Effacement vs. Dilation

[JTA Mom]

I don't know why, but I just remembered something from Elias' birth. I remember that while I was 'stuck' at a 4 for a long time (12hrs), I went from half effaced to pretty much completely effaced.

I was completely effaced and 4 (stretchy to 5cm) effaced with him for at least, geez, 6 hrs.

Why would I efface completely, but not dilate?

Shouldn't the two be related?

Ami

[katelove]

Effacement and dilation are related but not dependent on each other. During the course of a first labour it is typical for the cervix to fully efface before dilation begins. In subsequent labours it more common for effacement and dilation to occur simultaneously but effacement is *usually* complete before dilation progresses too far. Obviously there are lots of individual variations but what I've just described is a fairly common course.

Effacement allows the babies head to come down and press firmly against the cervix which aids dilation. I would guess, in your case, that you "stuck" at 4cm because your babe's head wasn't firmly against the cervix. During that time your cervix fully effaced which allowed the babe's head to apply firmly to the cervix and then you continued dilating. The fact that you had some dilation was probably related to the fact that this is your 3rd (from your signature).

Anyway, that is my guess, based on what you wrote. Of course there may have been other factors as well such as babe needing to rotate a bit or flex his head to fit better.

Hope that makes sense.

Cheers
Kate

[nia82]

Yes to the PP.
I had a similar situation. I was 80% effaced and 3cm dilated at the onset of labor. After hours of back labor, I was at 4cm and 100% effacement, which sort of discouraged me, but the nurse explained that effacement is very hard work, just like dilation, which sort of encouraged me again. I was at 4cm and 100% for about 4 hours, and within the next hour at 10cm. Everybody dilates so differently... But it is true that effacement has to be complete before dilation can progress completely. I imagined my cervix like a turtleneck sweater that gets shorter and shorter til the turtleneck is gone, and then the head opening has to dilate... Visualization helps me

[caned & able]

Usually effacement is separate from dilitation in a primipara, though not always; usually effacement and dilatation occur together in multiparas, though not always.

Effacement: vertical descent - cervix is Latin for neck; the cervix is like a turtle neck sweater or tube sock. It is closed and a sign that it is thinning is the loss of the mucus plug that is held in place by capillaries in the cervical canal. The cervical canal will gradually become shorter with the descent and weight of the baby's body and presenting part, usually the fetal occiput, and with the action of the uterine musculature.

The os or opening of the cervix is marked by dilatation; dilatation is a horizontal motion. Complete dilatation is considered ten centimeters or four inches. Dilatation and effacement pull the cervical canal into the uterus and are one with the birth canal by the time the baby is on the pelvic floor ready to be born.

The uterus scrunches the placenta off the interior uterine wall after the birth through the continued uterine contractions and oxytocin action.

It is a wonderful mechanism when one understands it. I always wonder why doctors feel they have to mess around with it.

[Sijae]

Well I think that if you were effacing during that time then you were not technically stuck. It's possible that the position of your baby was not conducive to dilation and needed time and contractions to work with baby to get in a better position. Either way, try to think of it as your body working perfectly, rather than not. Labor is a dynamic and individual process. Rather than focus on dilation, it's better to think about progress during labor. Progress comes in many forms and effacement even without dilation is one of them.

Laura

[HeatherB]

I agree that many people (med folks, included) tend to get stuck on dilation and not focus as much on effacement as well as baby's descent. Contractions are always doing *something* - the question, sometimes, is what. Dilation is easy to "see," and effacement is behind that as far as obvious changes. The baby's descent AND positioning are important, indeed critical, parts of the whole picture. I know I've had hours and days of labor that were JUST for getting the baby into a better position. It's considered "prodromal" because it's not causing cervical changes, but it WAS making a change. (Thankfully, a chiropractic adjustment helped, too!)