Cervical checks during pregnancy: What to expect and when they happen
- Updated Jan 28, 2025
- Published
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Created with Hector Chapa, MD, FACOG, Clinical Assistant Professor of Obstetrics and Gynecology, USA
- Cervical checks are physical exams often performed towards the end of your pregnancy and during labor.
- During a cervical check, your healthcare provider will determine how dilated, thin, and firm the cervix is, as well as the position of the cervix and baby.
- Cervical checks are useful if you’re being induced, to monitor progress during labor, or if you have any signs of early labor.
A cervical check, or cervical exam, is a routine part of prenatal pregnancy care where a healthcare provider performs a physical exam to check the state of your cervix. You may be offered this physical exam at around 36 weeks of pregnancy as well as during labor. If you show any signs of early labor, or bleeding, then it may be performed earlier.
If you’re not sure what a cervical check is, what it can and can’t tell you, or if there are any risks to the procedure, then you’ve come to the right place. This guide takes you through everything you need to know about cervical checks in pregnancy.
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What is a cervical check?
A cervical check is a physical exam that can be performed by a healthcare professional towards the end of pregnancy and during labor. During the examination, the position, dilation, and effacement of your cervix is checked. Let’s break down what that means:
- Position: Your cervix changes position as you get closer to labor, moving from a posterior position (pointing back toward your spine) to an anterior position (pointing forward down your birth canal).
- Effacement: This refers to the thinning of your cervix in preparation for childbirth. . Before a vaginal delivery, your cervix will go from long and thick to short and paper thin. Cervical effacement is expressed as a percentage, 0% effaced means your cervix is still thick and unchanged, whereas 100% effaced means it’s paper thin and ready for labor. Your cervix has to be 100% effaced before your baby is born.
- Dilation: This is how open your cervix is, a healthcare professional uses their fingers to measure the opening and then translates this into centimeters (cm). If you’re having a vaginal birth, then your cervix will go from 0 cm to 10 cm dilated before your baby is born.
- Consistency: This is how soft your cervix feels. During labor, your cervix will become very soft, as it has to dilate. This measurement is purely observational and therefore dependent on the judgment of the healthcare professional doing the examination.
- Baby’s position: The location of the baby’s head, how low down it is, and if the waters are still intact will also be noted.
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Cervical checks are often offered towards the end of pregnancy to help gauge how ready your body is for labor, especially if you’re being induced. They are also used during labor to monitor how the labor is progressing and what stage you’re in.
| Good to know: |
|---|
| A cervical check can only tell you what is happening with your cervix right now. It cannot be used to predict when labor will start. Some women’s cervixes will slowly start to dilate and thin weeks before labor starts while others won’t change until labor begins.
A cervical check can be a useful tool to guide induction and during labor to monitor progress or if you have any signs of early labor. |
When do cervical checks start during pregnancy?
Some healthcare professionals may offer to perform a cervical check at your prenatal check-ups at around 36 weeks of pregnancy, as long as your waters haven’t broken and you don’t have placenta previa. But, because a cervical check can’t tell you when labor will start, many providers don’t consider them a routine part of the prenatal check-up. However, if you’re keen to know what your cervix is doing you can always ask for a cervical check even if your provider doesn’t routinely provide them.
A cervical check might also be performed before 36 weeks of pregnancy if there are signs of preterm labor such as:
- Contractions before 37 weeks
- Vaginal bleeding
- unusual vaginal discharge
- waters breaking (a gush or continuous trickle of fluid)
- Belly pain
- Back pain
- A feeling of pressure in your pelvis or lower belly
When you’re in labor you may be offered multiple cervical checks. These are usually performed to track how your labor is progressing, what stage of labor you’re in, and to help determine if labor has stalled. They might also be performed if there are signs that your baby is struggling with issues like fetal heart decelerations during labor, and to check for conditions like a prolapsed umbilical cord.
What happens during a cervical check?
A cervical exam is a physical exam performed by a healthcare provider. Here’s what you can expect during the process:
- Your healthcare provider will first discuss performing a cervical check. This is the perfect opportunity to ask any questions you have about why they want to perform one, what to expect, or to decline the procedure if that’s your choice.
- If you agree to a cervical check then you will need to undress from the waist down and position yourself on the examination table as directed.
- Once comfortable, your healthcare provider will insert one or two gloved fingers into your vagina, they may use a lubricant to make it more comfortable. They will be feeling for cervical position, consistency, effacement, and dilation. They will also note how low down in the birth canal your baby’s head is and whether your waters are intact.
- The entire examination should last between 30 seconds and a couple of minutes. Some women can find the procedure uncomfortable or mildly painful.
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Can a cervical check induce labor?
No, a cervical check on its own doesn’t induce labor, although it can cause some mild cramping or spotting. However, sometimes a cervical check can be combined with a membrane sweep.
A membrane sweep is usually performed around or after your due date to help induce labor naturally. During the procedure, your healthcare provider uses their finger to loosen the amniotic sac from the wall of your uterus in the hope of jump-starting labor. However, it can only be performed if your cervix has already started to dilate. Your healthcare professional should always discuss the pros and cons of a membrane sweep with you first, and it’s always your choice whether to have one.
Pros and cons of cervical checks before labor
The decision to have a cervical check is a personal one, and there are many reasons why you may wish, or not wish, to have one. Here’s a look at some of the pros and cons of cervical checks.
| Pros | Cons |
|---|---|
| During labor, it provides information aboutthe progression and stage of labor. It can help determine when to start an epidural (if you want one) or other scenarios, like if labor has stalled. | Can be painful or uncomfortable. |
| If you’re being induced, it provides useful information for measuring your Bishop score. This score can help determine how and when you’re induced. | Can be triggering. Some women may find internal examinations a triggering event and wish to keep them to an absolute minimum. |
| If you have vaginal bleeding, signs of premature labor, or infection, a cervical check can help determine what is going on. | May cause some light bleeding or cramping after the procedure. |
| Some women like to gather as much information as possible about their bodies toward the end of the pregnancy to help them prepare for labor. | Small chance of breaking your waters during a cervical check. |
| Small increased chance of infection. A 2021 study published in the American Journal of Obstetrics and Gynecology found that women who had a high number of cervical checks (more than 8) were 1.7 times more at risk of developing Chorioamnionitis (an infection in the sac surrounding your baby). |
How to prepare for a cervical check
The best way to prepare for a cervical check is to first discuss it with your healthcare provider. They will be able to explain why they think you need, or don’t need a cervical check. If you choose to go ahead with the examination, then here are some tips to help make the experience more comfortable:
- Discuss any concerns with your healthcare provider first
- Empty your bladder beforehand
- Stay relaxed
- Practice slow breathing techniques during the procedure
👉Find out more: Best positions to relieve gas while pregnant for immediate comfort
When to decline or delay a cervical check
You have the right to decline or delay a cervical check for any reason. Your healthcare provider should explain the risks and benefits, but the decision is always yours.
If you’re unsure about whether to have a cervical check or not, consider asking your healthcare provider the following questions to help you decide:
- “Why do you want to perform a cervical check at this time?”
- “How will the outcome of the check change my plan or care?”
- “Is there any alternative to having the cervical check?”
Questions from the Femia community
Can cervical checks harm the baby?
Cervical checks are generally safe but should be avoided if your waters have broken, as there is a small increased risk of infection. They should also not be performed if you have placenta previa.
How accurate are cervical checks at predicting labor?
They can provide useful information during labor or before an induction but they cannot predict when you will go into labor. It can be hard to know when labor has started, if you have any concerns then don’t hesitate to reach out to your healthcare provider.
How often will I need cervical checks?
Your healthcare provider may offer a cervical check during your prenatal visits after 36 weeks. They will also be offered if you have signs of premature labor, vaginal bleeding, during labor, or before an induction.
Can a cervical check replace an ultrasound?
No, they serve different purposes. Cervical checks assess the state of your cervix and can be used to predict labor readiness. An ultrasound scan is used to visualize the baby.
What happens if I refuse a cervical check?
This will depend on why your healthcare provider wants to perform a cervical check. If it's to track the progress of labor then they may use other methods to assess labor progress, such as monitoring contractions or external exams.
The bottom line
Cervical checks are often considered a routine part of prenatal care, starting at around 36 weeks and continuing through to labor. During a cervical check, your healthcare provider will note the position of the cervix and the baby as well as how thick, dilated, and hard the cervix feels.
Cervical checks are useful if you’re being induced, as they can help inform when and how to induce labor. Monitoring the cervix can also be useful during labor to track labor progress, determine when to start an epidural, or monitor for signs of stalled labor. However, they cannot predict when labor will start. The cervix can thin and dilate slowly over a period of time or within a matter of hours, so all a cervical check can tell you is how ready the cervix is at that exact time.
If you aren’t sure whether you want a cervical check or not then it’s important to speak to your healthcare provider. They will be able to explain why they want to perform one, what it will tell them, the risks of a cervical check, and if there’s an alternative way to gather the same information. But remember, having or not having a cervical check is always your choice.
References
- “Bishop Score.” Perinatology, perinatology.com/calculators/Bishop%20Score%20Calculator.htm.
- “Cervical Effacement and Dilation.” Mayo Clinic, www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/multimedia/cervical-effacement-and-dilation/img-20006991.
- “Placenta Previa – Symptoms and Causes – Mayo Clinic.” Mayo Clinic, 11 May 2022, www.mayoclinic.org/diseases-conditions/placenta-previa/symptoms-causes/syc-20352768.
- “Preterm Labor – Symptoms and Causes.” Mayo Clinic, www.mayoclinic.org/diseases-conditions/preterm-labor/symptoms-causes/syc-20376842.
- Professional, Cleveland Clinic Medical. “Bishop Score.” Cleveland Clinic, 1 May 2024, my.clevelandclinic.org/health/diagnostics/24252-bishop-score.
- “Membrane Sweep.” Cleveland Clinic, 1 May 2024, my.clevelandclinic.org/health/treatments/21900-membrane-sweep.
- Slagle, Helen B. Gomez, et al. “Incremental Risk of Clinical Chorioamnionitis Associated With Cervical Examination.” American Journal of Obstetrics & Gynecology MFM, vol. 4, no. 1, Nov. 2021, p. 100524. https://doi.org/10.1016/j.ajogmf.2021.100524.
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