervical exams are, when they typically start, and what to expect.

We’ve also included several other helpful tips to help new moms prepare for labor and delivery!

What are cervical checks?

A doctor puts on white gloves in front of a pregnant woman on a chair.

Cervical checks are an exam doctors may perform towards the end of pregnancy to gain information on how ready a woman may be for labor.

The cervix is the bottom end of the uterus, where it meets the vaginal canal. In late pregnancy, the baby’s head pushes down on the cervix. And the cervix stretches and opens in preparation for delivery.

Doctors use cervical checks to monitor the following conditions:

  • Cervical dilation—How open is the cervix? This is a number, measured in centimeters, typically between 1 and 4 (until you move into active labor).
  • Cervical effacement—How much has the cervix shortened? The cervix is typically around 4 centimeters long. At the end of the pregnancy, it will become shorter and thinner. This number is a percentage from 0-100%
  • Fetal station—This is a measurement of how far down the baby’s head is in the pelvis and is a number from -4 to +4.
  • Fetal presentation—Whether or not the head is down.
  • Cervical consistency–Is it thick and hard, or is it soft?

All of these things can be combined into what’s called a bishop score – a measurement of how ready the cervix is for labor.

Are cervical checks really necessary?

There is some debate on whether cervical checks are necessary and whether they may do more harm than good.

Cervical checks for most pregnant women typically only serve to satisfy curiosity and tradition.

But, they may be medically necessary if you’re having symptoms of labor (pain, bleeding, or a clear or pink sticky discharge) or if you’re going to be induced (either for medical reasons or by choice). 

The better the Bishop score and the more dilated the cervix, the less likely labor induction will lead to an unplanned c-section.

Cervical checks may also help women with a previous c-section determine whether it’s safe to move forward with a VBAC (vaginal birth after cesarean).

Other names for a cervical check are:

  • Pelvic exam
  • Vaginal exam
  • Cervical exam
  • Internal exam
  • Vaginal examination

RELATED: How Many Stitches Are Required for a C-Section?

When do cervical checks start in pregnancy?

A female doctor performs a cervical check on a pregnant woman with legs draped with green cloth.

Cervical checks typically start in the third trimester, during the last month of pregnancy. Or around 36-40 weeks.

When cervical checks start may vary depending on the doctor.

Cervix dilation and effacement might be checked every week during your weekly prenatal appointments starting at 36 weeks or sooner or not until week 38 or 39.

Your OB might not even do a vaginal exam until you’re in labor.

However, if you go past your due date, your doctor will definitely perform an internal exam to decide whether induction is necessary.

RELATED: How Being Induced Works

Can cervix checks predict labor?

Yes and No.

Cervix checks aren’t always a good indicator of labor. They’re most helpful for determining when to induce labor and when to start pushing during active labor.

Lack of cervical change doesn’t mean labor couldn’t start soon. And women with a very open cervix, even 4-5cm, may still wait quite some time without labor happening. 

This can be confusing for a first-time mother.

Keep in mind that some people dilate slowly over the course of a few weeks and others will experience rapid dilation right before their baby is born.

Ask your healthcare provider about effacement if he or she only mentions dilation, since it’s a better predictor of labor progress.

You can also ask about your Bishop score which includes not just effacement and dilation, but also the cervix’s position and the position of the baby.

What To Expect During a Pregnancy Cervical Check

How does the doctor check your cervix during pregnancy?

During the cervix check, the pregnant woman will sit at the edge of the examination chair as you would for a pap smear.

The doctor will put on sterile gloves and place their gloved hand (normally just the pointer and middle finger) into the birth canal past the pubic bone, and feel for the pregnancy indicators listed above: dilation, effacement, baby position, etc.

Does it hurt when they check for dilation?

Cervical exams can be painful or uncomfortable, especially for people who have a history of trauma or pelvic floor pain or dysfunction.

Genital areas are also more sensitive late in pregnancy, so keep that in mind.

It may be helpful to put your fists (or a rolled up towel) under the cheeks of your backside during the exam (especially if the cervix is far back).

After a cervical exam, you may have a bit of vaginal bleeding due to stretched tissues. This will usually manifest as light spotting (not heavy bleeding) and is nothing to worry about. However, if you have concerns, you can always reach out to your doctor.

You may also notice an increase in contraction frequency and intensity after the exam. But this should subside in a couple of hours.

Other Things to Keep in Mind

  • Cervical checks may cause your water to break early. One study showed that people who had weekly cervical exams before labor had a three times higher risk of their water breaking early compared with people who did not have cervical exams before labor.
  • You can refuse a cervical check as part of a prenatal visit. If you’re uncomfortable with cervical checks for any reason, communicate this to your doctor. And they can help you decide how to move forward for your next office visit.
  • A cervical check is not the same as a membrane sweep (or cervical sweep). This is a form of induction. Your doctor should ask you for your consent to do a membrane sweep as part of your cervical exam, but many don’t. If you don’t want a membrane sweep, be sure to communicate that with your doctor before your first check.
  • Cervical checks may increase the likelihood of contracting Group B Strep. Anytime any object is introduced into the opening of the cervix, the risk of infection increases.
  • A cervical check can induce labor. Any contact with the cervix has the potential to release prostaglandins and kick start the process.

If you don’t have a medical reason for a cervical exam, weigh the pros and cons of the procedure, and make the choice that’s right for you!

More Pregnancy and Labor Tips for New Moms

A pregnant woman in a white shirt and tan sweater cradles her baby bump.

Now that we’ve discussed when cervical checks start during pregnancy, here are some other helpful tips for the end of your pregnancy journey.

Prepare yourself in the last weeks of pregnancy by reading helpful first time mom books like The Mother of All Pregnancy Books.

Books like these can help you learn about the labor process so you’re more confident and know how to advocate for your needs.

Here are some lesser-known facts to keep in mind:

  • The start of labor might not be like the movies: Your water (amniotic fluid) doesn’t always break before you need to go to the hospital, and sometimes your water breaks and you don’t notice! Uterine contractions are your best indication of when to go to the hospital. In some cases, contractions don’t start until hours after the amniotic sac breaks. If your water does break and you’re not experiencing contractions, let your doctor know and they’ll help you decide when to come in.
  • In the early stages of labor, you may also experience symptoms of labor like bloody show and the loss of your mucus plug. Bloody show is light pink, red or bloody vaginal discharge. This discharge is caused by ruptured blood vessels in the cervix as it effaces and dilates in preparation for labor. The mucus plug is created during pregnancy to keep bacteria from entering the uterus and harming the fetus. When the mucus plug passes, it will manifest as a thick, jelly-like discharge that is clear or slightly tinged with pink.
  • Active labor can last anywhere from 4-8 hours and the entire labor process can take up to 48 hours in some cases! For first time moms, labor will often be longer, so don’t feel discouraged if you don’t have a baby in your arms after 8 hours of labor or don’t get to the pushing stage for several hours.

Read this post on what to expect during labor to learn more!

Make sure to prepare your baby registry checklist well in advance so you have everything you need for you and your baby before you get home from the hospital.

And make sure your hospital bag is stocked with everything you need for a comfortable stay after delivery.

You can use this hospital bag checklist so you don’t miss anything important.

FAQs

Should I get my cervix checked at 36 weeks?


When cervix checks start and whether they are necessary may vary by doctor and your unique circumstances.

Cervical checks are often a matter of tradition and may not be medically necessary unless you’re having symptoms of labor, are preparing for a scheduled induction, or you’ve had a previous c-section.

If your doctor doesn’t offer a cervical check at 36 weeks, and you want one, you can always request it.

Do they check your cervix at every prenatal appointment?


No.

Cervix checks don’t typically start until the very end of pregnancy between 36-40 weeks. When and how often cervix checks start may vary by doctor and your unique circumstances.

Some doctors like to perform a check with every prenatal appointment in the last month of pregnancy. And others may not do a cervical exam until you’re in labor.

However, if you have a planned induction, show symptoms of labor, have had a previous c-section, or go past your due date, your doctor will definitely perform a cervix check.

Do cervical checks predict labor?


Yes and no.

Lack of cervical change doesn’t mean labor couldn’t start soon. And women with a very open cervix, even 4-5cm, may still wait quite some time without labor happening. 

A Bishop score which includes not just effacement and dilation, but also the cervix’s position and the position of the baby is the best indicator of when labor will start.

Want More?

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Your Turn

Did we answer all of your questions about when cervical checks start during pregnancy? Let us know if we missed anything in the comments!

Pinterest graphic with text and a doctor performing a cervical check on a pregnant patient.