Ah, cervical ripening. If you didn’t know that this had to do with the birthing process you might almost think it was a horticultural term for fruit. And in a way, I guess it does have to do with fruit- after all, you probably have gotten all those text reminders about what size fruit your growing baby is equivalent to at your current stage of pregnancy.

Jokes aside, cervical ripening plays an integral part in your birthing process. Your cervix is an amazing body part- it stays firm and closed throughout your pregnancy to help support your growing uterus and keep that baby inside as they continue to grow and develop. Towards the end of your pregnancy your cervix will begin to get softer or “ripen.” The medical term for cervical ripening is called effacing. It is one of the two things your cervix does in preparation for birth with the other being dilation. It is also one of the things many doctors will look at to see if you are progressing towards labor as you get towards the end of your pregnancy.

Although any news that you’re moving towards labor in the last few weeks of pregnancy is exciting news, don’t get too excited if your doctor tells you that your cervix is ripening. With my first pregnancy, my doctor told me I was 3cm dilated and 50% effaced. I called my mom immediately and told her she needed to be on the next flight out because this baby was sure to come any day.

Of course, back I didn’t have a smart phone to look up what cervical ripening actually meant in terms of labor and delivery. Long story short, I didn’t have my daughter for another 2 and a half weeks, exactly on her due date.

How does cervical ripening happen?

During pregnancy your cervix is about 3.5 to 4 centimeters long. Towards the end of your third trimester your cervix will begin to soften or efface. This can happen several weeks before you deliver and is not necessarily an indication of imminent delivery but it does show that your body is progressing towards delivery.

In order to get your cervix to soften, your body will begin producing prostaglandins. As your body and uterus start to contract, your cervix gets softer and softer. That’s why Braxton Hicks contractions can be important- they are helping your body progress towards cervical ripening. In fact, research has shown that the softer your cervix is at the time of delivery the faster your cervix will dilate making delivery go faster.

Symptoms of cervical ripening

So how do you even know if your cervix is getting softer? Besides doing a cervical exam, which should only be performed by your doctor or midwife, you may notice the following symptoms for cervical ripening:

Braxton hicks contractions- These are also known as “false labor contractions.” Basically, they are contractions that are inconsistent and not as strong as real labor contractions. They don’t mean you are in labor; its just your body preparing for you to be in labor.

Loss of mucus plug- Many women think this is a strong indicator that labor is imminent but it’s not. Some women will lose it, some won’t, and some will lose it weeks before real labor has started. But it may be a sign that your cervix is ripening.

Increased vaginal discharge

Feeling like your baby has dropped lower into your pelvis- As your cervix ripens and softens, your baby will have more room to drop into the birth canal. Hello, lighting crotch!

If you are a new mom, it is important to remember that everyone’s labor experiences are different. Many of the above signs and symptoms are simply common experiences at the end of pregnancy and do not necessarily indicate effacement or even early labor.

Does cervical ripening mean the baby is coming?

The short answer to this question is not really. Although cervical ripening does indicate that your body is moving in the right direction towards delivery, it doesn’t mean that you will be giving birth in the next few hours. It doesn’t even mean you will be giving birth in the next few days. Some women start to have softened cervix 4 to 5 weeks before delivery so even if your doctor does an exam and says that your cervix is effacing, it doesn’t mean you will be having a baby any time soon.

There are cases in which a mother’s cervix doesn’t efface on its own. Most doctors and midwives will allow a pregnancy to continue to see if the cervix ripens on its own up to 42 weeks of pregnancy, but anything beyond that may call for induction.

How cervical ripening is measured

Cervical ripening is measured from 0 to 100 perfect You are at a 0 throughout most of your pregnancy- in other words, if your cervix is 2 centimeters or longer, then you are at a 0 percent. Your cervix will continue to thin out as you get closer to delivery. At 50%, it is about the width of the rim of a mason jar. At 100% it is as thin as a piece of paper.

You cannot deliver your baby vaginally until you have hit 10 centimeters dilated and 100% effacement. In fact, your cervix will not dilate fully until you have hit 100% effacement, so it is an important process in labor and delivery.

What happens if my cervix ripens too early?

If your cervix ripens or softens too early in pregnancy you will probably be put on bed rest. This is to help slow your cervical ripening so that you do not go into preterm labor.

How can I help my cervix get softer in preparing for baby’s arrival?

Luckily there are several ways in which you can help your body with cervical ripening at home. If your cervix isn’t effacing on its own and you are at the end of pregnancy or past your due date, you can try these few things to see if you can get a jump on things:

Have sex- Semen has a high concentration of prostaglandins that may help it soften and thin out your cervix. But don’t have sex if your doctor has instructed you not to for some reason or if your water has already broken.

Stand with your feet parallel- Standing with your feet parallel to one another rather than slightly splayed out will help to separate your sitz bones. This will help to guide your baby’s head into your pelvis. With this happens, more prostaglandins will be produced thereby helping your cervix efface.

Bounce on a birthing ball- This may also help to get your baby in the right position with their head on your pelvis. And you don’t have to bounce- you can also rock or sway. Do whatever feels best to you.

Walk around- Get moving to get that baby in your pelvis. Gravity will help push your baby down into your pelvis which will in turn help to dilate and efface your cervix.

For some mothers, however, medical intervention may be necessary. This is usually the case if your pregnancy has gone beyond 42 weeks or you are in active labor (contractions every 5 minutes or less and/or your water has broken) but you aren’t progressing on your own. Medications and procedures that help efface the cervix include:

Misoprostol is a medication that contains prostaglandins that will help efface the cervix. They are either taken orally or inserted directly into the vagina and the cervix to help with cervical ripening.

A ballon-like device called a mechanical cervical ripening that gradually pushes the cervix open.

“Stripping of the membranes”- This is often performed by a doctor. They will rub their finger between the amniotic sac lining and the uterine wall to help release prostaglandins and start contractions. Many women will ask for their doctor to do this at their last checkup before they hit their due date. It is very uncomfortable and not recommended by most doulas and midwives in terms of it being an optional choice (i.e., a woman asking it to be done just because she wants to go into labor versus it being medically necessary) as it can introduce unnecessary bacteria to the vagina as well as start labor prematurely.

The good news is that for most women, cervical ripening will happen on its own. The last month of pregnancy can feel extremely long, but your baby is cooking inside for good reason and needs every minute inside your belly to grow and develop healthy, strong lungs for the outside world. The best thing you can do is be patient and let your little one come on their own time. And you might as well get used to that feeling because eventually they will want to put their shoes on all by themselves, or they will be telling you a story about what their favorite character did on their favorite television show and let me tell you- you’re going to need major patience for that.

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