After a pretty long wait in the doctor's office we heard some good news and got to see our midwife!
She appeared with a very kind 3rd year medical student who observed and assisted in our examination today. The student completed a simple measurement with a hand-held measuring tape and a quick sonogram- to which the baby decided to give the med student a little kick. The student responds like a giddy girl on the playground, commenting to us all, "did you see that? she 'kicked' me!" (I let the "she" part slide in her excitement)
Then, our kickass midwife, gave me an examination.
To be completely blunt: Up goes the hand.
After undressing from the waist down and a friendly little white sheet is placed over my lower body, the midwife asks if I mind if the student watches. With my legs spread eagle for everyone in the room to see, I say that I can't be shy now. Then, in a scissor-like fashion, she's up and feeling around in there.
While she's exploring me like a caver, I think I might have even heard a slight echo in her voice as she comments that my cervix is "far up there." And then, her hand goes in even farther. Now, while I didn't watch, it felt like she was up to her elbow. And until this moment, other than hearing about some pretty gross pornographic films where these things occurred to women who've been poked, prodded, and stretched numerous times, I have never realized that an entire hand could fit in me...let alone to have it disappear into what feels like my stomach. Then, just as though it couldn't be any weirder, there's a horrible pinch and her hand slips back out. She says, "You're 3 centimeters dilated, 80% effaced, and at Zero Station. This baby may come out before Monday!"
So here's some anatomy:
The cervix, which from the front looks like a pigs snout with only one nostril (check out the picture above) is thick and long and includes a "plug" to keep the cervix closed. During the "first stage of labor," (there may or may not be contractions at this time) the cervix begins to shorten and thin out. The medical world measures it by percentages and the higher the number, the closer the cervix is to becoming a part of the uterine wall and the baby is to being in place for moving down the birth canal. At the end of the cervix is the "mucus plug" which seals the cervix from any outside aggravations or grossness inside the vagina. In my humble opinion, the "mucus plug" is one of the grossest terms to ever have to refer to in any setting...ever.
Anyway, as the cervix thins and shortens (called effacement, or effacing- an in: the baby is starting to show his face to the birth canal), the mucus plug is released out comes a "small" amount of blood, which is usually pinkish. Sometimes they call this escaping blood, "bloody show," cause it shows you that you should pack your bag if you haven't done do already. Like me... I've been packing like a madwoman ever since it began.
Image source from: http://birthsource.com/
So, maybe around the same time, usually after effacement, the cervix begins to dilate. So once it shortens and thins out and the plug is released, the baby's head has to fit through so it can come down the birth canal. Since I am at 3 cm, I still haven't entered into "active labor," which is when the contractions usually start. You don't start pushing the baby out until you've hit 10 cm, so I've got a while to go. But as the baby wiggles into a comfortable place and exits the cervix, that's where the term "station(s)" comes from.
Stations refer to how high/low the baby's head is in the pelvis (if (s)he is coming out in the ordinary position, otherwise this will refer to the baby's feet). At "Zero Station" the baby is ready to come out. Anything with a negative number is higher or more inside the pelvis, anything with a plus means the baby is on his/her way out.
So while he's definitely on his way, it was all shocking news to us considering we are "due" until July 1st. But before we go all crazy, this is only the beginning of labor and I'm still bumming around at home waiting for it to continue to progress and for contractions to start.
I'll keep everyone posted!
Mucous plug is indeed a wicked gross term. And it's pretty crazy when you have a midwife reaching inside you like you are an human version of Mary Poppins bag. The Vajayjay is amazing in all ways. Are you all packed and ready? Music? Pretty PJs? Favorite scented lotion?
ReplyDeleteWorking on a CD today but also doing some of the baby's room and still trying to get everything out of the old apartment. Finally got the bag packed and got some maternity pjs... i don't think the hospital staff would really appreciate my nudist (pj) tendencies in my own home.
ReplyDeleteHa - I'm a third year medical student on my OB rotation... I just googled "station effacement dilation medical student" so that I could review all of these things for my preceptorship and your blog came up.
ReplyDeleteFirst of all - I am totally the giddy girl on the playground when I get to do the doppler tones. Best part of my day.
Also, your descriptions of effacement, dilation, and station are great.
And last - thank you for allowing the medical student to be a part of your visit. It's interesting to read your perspective - and from my end I can say that I am so appreciative of the patients who allow me to further my education by sharing their experiences with me. Especially something as personal as carrying a baby. It's great - and someday she'll be a better doctor because of something she learned from that appointment.
:/ I'm 38 weeks and 2 days pregnant....I've been 3 cm 80% and at 0 station for a week or two now...Im sore cranky and sleep deprived from contractions...hospitalized 3 times from contractions but always sent home a few hours later...I need this baby girl out now lol she's seriously kicking the crap out of me....my son was so easy I went from 1 cm to 10 in a matter of hours....this is getting difficult and I guess my point is does any one think ill get to or pass my due date on July 19th...personally I wouldnt mind going into labor right now
ReplyDeleteI just got back from the dr. and I am 80% effaced, 3 cm- 3 1/2 cm dilated and a zero as well. How soon after this visit did you deliver? I am anxiously awaiting baby #2 and don't know if I am days away or weeks away.
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ReplyDelete@anonymous 80% effaced 3cm dilated: How long did it end up taking? I'm sure you've got a beautiful baby by now!! I believe it was about 2 weeks that I was like that but I know it changes depending upon you and the baby.
ReplyDelete@medical student: Thanks for the kind words! I'm so happy to hear that my work is helpful and enjoyable to read. Feel free to share with others in your medical community! :D
I'm 3 cm dilated 50% effaced and station 0 how long is this going to last! my contractions suck they wake me up, I don't want to go to the doctor and doctor said play with my nipples did that and the contractions get so much stronger. HELP
ReplyDeleteThanks for sharing! I am 38 weeks, 80% effaced, 1 cm dialated, and baby is stationed at 0. I am so anxious to meet my little girl! Good luck to you and your family!
ReplyDeleteIm 35 weeks and im 2cm and 50% effaced and the contractions are annoying. Im so ready to see my little prince... How many people are going Natural? I am going to try and go Natural again.. Good Luck ladies!!:)
ReplyDeleteMy daughter is 3cm and 80% effaced shes been having some contractions but not strong enough anyone know about how long it could be before she goes in active labour
ReplyDelete3Cm dilated & 90% effaced been this way since 33 weeks abd now I'm 36&5 so.....
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