What does cervical dilation from 1 to 4 fingers mean?

One crucial indicator that labor is progressing is cervical dilation. It describes how the cervix gradually opens to let the baby pass through the birth canal. The measurement of this process is commonly expressed in fingers, with one to four fingers serving as a proxy for the stage of labor.

Cervical dilation can be overwhelming for many expectant parents to comprehend. Although it’s common to hear medical professionals or midwives refer to the number of fingers as a measure of how much the cervix has opened, what does this measurement actually mean?

This post will explain what it means to have cervical dilation between 1 and 4 fingers and how it corresponds with the different stages of labor. As delivery day approaches, this information can help you feel more prepared.

When the cervix starts to open during the early stages of labor to allow the baby to pass through during childbirth, it is referred to as cervical dilation from one to four fingers. It is a slow process that frequently involves contractions and shows that the body is getting ready to give birth. The number of fingers that can fit into the cervix at this point indicates the dilation, with one to four fingers signifying the first stage before active labor starts. Parents can better prepare for what to expect as labor advances by being aware of this.

What is happening?

Before talking about fingers and their use in assessing the condition of the cervix, it is necessary to explain what is happening in general and when there is a need for an assessment of the condition of the cervix. Around 36 weeks, the cervix begins to actively prepare for childbirth. Until this moment, it was entrusted with the responsibility of keeping the growing baby inside the uterus, preventing it from leaving the womb prematurely. The cervix is ​​a tight round muscle, which is normally tightly closed throughout the entire gestation period in the absence of pathologies in a woman. It is this that stands in the way of the baby to the birth canal. A few weeks before labor, the length of the cervix begins to decrease from the initial 3 centimeters, the round muscle gradually softens and shortens. Before labor, the mature cervix is ​​1-1.5 centimeters long and slightly opens.

The weight of the significantly larger baby and the fetus’s descent and pressure on the internal os cause the cervix to shorten and soften more quickly. Regular contractions of the uterus cause the cervix to gradually open up when labor starts. It has to open up from a tightly closed muscle to allow the baby to pass through and start its journey down the birth canal to meet its mother.

When a woman begins to give birth, the dilation of the cervix is ​​gradual, and this is the longest period of labor. It can take up to 14 hours for a woman giving birth for the first time. With the first contractions, the round muscle expands gradually, as it opens, the intensity of the expansion will be higher. Initial contractions are not characterized by pronounced pain syndrome, they are quite rare. Usually recur with a frequency of once every half hour, each contraction lasts no more than 20 seconds. It is too early to go to the maternity hospital, since the latent period is underway. It can last up to 6 hours for women giving birth again and up to 10 hours for women giving birth for the first time. Contractions become more frequent, stronger and longer.

If your contractions are happening every 15 to 20 minutes, you should visit the maternity hospital. The cervix typically opens up to three centimeters by this time.

Already in the hospital, the woman will enter the active phase of contractions, when the opening will be faster. In 3-5 hours of contractions, the cervix will be able to open a few more centimeters. Usually, by the end of the period, doctors confirm the opening up to 7 centimeters. The last contraction period is transitional. It lasts from half an hour to an hour and a half. These contractions are the longest and most painful, each can last for a minute and repeat after 1-2 minutes. The cervix makes a “decisive leap” and opens completely – up to 10 centimeters. This is full opening. After it, the woman in labor begins to experience an irresistible desire to visit the toilet and push. This is how pushing begins, during which the baby will be born. This is full opening. After it, the woman in labor begins to experience an irresistible desire to visit the toilet and push. This is how pushing begins, during which the baby will be born.

Finger measurement

Naturally, a woman can get a vaginal ultrasound done during labor to find out how much of her cervix has already opened. Obstetricians have devised a quick and simple "manual" measurement system, however, because time is of the essence. They measure the opening in their fingers. Of course, in their own.

The woman is checked on a regular basis while in the prenatal ward, whether she is in the stage of transitional or active contractions. In order to do this, the obstetrician touches the genital tract with multiple fingers of his own hand while wearing a sterile glove to determine how many of them the cervix will "let through."

In the antenatal clinic, a woman may already be faced with a manual assessment of her cervix’s condition in the latter stages of her pregnancy. The doctor will assess the round muscle’s maturation and readiness for delivery following the 36th week of pregnancy. The obstetrician-gynecologist typically reports that the opening is 1 or 1.5 fingers at 39–40 weeks. This indicates that the cervix is prepared for childbirth and that any minute now the birthing process can start.

One finger will correspond to an expansion of roughly 1.5–2 centimeters when measured in centimeters (there will be an error because different obstetricians have naturally different fingers).

The opening is typically about 3 centimeters when the patient arrives at the maternity hospital with contractions that recur every 15-20 minutes. Using a manual assessment method, the obstetrician in the emergency room can determine an expansion of up to 2 fingers or slightly more. You can measure your fingers manually to determine the dilation of up to 3-3.5 fingers, and occasionally up to 4 fingers, by the end of active contractions. The dilation is 6-7 centimeters.

The dilation of the cervix is complete at the moment of pushing. Four fingers or more is full dilation. In this instance, neither number five nor number six is announced, even with dilation up to ten centimeters, because the obstetrician can only insert four fingers on one hand. The woman is taken to the delivery room, where the placenta is born, and the pushing phase of labor occurs, if they are allowed to enter and the baby’s head is felt to be ready for birth.

It is sufficient to simply keep in mind that one obstetric finger (as a measure of length in this instance) is equivalent to 1.5–2 centimeters in accordance with the standards adopted in obstetrics to avoid questions.

A woman can compute the remainder on her own with ease; these basic math activities will help her divert her attention, relax, and switch off a bit. Plus, you won’t have to bother the doctor with inquiries about how many centimeters the opening of three fingers will be during labor.

Other measures and evaluations

• Density. With vaginal examination, manually consistency is determined. Dense and hard neck is awarded 0 points. Softened at the edges, but dense inside – 1 point, soft – 2 points. The softer the neck, the better it will behave in childbirth, the disclosure will occur less painfully, more quickly, the likelihood of rupture of the neck and injuries of the fetal head will be considered insignificant.
• Length. A long neck of more than 2 centimeters – this is 0 points. Organ, the length of which is from 1 to 2 centimeters – 1 point. Shortened less than a centimeter – 2 points.
• Passing capacity. If, upon examination, the neck is tightly closed and does not pass a single fingers of the obstetrician, put 0 points. If the cervical canal located inside the neck is slightly expanded up to the boundaries of the inner pharynx, 1 point is placed. If the neck passes 1-2 fingers, well-deserved 2 points are awarded.
• Location. A cervix that bends back is considered unready – 0 points on the specified scale. If the inlet of the neck “looks” forward – 1 point. The neck is best prepared, which is clearly in the middle – 2 points.

Usually between 38 and 39 weeks, the most common gynecological examination determines all of these criteria. The total, which represents whether or not the uterus is prepared for childbirth, is calculated by adding the points for each of the indicators.

The woman’s body is fully prepared for childbirth, according to the doctor, who concluded that the neck’s maturity score of 5-8 points indicates that childbirth can start at any time. Less than three points on the Bishop are unremarkable for childbirth, which may necessitate medical intervention. Scores of three to four indicate insufficient maturity.

In this case, hospital preparation will be undertaken. In addition to hormonal medications and antispasmodic medications to relax the round muscle, the woman will also be prescribed laminaria, which will cause swelling in the cervical canal and eventually cause the cervix to mechanically expand.

Possible problems

Medical encyclopedias and obstetric manuals do not always accurately describe how cervical dilation works. Every birth is unique in a lot of ways. As a result, various issues may surface at various phases.

Too rapid dilation

Rapid labor is risky for both the mother and the unborn child and occurs when the cervix dilates too quickly during labor. This typically occurs in multiparous, pregnant women with weak uterine muscles who are carrying twins or triplets and who have been diagnosed with isthmic-cervical insufficiency during the course of childbearing. Both women who underwent induction (stimulation) of labor and women in labor who give birth prematurely exhibit abnormally high dilation. Rapid labor development has a complicated mechanism that contemporary medicine is not always able to fully explain.

The obstetrician talks about discoordination of contractions if they discover that the opening surpasses the conditional norm for the current contraction period (for instance, opening more than 6 centimeters with contractions once every 5 minutes).

In order to prevent rapid labor and allow her body to "catch" the proper pace, the woman is given medications that artificially slow down her contractions.

Insufficient

They also discuss discoordination and the main weakness of the labor forces if the contractions are severe and the opening does not match the stage. The cervix opens too slowly, to put it another way. In this instance, oxytocin and prostaglandin medications, along with antispasmodic medications to relax the muscles, are used to amplify contractions. In the event that the cervix fails to dilate to the necessary extent due to such drug stimulation, an emergency cesarean section is carried out.

There are several possible causes for this, not all of which make sense. Therefore, intense fear, tight muscles, pain phobia, and reluctance to give birth frequently result in the development of the labor forces’ primary weakness.

Additionally, women who are primiparous, have had multiple abortions in the past, have reproductive system health issues, or suffer from endocrine disorders are more likely to experience this type of birth complications.

One crucial stage of labor is cervical dilation from one to four fingers. It shows that the cervix is gradually opening to allow the baby to pass through the birth canal, signaling the body’s preparation for childbirth.

It’s critical to maintain your composure at this point and heed any advice given by medical professionals. Every woman has a unique experience, and the length of time and intensity of dilation can change.

Knowing what cervical dilation is helps expectant mothers feel more confident as the delivery date approaches and helps them know what to expect.

Video on the topic

EXAMINATION OF THE CERVIX DURING PREGNANCY

Dilation of the cervix. Full video already in the feed.👇

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Bimanual examination: palpation of the vagina, cervix, body of the uterus, ovaries (on a dummy)