The knot and nub of it – an effaced cervix

by Idiolector on flickr

Ready for an anatomy lesson?

These balloons are a model of your cervix and uterus.  Well, 3 cervixes and utereuses.   Really! The bottom of the ballon, let’s call it, the knot and nub (don’t you think that would make a great name for a book or something?) is your cervix when you are not pregnant.  It is all closed and quite long. The balloon walls are like your uterus, flat and smooshed together until a baby grows and makes that huge muscle inflate!  AMAZING!

You may have heard your doctor or midwife talk about your cervix being effaced and dilated.  What the? What’s the difference.  Let me efface any misunderstandings, and get to the bottom of all this medical jargon.

I’ve been in labor twice, but even little ol’ me forgot what effaced meant (this was, uhm, many, many years ago, before I knew EVERYTHING… ha ha ha ha ha).  So, I did what every health professional does when confused.  I googled it! Well, not quite… I looked up “efface” in the dictionary.  According to dictionary.com, efface means

1) to wipe out, to do away with, to expunge,

2) to rub out

Ha ha ha ha ha… did they just say to rub out?  Husbands all around the world will love that one.  ”Husband, can you help me rub out my cervix?”  Sigh, I digress, again.

So, back on subject… Just like the balloon example, your cervix is a nob at the top of your vagina.  It is the entrance to your uterus.   If you are not pregnant, your cervix is very long (about 4 cms) and closed.  An effacing cervix is a cervix that is shortening.    When it is effacing, the cervix (nob) is being wiped out, being done away with, being expunged, by shrinking.  Your cervix, before your baby is born, can be totally effaced, but still undilated. Dilated means open, and I think almost everyone has heard that your cervix needs to dilate to 10cm to bring your baby into the world.  Thankfully, effacement and dilation tend to happen somewhat together.

Would you like to see a picture of a real live cervix, that is closed and not effaced?

Here is my warning… this photo is a real photo of a cervix.  If you are squirmish, you may want to scroll down really quickly.  I personally think that this photo is SO AWESOME!  I found it on the website www.beautifulcervix.com, an amazing project to empower women to take photos of their own cervixes and learn what is happening in their own bodies!  Whoop whoop… love it… anyway… drum roll please… the photo…

day-14

Wow. Here is a closed cervix. The pink walls are the vagina, and the nub, donut looking thing is the cervix.  This cervix is nice and thick (about 4 cms long), and is closed, complete with a mucus plug in the middle for total closure (mucus plug not pictured!).  The milky fluid is this woman’s body telling her she is getting ready to ovulate, and that milky fluid will allow sperm to pass through the cervix into the uterus to find an egg.  Hello, isn’t the body a miracle?  I mean, how did this all happen??  If you or someone else touched this cervix, it would feel mostly hard, described like touching the end of your nose.  As the cervix becomes effaced preparing for labor, it not only gets shorter, but also softer (hence the term ripening that you have probably heard).  It goes from feeling like the end of a nose, to a soft ear lobe, to the inside of your cheek. Gooshey.

Ladies (and gents, if you are reading), this piece of muscle is “wiped out, expunged” in preparation for childbirth.  This cervix will disappear into the uterine walls… it will be effaced, during (and a little before) labor.

Effacing cervixes are described by the people who are looking (doctors and midwives) by percentages.  100% effaced means all gone.  50% means half way there.  25% effaced means still has a way to go.  0% effaced, you haven’t started softening and shortening yet, get a move on!

That’s all I have to say about effacing cervixes.  Go and donate to the beautiful cervix project and take a photo of your own cervix while you are at it!  Effacing and dilating are 2 parts of the labor story.  An important other part of the story is the baby station.  Know all these terms, and you will be empowered during your 1st stage of labor with the right information, able to make the best choices for yourself on how to handle your best labor.

That’s the knot and the nub of it.

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