Labour effacement, also known as cervical effacement, is a critical aspect of the childbirth process. It refers to the thinning and shortening of the cervix in preparation for delivery. Understanding the concept of labour effacement is important for expectant parents, as it's a little piece of insight that care providers use to assess progress of labour.
In this blog post, I share some basic understanding of the physiological process of labour effacement. I'll also share its significance - and it's insignificance - when it comes to the overall childbirth process.
What is Labour Effacement?
Labour effacement refers to the process by which the cervix, which is the lower part of the uterus, thins out and becomes shorter in preparation for childbirth.
During pregnancy, the cervix acts as a barrier between the uterus and the birth canal. During labour, it needs to efface in order to make space for baby to pass through. Effacement is often measured as a percentage, with 0% indicating a thick and long cervix, and 100% indicating complete effacement or a paper thin cervix.
The Significance (and insignificance) of Labour Effacement:
Progress of Labour: Effacement is one of the three main measurements used to assess the progress of labour, alongside dilation (opening of the cervix) and station (position of baby's head in relation to the pelvis). It's a good indicator of how the cervix is changing and preparing for delivery. As labour progresses, the cervix gradually thins and shortens, making way for the baby's descent through the birth canal.
Predicting Delivery Timeline: Labour effacement, along with dilation, provides an estimate of the timeframe until delivery. However, it's important to note that every woman's labour is unique, and the rate of effacement can vary significantly.
Readiness for Interventions: Labour effacement is also crucial for determining when interventions, such as induction of labour, may be appropriate. If the cervix is not yet effaced or dilated sufficiently, care providers should offer alternative options for parents to consider.
Relation to Dilation: While effacement refers to the thinning and shortening of the cervix, dilation refers to the opening or widening of the cervix. The two processes often occur simultaneously during labour, but it is possible for effacement to happen before significant dilation occurs. Dilation is usually measured in centimetres and represents how much the cervix has opened to allow the baby to pass through.
Monitoring Labour Effacement:
During labour, your midwife will offer to assess your cervical effacement by performing a vaginal examination. They use their fingers to feel and measure the thickness of the cervix.
Although internal examinations are routinely offered within maternity care for the reasons listed above, it's important to remember that this is your choice. Verbal consent should always be obtained, and you can decline.
What You Also Need to Know:
Vaginal examinations can slow down or reverse the progress made so far, as it can inhibit the release of Oxytocin.
Monitoring labour effacement through vaginal examinations only tells you how far you are at that moment. It doesn’t indicate how fast labour will progress. It's only a snapshot in time.
Vaginal examinations increase the risk of infections.
Measuring progress in percentages and centimetres can affect the birthing person's mindset and their ability to surrender and trust their body and the physiological process.
There may be particular circumstances when the information gained is necessary to make a clinical assessment, or for medical professionals to provide appropriate care and support but this is not the case for all births.
Conclusion:
Labour effacement plays a vital role in the physiological process of labour and birth. Monitoring labour effacement can help healthcare providers track the advancement of labour. However, every labour is unique, and internal examinations only provide a snapshot in time. Only you can decide the type of care you'd like to receive so it's important that you consider the benefits and risks of each interventions.
If you wish to learn more about birth physiology, and how to prepare for a calm and empowering birth experience, join one of my Complete Hypnobirthing and Antenatal Courses in Bristol and online!
Photo by Lindsey Eden Photography