“In the usual context of modern birth, it is the midwife’s or the doctor’s finger that gives information about the progress of labor. When a woman is allowed to give birth according to the method of the mammals, the finger is uncalled for. Many aspects of the mother’s behavior—her breathing, the noise she makes, her position—provide the attendant with much more insight.”
—Dr. Michel Odent,
renowned obstetrician and author of 11 books
Whether or not you feel the need to limit vaginal exams, it is fascinating to realize they are not the only way to determine labor is moving along. Numerous signs of progress exist, some which a mother can observe herself, and others which involve alternate techniques used by the care provider. An experienced practitioner or doula can often estimate dilation using these techniques, without a pelvic exam (when an exam is used, it often simply confirms the outward signs). Some of these signs of progress are listed below; think of them as a reminder that dilation alone may not deserve the importance it has taken on.
1. Changes in Contractions
2. The Height of the Belly
3. Bloody Show
4. “The Bottom Line”
5. Descent Of The Baby
6. The Baby’s Heartbeat
7. Waters Breaking
8. Ultrasound
9. Rectal Pressure
10. Involuntarily Having a Bowel Movement
11. “Opening the Back”
12. Seeing the Head
Another Point of View
Gloria Lemay is a doula trainer and traditional midwife, and an Advisory Board member of the Canadian Doula Association. She reminds women they have the option of feeling their own cervix for dilation. She explains: “Your vagina is a lot like your nose—other people may do harm if they put fingers or instruments up there, but you have a greater sensitivity and will not do yourself any harm.” Just as sexual touching is safe during pregnancy, so is this kind of self-exploration. Women who charted their fertility before pregnancy may already be familiar with touching their own cervix and feeling for its changes. (Refrain from inserting anything into the vagina if the waters have broken or there is heavy bleeding.) This is Lemay’s description:
"The cervix in a pregnant woman feels like your lips puckered up into a kiss. When it is dilating, one finger slips into the middle of the cervix easily (just like you could slide your finger into your mouth easily if you are puckered up for a kiss). As the dilation progresses the inside of that hole becomes more like a taught elastic band and by 5 cm dilated it is a perfect rubbery circle like one of those Mason jar rings that you use for canning, and about that thick.”
While this option may not be for everyone, numerous women report getting to know their bodies in this way. This is not meant to be a substitute for medical care, but rather a way for women to discover their own anatomy, or as Lemay would say, to reconnect with a sense of “ownership of their bodies.” Your cervix, after all, belongs to you!
