The frustrating truth of pregnancy is that despite millions of babies being born yearly, there's a veil over the common practices of labor and delivery. Most of us go into pregnancy without understanding why and when certain procedures are performed or their inherent risks or benefits. On the long list of exams, tests, and interventions involved in pregnancy there are cervical checks. Before you consent to one, it’s your right to know whether a cervical check can induce labor and what’s involved — risks, as well as benefits.
Strangely enough, while it is reasonable to think that a routine physical examination completed in the end of pregnancy would be safe as houses, that might not exactly be the case. Veteran OB-GYN Elizabeth Sauter, M.D., FACOG of Westport, Connecticut, tells Romper that every patient is an individual, so there is no clear black-and-white answer, but that "in a normal cervical exam at 36 to 42 weeks, a non-aggressive exam will not put a patient in labor.” However, she explains, if the cervix is ripe (dilated, effaced, or soft), it could stimulate the release of prostaglandins which are actually used to induce labor. The Mayo Clinic supports this sentiment and noted that any type of labor induction is only effective if a pregnant person's cervix is "ready" and ripe for labor.
If you talk to moms, you'll find there are really two camps: one is the camp of "a day after my last vaginal exam, poof — I went into labor," and the other is the camp of "you could drive the truck from Mad Max: Fury Road through my vagina and that baby would stick." I am in the former camp. My son was born a scant two days after my last vaginal exam. During that exam, I learned I wasn't effaced at all. I was maybe 1 centimeter dilated, and he was high up in my abdomen. Extremely high — unending reflux-feels-like-a-foot-in-my-throat high. But, because my anemia was so bad, and my Braxton Hicks were so bad, I was going to the OB-GYN a few times per week at that point. That last week, I had three pelvic exams. In a normally progressing pregnancy, however, that’s not the norm
Near the end of pregnancy, about 35 to 37 weeks, most women will receive a cervical exam. Obstetricians and midwives perform cervical checks to determine dilation and possibly the position of the baby, reported Verywell Family. The health care provider uses a gloved hand to insert two fingers into the vagina to the cervix to feel for thinning, opening, and to determine the position of the cervix. Though sterile gloves are typically used, there’s still some risk involved with a cervical exam. A 2020 review in StatPearls noted that frequent cervical exams are associated with a higher risk of infection. That’s because, as Verywell Family explained, the exam might push bacteria in the vagina up to the cervix.
As for whether a cervical check can directly induce labor, according to board-certified OB-GYN Sheila Chhutani, M.D., of Dallas, Texas, only when accompanied by a common labor induction method. "A cervical exam in and of itself will not induce labor," she says. "During an exam, a practitioner can 'sweep the membranes' which means using their fingers during an exam to separate the amniotic bag of water from the uterine wall.” This can then jumpstart the release of hormones that bring on labor, reported The Journal of Clinical Gynecology and Obstetrics.
It also hurts like heck. When I went in to be induced with my daughter, this was the first thing my OB-GYN did to get things started. I didn't love it, but it worked. According to Chhutani, it doesn't always though. "During an aggressive exam, the bag of water can accidentally be broken and thereby incite labor. This happens rarely without the aid of a device to break the water, unless the practitioner is actively trying to on exam."
The bottom line is that whether or not a cervical exam will induce labor is highly dependent upon the mother and the practitioner, but it's not entirely out of the realm of possibility. Cervical checks are after all an intervention, so the most important thing is that your provider discusses the purpose of the procedure for your individual situation as well as the risks.
Hutchison, J., Mahdy, H., Hutchison, J. (2020). Stages of Labor. StatPearls, https://pubmed.ncbi.nlm.nih.gov/31335010/
Zamzami, T., Al Senani, N. (2014) The Efficacy of Membrane Sweeping at Term and Effect on the Duration of Pregnancy: A Randomized Controlled Trial. The Journal of Clinical Gynecology and Obstetrics, https://www.jcgo.org/index.php/jcgo/article/view/225
Sheila Chhutani, M.D., board certified OB-GYN in Dallas, Texas
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