Women, especially those who are about to give birth for the first time, are surprised to learn that the dilatation of the cervix during the birth of a baby and the pace of labor are often measured by experts in ... fingers. Naturally, it is not immediately clear which fingers are meant, and what should be normal for cervical dilatation during childbirth. This will be discussed in this article.
Disclosure - the timing of the assessment and the essence of what is happening
The need to assess the degree of cervical dilatation arises only in certain situations - during preparation for childbirth, as well as directly in the birth process. For the first time, the doctor may become interested in the degree of opening and preparedness of the cervix after 35-36 weeks of pregnancy. From this time on, this part of the female reproductive organ, like the entire female body, is actively preparing for the upcoming process of childbirth.
During the entire period of bearing the baby, important responsibilities for preserving the fetus were assigned to the neck - it reliably protected the entrance "gate" to the uterine cavity from viruses, bacteria, fungi and other uninvited "guests" that could harm the fetus. Inside the cervix in the cervical canal, from the very beginning of pregnancy, there is a mucous plug (cervical secretion thickened under the action of progesterone). And it depends on how tightly the cervix is closed whether a woman brings her baby before the due date.
The cervix is a round muscle. In order for the child to leave the uterus on the appointed day, he has to overcome the path through the cervix, and for this it must open.
The fact that the neck is preparing for opening is indicated by its softening and shortening... From 3 centimeters, it decreases to 1 centimeter, and then it is completely smoothed out. Only after that the divergence of the round muscle begins, the opening. The baby himself actively contributes to this process. As labor approaches, it sinks lower, begins to press with the head on the internal os of the cervix, and this internal effect helps the cervix to shrink in length faster and become softer.
With the onset of labor, contractions are nothing more than the process of opening the cervix. When the cervix reaches its maximum opening, the contractions will stop and the attempts will begin - the baby will begin its path along the birth canal of the mother. During contractions the disclosure occurs gradually, smoothly, while the intensity of the contractions increases, their duration increases along with the painful sensations of the woman in labor.
At the very beginning, contractions are rarely repeated, about once every half an hour or less, and their duration usually does not exceed 20 seconds. At this stage, the woman feels quite easy, and it is too early to go to the maternity hospital. This period lasts up to 5-10 hours, after which the contractions become more tangible, frequent. You need to go to the obstetric facility when the frequency of contractions reaches one in 5 minutes. Usually, by this time, the woman's cervical opening is about 3 centimeters.
In the active period of contractions, the intensity of contractions increases, but the opening itself becomes faster. In just 4-5 hours, opening can reach 7 centimeters, and in the stage of transitional contractions (when the duration of each contraction is maximum, and the break between them is minimal in time), opening in literally half an hour or an hour can reach a maximum. This is 10-12 centimeters (depending on the size of the small pelvis).
Full disclosure is accompanied by the subsiding of contractions, but the appearance of an incredible desire to go to the toilet and push right now. This period of labor is already led by obstetricians who tell when a woman needs to breathe and strain, and when to relax and hold her breath.
What does the finger method mean?
During childbirth, the width of the opening can be determined in different ways, for example, by performing an ultrasound examination in real time with appropriate measurements. But this is associated with significant time costs and physical inconveniences - it is scary to imagine that a woman will have to spend quite a lot of hours in a chair under an ultrasound sensor.
Obstetricians around the world use the finger method for simplicity - the same opening of the uterus for a certain number of fingers. There are no reference fingers, and therefore each specialist uses his own.
After arriving at the hospital, there is no great need to constantly monitor the rate of disclosure. therefore the examination at the front desk is usually the first and the only one for the next few hours. Already in the stages of active and transitional uterine contractions, a repeated digital examination is carried out. Technically, it is quite simple - the obstetrician inserts several fingers into the vagina with a sterile medical glove, and then checks by touch, how many fingers can overcome the neck ring... This is the opening in the fingers.
During a gynecological examination of the cervix before delivery, the doctor may report that the opening is already one or one and a half fingers. This means that the cervical ring is ready for opening, and labor can begin at any time. Usually, such an opening is typical for 39-40 weeks of pregnancy.
Converting fingers to centimeters is harder than it sounds, simply because the fingers are different for different healthcare providers. But on average, it is believed that 1 finger is 1.5-2 cm.
When the cervix is opened by 3 centimeters (with this, a woman usually enters the maternity hospital), most often the opening is 2 fingers. Active contractions end with an extension of up to 7 centimeters, which is 3-3.5 in the fingers. And full disclosure is 4 fingers or more.
Important! Opening in 5, 6 or more fingers does not happen, since the doctor simply cannot physically insert more than 4 fingers into the cervix, and therefore they talk about 4, and "more" is the freedom of introduction. This is the answer to the question of how many fingers the uterus should open during childbirth. The woman enters the stage of attempts, and after a short time the child leaves the birth canal.
Complications
The cervix of each woman in labor opens in its own way, at an individual pace. Rare births are carried out according to obstetric encyclopedic standards. Therefore, you need to be prepared for any development of events.
Quick disclosure
Opening the short neck too quickly is dangerous because labor can be rapid. This is a risky birth for both the woman in labor and the baby. The cervix can open faster in women who have given birth several times before (weakened muscles), in those who are carrying two or three children at the same time, as well as in women with pathological weakness of the cervical ring (ICI). Rapid disclosure is not uncommon in preterm labor and after medication-assisted labor.
Special medications, which are administered to the woman in labor, help to slow down the contractions so that the contractions become coordinated.
Slow disclosure
Too slow opening rates or no opening is primary birth weakness. It is no less dangerous for both the woman and the child - prolonged labor threatens with fetal hypoxia, bleeding in a woman. Help speed up the process drugs that stimulate contractions. If this does not help, the woman is given emergency caesarean section.
For the cervix and the unnatural pain of childbirth, see the next video.
