Because they’re clever…

It’s pretty well known by now that eating dates prenatally can help with preparing your cervix, if you’re interested in that kind of thing. There have been studies that show that those who consume 4-6 Deglet Noor dates per day in the last 4 weeks of pregnancy will have a more “favorable” cervix by the time your birthing begins. I know what you’re thinking – that’s a lot of dates. Maybe. But they can be thrown in somewhere… and it’s worth it for all of the sited benefits.

Studies have shown that those who consumed Deglet Noor dates (60-80 grams daily) were more likely to have spontaneous onset of birthing waves, have intact membranes (their water did not break) upon admission to the hospital or active birthing time, and have less postpartum bleeding! Wow! I wasn’t so sure I believed the hype. That is, until I started seeing it with my own eyes.

Dates also have many health benefits. Thanks to Baby Chick for this thoughtful breakdown.

• Fiber – we all know that fiber helps relieve constipation, helps you stay full, but did you know that it also helps lower your risk for gestational diabetes and preeclampsia? Dates contain a combination of soluble and insoluble fiber and thus are helpful in maintaining your digestive system.

• Magnesium – this supports your muscular health and helps to alleviate muscle spasms and cramps during pregnancy.

• Potassium – this is one of the best electrolytes and it helps you maintain water/salt balance which also helps regulate blood pressure and regulate your nervous system.

• Natural sugars (fructose) — it offers high energy, but thankfully has a low glycemic index, easily breaks down in the body and does not usually spike blood sugar levels. This is why eating dates during your pregnancy and/or your labor is an excellent choice. (If you have GDM, please consult your provider and check your BGL to ensure that dates are not giving you a spike.)

• Vitamin K – helps maintain proper blood clotting and keeps your bones healthy.

You can look up many different ways to get your dates in, like smoothies, stuffing them with almond/peanut butter, chopping up and throwing on a salad, in savory dishes, granola ect... You don’t have to eat them all at once, so spread them out throughout the day and get them in however you can. Tip: Lara Bars are made with dates!

Dates are one of my top recommendations for physical prep. Read more about that HERE.

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Photo by Thandy Yung on Unsplash

Let’s talk about cervical exams. To have… or not to have, prenatally?

Well, besides the fact that a cervical exam doesn’t tell us much of anything at all before birthing time actually begins, there are also risks involved.

What are the risks?

• They can be extremely uncomfortable, especially in the weeks leading up to your birthing time when the cervix is supposed to be high, firm, closed, and posterior.

• They can give us an unnecessary, false sense of hope or discouragement.

• An increased risk of infection.

• Bleeding and cramping.

• A signal to your body that there is a threat.

• A chance for premature rupture of membranes, especially if there is a “stretch and sweep”, or stripping of membranes performed. (Sometimes additional consent for a sweep isn’t always obtained first, and is thought of by some providers as “part of the exam” which is unacceptable.)

It’s not uncommon for providers to begin wanting to check the cervix in the last few weeks of pregnancy. Sometimes as early as the 36th week of pregnancy. Usually well-meaning providers are looking for information to share with you as you approach the home stretch. Sometime they are requested because people falsely believe the information is important. Most times this is done out of tradition and routine.

What exactly are we hoping to accomplish by assessing the cervix prenatally?

Let’s ask ourselves a few questions.

• What is the purpose of the exam?

• What is it that we are looking for?

• What are we going to do with this information?

• Does the information we gather change the intended course of action?

• If not, then why are we doing it?

Photo by Jon Tyson on Unsplash

If we know that cervical dilation is only a very small part of the equation, what are we expecting to gain by learning of the cervix’s current status — and what the cervix is doing before birthing time even begins?

If we know that the cervix can change very quickly, or stay unchanged for an extended period of time... even during birthing time, what exactly are we able to do with the information before birthing time even begins? There are many other important, and often unmeasurable things at play.

In my experience, a cervix can go from completely closed to 10cm in four hours. In contrast, a cervix has the ability to remain at 3/4cm for a few weeks before birthing time even begins. Both are normal scenarios.

The #1 reason for prenatal cervical checks is pure curiosity, and tradition.

If you would like to know your cervical status in the weeks leading up to your guess date, and before birthing time begins, that’s your choice. Just keep in mind that it doesn’t mean much before labor begins. It ONLY tells you what your cervix is doing at that exact point in time and that’s about it. As long as you are aware that your cervix is not a crystal ball, and will not indicate when your birthing time will begin or how your birth will go in terms of length or difficulty. The cervix has a mind of its own and can be very unpredictable before and even during the early and active phases of the birth process.

Besides, who wants to hear their provider say, “You’re only 1cm dilated.”

ONLY???

The word “only” has a negative connotation when speaking in terms of progress, which is what most people are hoping is going on. It can be very discouraging and counterproductive.

Photo by Nathan Dumlao on Unsplash

Your cervix has a job. That job is to do nothing until it’s time to do something!

But it’s not exactly doing nothing. It has a few main functions in relation to pregnancy and birthing. One main function is to keep your baby protected and safe until it’s time to be born. I’d say a cervix that was “only” 1cm dilated before the baby was ready to be born is doing a great job at performing one of its main functions. When the baby and the body are ready, the cervix will assume its other very important function which is to soften and dilate - usually in conjunction with (and not before) a continuous pattern of uterine surges.

For the data driven, here are a few quotes about the underlying mechanisms and functions of the cervix.

“During pregnancy, the primary biomechanical function of the cervix is to maintain the fetus within the uterus. This requires withstanding multiple forces from the uterus, including the weight of the growing fetus and amniotic sac, as well as passive pressure from the uterine wall.”

“The structure of the cervix is integral to the maintenance of pregnancy, keeping the developing baby in utero and forming a barrier to the ascent of microorganisms from the vagina.”

“The function of the cervix from this moment is to retain and protect the growing conceptus. An effective barrier is primarily accomplished through retaining a sufficient length of closed cervix within which the mucus plug can deter ascent of microbes from the lower genital tract. This is aided by maintaining sufficient strength at the level of the internal os to discourage descent of the fetal membranes and conceptus down the cervical canal, which may shorten this barrier and/or dislodge the mucus plug.”

“Throughout the latter stages of pregnancy, the cervix undergoes this process as a result of increased collagenase activity. Labour onset at term is governed by fetal and placental endocrine signalling, which triggers an inflammatory cascade of cytokines, prostaglandins, and oxytocin release. In response to uterine contractions, the already softened cervix begins to efface and dilate as a result of the pressure being exerted either by the fetal membranes and/or the presenting part.”

Your cervix is performing its job - Isn’t that great news?!

Remember…

• It is your right to refuse cervical exams if you are not comfortable or don’t see a point with having them.

• You can simply say, “No thank you, I will not be having a cervical exam today.”

• And if you’re a go-with-the-flow kind of patient, and it makes it easier, you can just keep your pants on if the only reason for undressing during your appointment is to receive a “routine cervical exam.”

Your body, your choice.

ALWAYS.

Have you had cervical exams during pregnancy? Why or why not?

References:

https://www.sciencedirect.com/science/article/pii/S2214854X1530008X

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4459908/

https://evidencebasedbirth.com/evidence-prenatal-checks/

https://www.ncbi.nlm.nih.gov/pubmed/?term=lenihan+antepartum+pelvic

https://www.ncbi.nlm.nih.gov/pubmed/?term=mcduffie+weekly+cervical+examinations

Disclaimer: The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only. Northern Star Doula makes no representation and assumes no responsibility for the accuracy of information contained on or available through this web site, and such information is subject to change without notice. You are encouraged to confirm any information obtained from or through this web site with other sources, and review all information regarding any medical condition or treatment with your physician.

NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE OR DELAY SEEKING MEDICAL TREATMENT BECAUSE OF SOMETHING YOU HAVE READ ON OR ACCESSED THROUGH THIS WEB SITE. NORTHERN STAR DOULA IS NOT RESPONSIBLE NOR LIABLE FOR ANY ADVICE, COURSE OF TREATMENT, DIAGNOSIS OR ANY OTHER INFORMATION THAT YOU OBTAIN THROUGH THIS WEB SITE.