All About Cervical Checks During Pregnancy and Labor
What They Are and Why It’s Okay to Say No
When it comes to navigating pregnancy and labor, one of the most commonly misunderstood practices is the cervical check. Many people are surprised to learn that these exams are completely optional, even though they’re often offered as part of “routine” care.
So let’s talk about it.
What exactly is a cervical check?
Why are they done?
And why might someone choose to decline them?
This post will walk you through what to expect, how they’re used (and sometimes misused), and how to make an informed choice that feels right for you.
What Is a Cervical Check?
A cervical check, or cervical exam, is a manual procedure where a provider inserts gloved fingers into the vagina to assess several things about your cervix and baby’s position. These checks can be done in late pregnancy or during labor.
During a cervical check, your provider is looking for:
Dilation — how open the cervix is (measured in centimeters)
Effacement — how soft and thinned out the cervix has become (measured in percentages where 0% is fully thick and closed and 100% is thin and ready for labor)
Station — how low the baby’s head is in the pelvis (measured in centimeters above or below the ischial spines, with -5 being high in the pelvis and +5 being crowning)
Position and consistency — whether the cervix is facing forward or backward, and how firm or soft it feels
While this information can be helpful in certain contexts, it’s not always necessary, and it doesn’t always mean what we think it means.
Cervical Checks in Late Pregnancy
Cervical checks often begin around 36–38 weeks of pregnancy. Some providers offer them weekly at prenatal visits, and they’re often framed as part of the "check-in" to see how close labor might be.
But here’s what’s important to know:
A cervical check does not predict when labor will start.
You might be:
3 cm dilated and not go into labor for weeks
Completely closed and go into labor the next day
Walking around 80% effaced and not feel a single contraction
Cervical changes can happen slowly over time or all at once. They’re one piece of a much bigger picture.
Reasons Some People Choose to Decline Cervical Checks in Late Pregnancy:
You don’t want to feel discouraged by numbers that don’t actually mean much
The exam feels physically uncomfortable or emotionally triggering
There is no medical reason to check
Desire to avoid unnecessary vaginal exams, especially if your water has broken
They're practicing bodily autonomy and feel better waiting until there's a clear benefit
Cervical Checks During Labor
Once labor begins—especially if you're in a hospital setting—cervical checks may be performed at admission, periodically throughout labor, and before pushing. While it’s common, you still have the right to say no or ask for alternative approaches.
Labor isn’t linear. Some people dilate slowly for hours and then progress rapidly. Others may stay at 6 cm for a while before moving quickly to 10.
Reasons to Decline or Delay Cervical Checks During Labor:
You're trying to stay in a rhythm or a focused mindset
You find the exam painful or disruptive
You’re coping well and don’t want to fixate on numbers
You’ve experienced past trauma and need to protect your space
You’d rather use other signs of progress (like vocal tone, body movements, emotional shifts)
Cervical checks can be helpful when:
You’re requesting medication or an epidural
There’s a concern about labor not progressing
You feel the urge to push and want to confirm dilation
Even in these situations, you can ask questions and make an informed decision.
Questions You Can Ask Before a Cervical Check
Advocating for yourself doesn’t mean saying “no” to everything; it means asking questions and making the best choice for you in the moment.
Here are a few ways to start the conversation:
“Can you tell me why this check is being offered?”
“Will the results change how we manage care today?”
“Are there any risks to checking now?”
“What are my other options?”
“Can we wait and reassess later?”
These questions open the door to collaborative care where you feel respected, informed, and heard.
Are There Alternatives to Cervical Checks?
Yes! Experienced birth workers and providers can often gather information about how labor is progressing without a vaginal exam.
Non-invasive signs of progress might include:
Change in the tone of your voice during contractions
Behavioral shifts (becoming more focused, vocal, or inward)
Stronger, closer-together contractions
The presence of the “labor cocktail” (nausea, shaking, sweating, or the need to poop)
The urge to bear down or push
These signs can often be more accurate than a number on a chart, and they reflect the real, lived experience of labor.
Your Birth, Your Choice
It’s easy to forget that every part of your care is your decision, especially when providers are moving quickly or following a routine. But your voice matters. You can say yes, you can say no, and you can ask for time to think about it.
If you want support navigating these conversations, understanding your options, or making a birth plan that reflects your values and preferences, I’d love to help!
✨ I offer personalized Birth Planning Sessions where we go over all of this and more, so you can walk into birth feeling informed, confident, and supported.
Ready to talk through your birth plan? Contact me!
