Dilation and Effacement

[callieollie]

I was just curious about the relationship between dilation and effacement. Does one tend to occur before the other or do they tend to occur simultaneously? Is it different for first time births compared to subsequent births? With my ds, I was 100% effaced when I arrived at the birth center but only 3 cm dilated and then I only progressed to 6 cm after 16 hours of labor. I just wondered why I would have been fully effaced but taken so long to dilate. If this is relevant, my ds MAY have been posterior (they aren't sure), but the midwife guessed that he may have been due to the long labor, slow progression, back labor, long contractions (each one lasted 2-5 minutes each because of the back labor), and several double peak contractions. Not sure if that would be related or not. Thanks!

[JamieCatheryn]

Much/most or all of the effacement happens early on or before dilation, often before labor, then the rest happens with dilation. That's normal. Measurements of effacement are a very rough estimate and subjective, but an experienced care provider can tell pretty well.

My labor was long too with an ROA baby, 30 hours of labor, 6 of that active, got me to 4cm. There was psycological letting go issues too. But all that time got things ready even w/o much dilation and then I progressed quick enough.

[maxmama]

Originally Posted by JamieCatheryn

Much/most or all of the effacement happens early on or before dilation, often before labor, then the rest happens with dilation. That's normal. Measurements of effacement are a very rough estimate and subjective, but an experienced care provider can tell pretty well.

True with primips. Not true with multips. (I regularly check multips who are 4-5 cm and still 2cm long.)

[Shanana]

Originally Posted by maxmama

True with primips. Not true with multips. (I regularly check multips who are 4-5 cm and still 2cm long.)

My doula at dd's birth (my first) used to be a midwife, and she told me that at subsequent births I would not need to efface as much in order to dilate. Whereas with my dd's birth, my dilation was slowed waaaaay down because I wasn't effacing (took 24 hours of hard contractions to get to 4 cm ... I think I was 80 or 90% effaced at that point). In my case, dd was posterior and her head was acynclitic (tipped), so it wasn't applying even pressure to my cervix. This resulted in an uneven effacement (thinner on one side, thicker on the other). I also had cervical scarring from laser surgery, and I'm sure that didn't help things at all. Once I hit 4 cm, it was about 8 more hours before she was born.

I am fully expecting that things will be MUCH easier this time around .

[bobandjess99]

Originally Posted by maxmama

True with primips. Not true with multips. (I regularly check multips who are 4-5 cm and still 2cm long.)

Yes, this is what I have read/been told as well...effacement generally happens forst with primips, and dilation happens first with multips....