Common Reasons Why Your Cervix Is Not Dilating
Cervix dilation is one of the earliest signs that the birth of your baby is imminent. As you approach your due date, your doctor will check your weekly visits to see if you are dilated.
Dilation begins once you have lost your mucus plug and cervical effacement has occurred. You may also experience a bloody show, a mix of blood and mucus when you lose your mucus plug.
The first stage of labor could take several weeks, and you may stay dilated at only 1 or 2 centimeters for several OB-GYN visits in a row! When dilation fails to progress, women often wonder why is my cervix not dilating?
There are many reasons why it may seem there is a failure to progress in labor. We will break down the various reasons for the cervix not dilating and what to expect during the different stages of labor.
Dilation During The 3 Stages of Labor:
There are three stages of labor: latent labor, active labor, and the delivery of the placenta, which is often glossed over when discussing labor.
As labor progresses, so will cervical dilation, from 1 cm, roughly the size of a blueberry, to 10 cm, the size of a bagel.
- Latent Labor (The first stage of labor is 1- 9 cm dilated)
- Active Labor (The second stage of labor is 10 cm dilated)
- Placenta Delivery (The third and final stage of labor)
Failure to Progress in Labor
When labor fails to progress, it means your cervix is not dilating, and your baby is not descending. When this happens, your healthcare provider will likely assess what are known as the Three Ps.
- The Passenger (The size of the baby and his position in the uterus)
- The Powers (The efficiency of your contractions)
- The Passage (The size and shape of your pelvis)
In early labor, these three elements work together to progress toward the active phase of labor.
If one of these elements is not aligned, the latent phase of labor may not progress as quickly or smoothly as mom or the doctor would like.
Common Reasons Why Your Cervix Is Not Dilating
Cephalopelvic Disproportion (The Passenger)
Cephalopelvic Disproportion (CPD) occurs when the baby’s head is too large to fit through the woman’s pelvis. The condition is considered rare and can only be fully diagnosed during labor, and 70% of pregnant women are able to deliver vaginally and without major complications.
Sometimes Cephalopelvic Disproportion may be suspected before labor in late pregnancy if your doctor’s measurements indicate the baby will be large.
If CPD is suspected, but the baby's head has engaged, you can still attempt a vaginal birth. Your doctor and nurses will monitor the labor with a labor graph, and if there are signs that the baby is in distress, an emergency cesarean may be performed.
Likewise, a planned cesarean may be offered if the head hasn't engaged toward the end of labor or your doctor suspects CPD may be a concern before labor.
Inefficient Contractions (The Power)
Another reason your labor may not be progressing could be because your cervix is dilating slowly or has stopped dilating. Once labor begins, regular contractions will occur every 2 to 3 minutes.
Your doctor will also assess how strong the labor contractions are by palpating your abdomen: the firmer it feels during contractions, the more likely they are to be effective.
If your contractions become too intense, you can request an epidural to help with the pain. Keep in mind; however, it could be an hour or more after you request it before you are able to receive pain relief.
Additionally, not all women and pregnancies can receive an epidural, so be sure to discuss the specifics with your doctor long before labor starts.
If you have begun having contractions but they are widely spaced, and their strength indicates they're unlikely to be effective, your doctor may use one or two techniques to speed up labor, known as augmenting labor.
First, they may artificially rupture the membranes if it hasn’t happened naturally. The rupturing of the membranes is also known as when your water breaks.
If this procedure fails to further dilation and the cervix opens only minimally. In that case, you may be given the drug oxytocin to increase the strength and frequency of contractions, also known as labor induction.
It is more common for first-time moms to need an induction to produce uterine contractions than those who have experienced labor before.
Initially, a small dose is given and then increased over time until you're having three or four moderately strong contractions every 10 minutes. You’ll have continuous electronic fetal monitoring to ensure that the baby is not distressed by the sudden onset of stronger contractions if this is done.
If your labor is still not progressing several hours after the drugs have been started, then a cesarean may be recommended.
Posterior Presentation (The Passage)
The best position for your baby in labor is an occiput-anterior position with the back of the head (occiput) facing your front. If the back of the head faces your back (occipito-posterior), this can make it hard for the baby to turn and move down the birth canal and can prolong labor.
The doctor may suggest that you change positions to encourage the baby to turn. If the baby fails to rotate, forceps or a vacuum may be needed to aid the delivery.
- A gynaecoid pelvis is a name given to a pelvis that has a circular shape. The generous proportions of this more typical "female-shaped" pelvis provide room for the head to pass through during birth.
- An android pelvis is a term used to describe a pelvis with a more triangular shape. This reduces the room available for the baby's head to pass through and is more likely to cause problems during vaginal delivery.
The good news is that the obstetrics community states that the shape and size of your pelvis have no bearing on fertility or your ability to become pregnant.
Cephalopelvic Disproportion: Signs, Causes, and Potential Risks. (2019, October 3). Flo.health - #1 Mobile Product For Women’s Health. https://flo.health/pregnancy/pregnancy-health/complications/cephalopelvic-disproportion
Fray, K. (2018, January 12). The 5 P’s of Normal Labour and Birth - Kiwi Families. Kiwi Families. https://www.kiwifamilies.co.nz/five-ps-normal-labour-birth/
Premature rupture of membranes: MedlinePlus Medical Encyclopedia. (n.d.). Premature Rupture of Membranes: MedlinePlus Medical Encyclopedia. https://medlineplus.gov/ency/patientinstructions/000512.htm
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