Effacement vs. Dilation

Now that I'm 38 weeks and having weekly doctor appointments, I'm also getting checked weekly for dilation and effacement. 

At 36 weeks I wasn't even a centimeter dilated.

At 37 weeks I was 1 cm dilated and 50% effaced. Making progress! 

We will have to wait and see what I am at my doctor's appointment tomorrow.

While I'm not a doctor or nurse, I have done some research and reading into what exactly "dilation" and "effacement" are. 

My main conclusion is this: 

Dilation means nothing without effacement and effacement means nothing without dilation. 

You need BOTH before you can push and delivery that baby. 

WebMD does a great job of explaining effacement and dilation. Dilation is how much the cervix is open and effacement is how thin or thick the cervix is. 

Here is a great visual from Mayo Clinic: 

In figures A and B, the cervix is tightly closed and still thick. 

In figure C, the cervix is 60% effaced and 1-2 cm dilated. 

In figure D, the cervix is 90% effaced and 4-5 cm dilated. 

The cervix must be 100% effaced and 10 cm dilated before you can push and delivery the baby. 

It is also important to note, that how dilated and effaced you are, can be somewhat varied. It is all really just a matter of opinion and not very scientific. One doctor or nurse may check you and say you are 2 cm dilated and 70% effaced. Another doctor or nurse may say you are only 1 cm or even 3 cm and 60 or 80%. 

The nurse who taught my childbirth class said that new nurses will check you and then go out of the room and put their hands in a 3D chart and guess which feels closest to what the patient felt like. That then determines the dilation. 

To help you get a visual, I found this great food comparison chart on Baby Center that relates a food to a certain centimeter of dilation. 

So you need to go from closed all the way to an opening the size of a bagel...no biggie, right? :) 

Another important thing to keep in mind...you can be only 1 cm dilated for forever and then all of a sudden BOOM! you are in labor and contractions are opening and thinning your cervix and its time to have a baby! 

OR you could be stuck at 3-4 cm (for example) and not go in to labor until you are induced. 

There really seems to be no magical number for dilation or effacement. However, progress in either area is showing that you are heading in the right direction. But then again, no progress doesn't mean you won't make your way into labor either....

Hope this helps a little! 

You can also check out Elizabeth Allen's book Laboring Well to read more in detail about effacement and dilation from a nurse's perspective.

 

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