Delivery
Experts explain effacement and dilation.
As your labor and delivery experience draws near, you’ll continually be looking for signs that it’s finally happening — that you’re actually in labor and your baby is on the way. As sure as your OB-GYN may be, there’s really no telling exactly when your big day will be (unless you’re being induced, of course). But, watching your body for signs of labor is a great way to tell that you’re at least getting closer. You’ll hear the words “effaced” and “dilated” used a lot toward the end of your pregnancy, and it’s useful to know exactly what those terms mean, as well as familiarize yourself with signs that effacement and dilation have begun.
Before you can know whether you’re beginning to efface, it’s important to know the distinction between effacement and dilation. Both terms apply to the way the cervix prepares for labor. “Effacement is when the cervix starts to become soft and thins out. I like to describe it as a rubber band,” Stacy Fayling, a labor and delivery nurse, tells Romper. “At rest, the rubber band is thick, but the more it is stretched the thinner it gets. That's exactly what the cervix does as it begins to prepare for childbirth.” Dilation, on the other hand, is the opening of the cervix, and 10 centimeters is the magic number that means you’re fully dilated and ready to deliver. That magic number for effacement is measured as a percentage: At 70% effaced, you’re getting close, and at 100%, your cervix is thinned out enough for your baby to come through the birth canal.
While both effacement and dilation are crucial to the labor and delivery process, Dr. Jane Van Dis, an OB-GYN, explains to Romper that effacement is the true “magic” of labor. “While a woman can be dilated for weeks without going into labor, effacement is often an indication that the cervix is really ready for labor,” she says.
For first-time moms, however, effacement often begins long before you go into labor. It’s a process that takes different amounts of time for different women. Whether it happens overnight or over a few weeks, knowing the signs that your cervix is effacing can be helpful (and encouraging) as you prepare to give birth.
1
Your baby has dropped
Your baby “dropping” is a part of late pregnancy that will keep things moving towards labor. If you've noticed the shape of your bump changing, that you can suddenly breathe easier, or that your baby feels lower in your abdomen, they've likely dropped.
“You will often hear providers during a cervical exam say something like, ‘She's 3/70/-3.’ This means, the cervix is 3 cm dilated, 70% effaced, and -3 is the station the baby's head is in relation to the woman’s pelvis,” explains Fayling. “This would be a typical exam result for a woman who is nearing her due date.” Also known as lightening, this is the part of labor when Baby usually drops into position, putting pressure on and thinning the cervix, a few weeks to a few hours before labor begins, according to the American College of Obstetricians and Gynecologists.
2
Your discharge takes on a new hue
The large quantity of mucus that discharges near the end of pregnancy that we call a mucus plug provides “little, if any, clinical information about when a woman will go into labor,” Dr. Van Dis. Near labor, women do, however, often notice an increase in vaginal discharge that’s also blood-tinged. “The cervix is very vascular, so as it thins out and starts to dilate, bloody show is normal throughout the entire process of labor and delivery,” says Fayling. “It's a good sign that the body is preparing for childbirth and labor is likely near. It does not, however, predict an exact time of which labor will occur.” There’s no need to take photos of your mucus clumps or bring them in a baggie to appointments, reminds Van Dis. Also, even though it is normal to see some changes in the color of your discharge, it’s worth contacting your health care provider if you notice any obvious changes to your body as you near the end of your pregnancy, just in case. Occasionally, changes in the color of your discharge can indicate the presence of amniotic fluid.
3
Your cervix is dialating
Near those last days of pregnancy, your cervix will begin to open so Baby can pass through. If you’re pregnant and your doctor tells you you’re dilated between 1 and 3 centimeters, they might also let you know this might be your last prenatal appointment, says Fayling. Together, effacement and dilation are solid signs that labor is near. Effacement even might help dilation along. A 2017 study in the journal Obstetrics & Gynecology found that the more effaced a woman's cervix is before labor, the faster dilation might occur.
Only your healthcare team can safely and accurately tell you how dilated your cervix is. If you suspect labor for other reasons (contractions, amniotic fluid leaking, or sudden onset of nausea or diarrhea), Dr. Van Dis says it might be time to give them a call. “There's nothing that replaces the wisdom of a practitioner – midwife, physician, or nurse – in knowing true labor from false labor on the basis of a cervical exam,” she says.
Experts:
Stacy Fayling, BSN, RN, labor and delivery nurse
Dr. Jane Van Dis, OB-GYN
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