Pregnancy: Cervical Ripening

I am 31 weeks pregnant. As birth nears, shouldn't the cervix shorten and be hard to find? When I had an ultrasound at 14 weeks, my cervix was very long (you didn't have to reach in far to find it). Now it is very short. My doctor said that was good at my appointment three weeks ago, but the nurse at the hospital said she was concerned because my cervix was starting to efface. What are they talking about and should I be concerned?

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

I can really understand your confusion. Yes, as delivery nears, the cervix becomes shorter (but not necessarily harder to find) and it gets very soft.

The non-pregnant or newly pregnant cervix is about four to six centimeters long and it can actually be measured with transvaginal ultrasound. Only about two-thirds of it can be felt with a vaginal exam.

Usually after many years of experience, a provider can tell the difference between a cervix that is "ripe" (thin, soft, anterior and maybe dilated a bit) and one that is unripe (thick, firm, posterior and closed).

At 31 weeks, this is too early for your cervix to be ripening substantially. It should be soft, but still thick, posterior and closed. On pelvic exam, we are making only a subjective assessment of cervical length and condition. But if your provider commented that the cervical condition was "good," I'm sure he meant it was not thin or shorter than it should be. If it was thin, short and "ripe," he would have been concerned as this is evidence of a risk for preterm labor.

You might ask him to give you a better idea of the length in centimeters. If it is three centimeters or greater, this is not appreciably "short" for your gestational age. But again, most of this depends on change and not upon a one-time reading.

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