What Is Fully Dilated In Pregnancy?

What does fully dilated mean

What is dilation? – Dilation is when your cervix opens (dilates) and the opening is measured in centimeters. During the first stage of labor, the cervix opens and thins out (effaces) to allow the baby to move into the birth canal. During the second stage of labor, your cervix is fully dilated, your baby is descended down the birth canal and you will be encouraged to push and deliver your baby.
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At what cm does your water break

What to Expect When Doctors Break Your Water If your water (aka “amniotic sac,” “bag of waters” or “membranes”) hasn’t when you arrive at the hospital, and you’re five or more centimeters dilated, your OB might recommend bursting the bag by hand—especially if your cervix seems to be making slow (or no) progress.

Some OBs will go ahead and break your water at 3 or 4 centimeters.) The reasoning behind this: “Artificial rupture of membranes” (popping a hole in the amniotic sac) will usually jumpstart labor by getting serious contractions underway. If labor is moving along fine, you and your doctor might decide to wait this one out—after all, contractions tend to be more painful after your water breaks.

If the OB doesn’t rupture your membranes, the sac will probably break on its own during labor, though once in a while it stays intact until baby makes an exit. (Either way is fine.) To break your water, the doctor will reach up and prod it with something that looks like a crochet hook.

1. You might feel (very little) discomfort as the device enters your vagina, but as for the actual water breaking, most women only feel a big, warm gush of liquid.
2. Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such.

You should always consult with a qualified physician or health professional about your specific circumstances. Plus, more from The Bump: save article : What to Expect When Doctors Break Your Water
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How many hours does it take to dilate to 10cm

When to contact a midwife – Contact your midwifery team if:

your contractions are regular and you’re having about 3 in every 10-minute periodyour waters breakyour contractions are very strong and you feel you need pain relief you’re worried about anything

If you go into hospital or your midwifery unit before your labour has become established, they may suggest you go home again for a while. Once labour is established, your midwife will check on you from time to time to see how you’re progressing and offer you support, including pain relief if you need it.

• You can either walk around or get into a position that feels comfortable to labour in.
• Your midwife will offer you regular vaginal examinations to see how your labour is progressing.
• If you do not want to have these, you do not have to – your midwife can discuss with you why she’s offering them.
• Your cervix needs to open about 10cm for your baby to pass through it.

This is what’s called being fully dilated. In a 1st labour, the time from the start of established labour to being fully dilated is usually 8 to 12 hours. It’s often quicker (around 5 hours), in a 2nd or 3rd pregnancy. When you reach the end of the 1st stage of labour, you may feel an urge to push.
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Can you push before fully dilated?

Supporting women’s instinctive pushing behaviour during birth Artwork by Amanda Greavette This article was published in journal in June 2015 along with ‘practice challenge’ questions for midwives (not included here). Introduction Clinical guidelines recommend that women should be guided by their own pushing urges during birth (National Institute for Health and Care Excellence (NICE) 2014).

However, directing women’s pushing behaviour has become a cultural norm within maternity care. Women are still told when to push, when not to push and how to push. In order to promote and support physiological birth we need to reconsider the assumptions underpinning this practice. In addition, we need to reflect on how this practice influences women’s experience of birth.

This article discusses supporting instinctive pushing behaviour during uncomplicated, physiological birth. The current discourse around pushing and cervical dilatation is underpinned by a mechanistic understanding of the birth process: that the cervix opens first, then the baby is pushed through the vagina.

However, this does not reflect the multidimensional and individual nature of birth physiology. Descent, rotation and cervical dilatation happen at varying rates, and are not necessarily related. The urge to push is initiated by the position of the baby’s head within the pelvis (Roberts et al 1987). Therefore, the cervix can be fully dilated without the baby descending deep enough to initiate an urge to push.

Alternatively, spontaneous pushing can begin before the cervix is fully dilated. Directing a woman to push or not to push fails to support the individual physiology of her body and birth process. In addition, it contradicts the notion that women are the experts in their own births.

Directing women to push Once full dilatation of the cervix is identified or suspected, it is common practice to direct women’s pushing behaviour in an attempt to aid descent of the baby. Pushing directions usually involve instructions to use Valsalva pushing, or a variation of this method which includes: taking a deep breath as a contraction begins; holding the breath by closing the glottis; bearing down forcefully for eight to ten seconds (into the bottom); quickly releasing the breath; taking another deep breath and repeating this sequence until the contraction has ended (Yildirim and Beji 2008).

Directed pushing was introduced in an attempt to shorten the duration of the ‘second stage of labour’ in the belief that this would improve outcomes for women and babies (Bosomworth and Bettany-Saltikov 2006). This type of pushing has been found to have a number of detrimental consequences for women including alterations to circulation (Tieks et al 1995), and increased perineal trauma and long-term effects on bladder function and pelvic floor health (Bosomworth and Bettany- Saltikov 2006; Kopas 2014).

Valsalva pushing may also reduce oxygen circulating via the placenta to the baby (Aldrich et al 1995). Current research reviews do not identify a significant impact of directed pushing on fetal wellbeing, but further research is needed (Kopas 2014; Prins et al 2011). In addition, Valsalva pushing does not reflect how women push instinctively (Kopas 2014).

Normal Vaginal Birth with Cervical Effacement and Dilatation (Dilation)

Instinctive pushing does not commence at the start of contractions, and women do not take a deep breath before pushing: women alter their pushing behaviours, and use a mixture of closed glottis and open glottis pushing. The number of pushes per contraction also varies, with women not pushing at all during some contractions.

Women also instinctively alter pushes according to their contraction pattern. For example, if contractions are infrequent women tend to use more pushes per contraction, and if contractions are frequent they push less often. This individual and instinctive pattern of pushing helps to oxygenate the baby more effectively than Valsalva pushing.

Directing women not to push Some women will instinctively push before their cervix is fully dilated. This is often treated as a complication, and a common approach is to encourage the woman to stop pushing due to fear that cervical damage will occur. However, there is no evidence to support this concern.

1. Two studies examined pushing before full dilatation and found that between 20-40 per cent of women experienced an ‘early urge to push’ (Borrelli et al 2013; Downe et al 2008).
2. Borrelli et al (2013) found that the sooner the midwife performed a vaginal examination in response to a woman’s urge to push, the more likely they were to find an undilated cervix.

They also found that ‘early pushing’ was much more common for primiparous women, and occurred in 41 per cent of women with babies in an occipito posterior position. Both studies conclude that an ‘early urge to push’ is a normal variation and is not associated with complications.

• Perhaps there is a physiological advantage for ‘early’ pushing in some circumstances? For example, additional downward pressure may assist the baby to rotate into an anterior position, or assist with cervical dilatation.
• The impact of telling a woman not to push when her body is pushing also needs to be considered.

Once the baby is applying pressure to the nerves in the pelvis that initiate pushing, the woman is unable to control the urge. Attempting not to push at this point is like trying not to blink or breathe. In addition, telling a woman not to push when her body is instinctively pushing suggests that her body is wrong, and that she needs to resist her urges.

After resisting her body’s urges, she may find it difficult to switch into trusting and following her body once given the ‘go ahead’ (Bergstrom et al 1997). Encouraging a woman not to push when she is instinctively pushing can be distressing and disempowering for her. Another situation in which women are encouraged not to push is during crowning.

The rationale is to minimise the chance of perineal trauma by slowing down the birth of the baby’s head. A slow birth of the head reduces the chance of tearing as it allows the perineal tissues to gently stretch over time (Aasheim et al 2012). A number of techniques have emerged aimed at slowing down the birth of the baby’s head, including instructions and hands-on approaches.

1. However, these approaches fail to acknowledge instinctive birthing behaviour.
2. There is one study examining what women do during birth when following their instincts (Aderhold and Roberts 1991).
3. This very small study of four women birthing without instructions found that they altered their own breathing and stopped pushing as the baby’s head crowned.

This is consistent with my own observations of undisturbed birth. The intense sensations experienced during crowning usually result in the woman ‘holding back’ while the uterus continues to push the baby out slowly and gently. In addition, women will often hold their baby’s head and/or their vulva during crowning.

1. Some women will bring their legs closer together, not only slowing the birth but also providing more ‘give’ in the perineal tissues.
2. Telling a woman to ‘stop pushing’, to ‘pant’ or to ‘give little pushes’ distracts her at a crucial moment and suggests that you are the expert in her birth.
3. Instructing her to open her legs to ‘give the baby room’ contradicts her instinct to protect her own perineum by closing them.

Conclusion and suggestions for practice Evidence supports the notion that women instinctively push in the most effective and safe way for themselves and their babies during birth. A birthing woman is the expert regarding when and how she pushes. Providing directions implies she needs our guidance and that we are the experts.

Include information about the physiology of birth in antenatal education/preparation. Reinforce the message that women have an innate ability to birth without direction. Provide an environment that facilitates physiological birth and instinctive behaviour – low lighting, minimal disturbance, comfortable furniture that supports mobility and movement (floor mats, beanbags, birth pool, shower). Avoid asking the woman if she needs to push, or feels ‘pushy’ as this may suggest that she should and could interfere with her inward focus and instinctive behaviour. If the woman tells you she feels the urge to push, reassure her that this is good, but don’t encourage her to push. There will come a point when she is spontaneously pushing rather than feeling an urge to. Avoid vaginal examinations to ‘diagnose’ full dilatation. If you are not going to provide instructions about pushing based on cervical dilatation, there is no benefit in knowing this information. Do not disturb the woman’s instinctive pattern of pushing and breathing. Avoid directions and, if you must speak, gently reinforce her ability to birth. Avoid directions or distractions as the baby’s head is emerging to facilitate the woman’s instinctive perineal protecting behaviours (such as gasping, screaming, closing her legs, holding her baby and perineum).

Related posts: ; ;, References Aasheim V, Nilsen ABV, Lukasse M et al (2011). ‘Perineal techniques during the second stage of labour for reducing perineal trauma’. Coch Data Sys Rev, 12: CD006672. DOI: 10.1002/14651858.CD006672.pub2. Aderhold K and Roberts JE (1991).

‘Phases of second stage labor: four descriptive case studies’. Jour Nurse- Midwif, 36(5): 267-275. Aldrich C, D’Antona D, Spencer JAD et al (1995). ‘The effect of maternal pushing on fetal cerebral oxygenation and blood volume during the second stage of labour’. Brit Jour Obs Gyn, 102(6): 448-458. Bergström L (1997).

‘”I gotta push. Please let me push”: social interactions during the change from the first to second stage of labour’. Birth, 24(3): 173-180. Borrelli SE, Locatelli A and Nespoli A (2013). ‘Early pushing urge in labour and midwifery practice: a prospective observational study at an Italian maternity hospital’.

1. Midwif, 29(8): 871-875.
2. Bosomworth A and Bettany-Saltikov J (2006).
3. Just take a deep breath: a review to compare the effects of spontaneous versus directed Valsalva pushing in the second stage of labour on maternal and fetal well- being’.
4. MIDIRS Midwif Dig, 16(2): 157-165.
5. Downe S, Trent Midwives Research Group, Young C et al (2008).

‘The early pushing urge: practice and discourse’. In: Downe S (ed.). Normal childbirth: evidence and debate, 2nd edition. London: Churchill Livingstone: Elsevier. Kopas LM (2014). ‘A review of evidence-based practices for management of the second stage of labour’.

1. Jour Midwif Wom Health, 59(3): 264-276.
2. NICE (2014).
3. Intrapartum care: care of healthy women and their babies during childbirth.
4. NICE clinical guideline 190, London: NICE.
5. Prins M, Boxem J, Lucas C et al (2011).
6. Effect of spontaneous pushing versus Valsalva pushing in the second stage of labour on mother and fetus: a systematic review of randomised trails’.

BJOG, 118(6): 662-670. Roberts J, Goldstein S, Gruener JS et al (1987). ‘A descriptive analysis of involuntary bearing-down efforts during the expulsive phase of labor’. Jour Obs, Gyn Neon Nursing, 16(1): 48-55. Tieks FP, Lam AM, Matta BF et al (1995). ‘Effects of valsalva maneuver on cerebral circultation in healthy adults: a transcranial doppler study’.
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What stage of labor does water break

What will happen when your water breaks? – During pregnancy, your baby is surrounded and cushioned by a fluid-filled membranous sac called the amniotic sac. Typically, at the beginning of or during labor your membranes will rupture — also known as your water breaking.
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What does it feel like to be fully dilated?

Stage two: full dilation and pushing – Once the cervix has reached 10 cm, it is time to push the baby out. Contractions continue but also produce a strong urge to push. This urge might feel like an intense need to have a bowel movement. This stage can last anywhere from a few minutes to a few hours.

It is often longer for those giving birth for the first time. Historically, doctors told women to push according to a schedule, to count to 10, and to remain on their backs. Today, the advice is very different, and research says it is safe for women to push according to their body’s cues and for as long as feels comfortable.

Pushing from a standing or squatting position may also help speed things along. Allowing people to push from a range of positions gives the medical staff better access to the woman and baby should they need to assist with the delivery for any reason. As a woman delivers the baby, she may feel an intense burning and stretching as her vagina and perineum stretch to accommodate the baby.
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Does it hurt when you are dilated

As cervical dilation increased, there were significant increases in self-reported pain and observed pain on all the cited measures. Pain was characterized as ‘discomforting’ during early dilation and as ‘distressing, horrible, excruciating’ as dilation progressed.
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Can checking for dilation cause labor

Can checking for dilation cause labor? – A cervical exam performed by your practitioner or a self-exam to check for dilation can help you determine how dilated you are and (sometimes) the position of your baby. But can checking for dilation cause labor? Checking for dilation does not induce labor unless the exam is used in conjunction with one or more common labor induction methods,

• A common intervention that may be offered during a cervical exam is called a “membrane sweep,” which is a procedure that can be performed if you are at least one centimeter dilated.
• In this procedure, the care provider will “sweep” their finger around the diameter of the inside of the cervix, in attempt to separate the amniotic sac from the inside of the cervix.

This can cause a rush of the prostaglandin hormone, which can kick-start labor if your body is otherwise ready. Be sure to ask your care provider if they recommend this procedure, and what the benefits and risks are. Also know that if it is offered, you can decline if you do not find that the benefits outweigh the risks.

• Although checking for dilation can give you helpful information and a sense of your body’s progress, dilation doesn’t necessarily mean you’re about to give birth.
• You could be three centimeters dilated and not give birth for several more weeks, or your cervix could be completely closed but you could be in active labor in just a few hours.

It is common to experience a small amount of bleeding in the hours or day after a cervical exam, as the cervix is made of sensitive tissues that contain many capillaries and some may break during an exam. Measuring purple line dilation is another good way to estimate cervix dilation that often correlates with the stages of labor.
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How dilated should I be at 38 weeks?

Stage 1: Early Labor, Active Labor and Transition – Labor is divided into three stages. The first stage is the longest and consists of contractions, contractions andyep, more contractions! Your uterus is a muscular sack. During labor, it alternates between tensing up (contracting) and relaxing.

When it squeezes, the muscle pushes your baby downwardspressing their head against your cervix. That thins the cervix (effacement) and starts to push the cervix open (dilatation). ( Learn more about dilation and effacement !) Stage 1 usually gets off to a slow, creeping start. (The breaking of the bag of waters may be dramatic, but even that is usually more of a dribble than a flood.) Some pregnant folks describe the start of stage 1 as period-like pain or a lower-back ache, but soon, the contractions strengthen, lengthen, and become more frequent.

If you’re a first-time mom, this stage will likely last six to 12 hours, but might drag on for a day or longer. (For second-time moms, things can go a whole lot faster!) If it’s your first pregnancy—and you are low-risk—your care providers may have you stay home during most of this stage.

Try to relax, stay hydrated and eat light, carb-rich meals to keep your energy up. If you can sleep, catch some ZZZs (here are some tips on sleeping better during pregnancy )! Giving birth is a marathon, not a sprint, and you don’t want to tire yourself out early on. Your doctor/midwife will have told you to time your contractions (from the beginning of one to the beginning of the next—not to the end) and advised when to call/head to the hospital.

When you arrive, your cervix will be checked to see how far you’ve dilated. It’s possible you’ll be sent home or told to go out for a walk or a meal, if you need to dilate more. Once you begin active labor, you’ll have strong contractions around a minute long and 3 to 5 minutes apart.

1. It may be hard to talk or move easily.
2. At this point, your cervix will be dilated 3 to 10 centimeters.
3. Dilating one centimeter an hour is textbook, but like in early labor, it’s different for everyone.) If you’re opting for an epidural, the time isnow! Epidurals can erase the pain of contractions.
4. However, keep in mind that they may also weaken your contractions and prolong labor 40 to 90 minutes (it’s possible this could lead to more drugs—like Pitocin, which is given to amp up contractions).

Transition is the most intense stage. Luckily, it’s also the shortest! You’ll be dilating those last few centimeters and your contractions will be coming quicker. Stage 1 ends when your cervix has stretched to 10 centimeters (fully dilated).
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How much should your cervix be dilated at 39 weeks?

In preparation for the birth of your baby, your cervix effaces (thins and stretches) and dilates (opens) so your baby can fit through the birth canal. This cervical ripening can begin days or even weeks before delivery. You might notice this process beginning with an increase in vaginal discharge or even losing your mucus plug.

1. If you’re delivering vaginally, once your cervix opens to the magic number—10 centimeters—you’re ready to push and deliver.
2. Nowing what to expect can be a comfort when you’re preparing to give birth.
3. Being able to visualize what’s happening in your cervix, especially if it’s your first time, can help you feel more in control of the process—and even lessen your pain.

Keep reading to learn more about how cervical dilation progresses throughout the stages of labor, and check out our handy chart that helps you visualize the size of the dilation with familiar foods.
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How can I speed up dilation?

Move around – Getting up and moving around may help speed dilation by increasing blood flow. Walking around the room, doing simple movements in bed or chair, or even changing positions may encourage dilation. This is because the weight of the baby applies pressure to the cervix. People may also find swaying or dancing to calming music effective.
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Can I dilate without contractions?

Dilation and labor – You may have no signs or symptoms that your cervix has started to dilate or efface. Sometimes, the only way you’ll know is if your doctor examines your cervix at a routine appointment late in your pregnancy, or if you have an ultrasound.
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How can I break my water naturally?

– Share on Pinterest It can be dangerous for a woman to try and break her water at home before natural labor begins. There are no proven safe ways for a woman to break her water at home. It can be dangerous if the water breaks before natural labor begins or before the baby is fully developed.

• During the natural process of labor, the water breaks when the baby’s head puts pressure on the amniotic sac, causing it to rupture.
• Women will notice either a gush or a trickle of water coming out of the vagina.
• Many doctors say that women must give birth within 12–24 hours of the water breaking.
• After this time, a doctor may recommend a cesarean delivery to ensure the safety of the woman and the baby.

This is because it is easier for bacteria to get into the uterus after the water breaks. This increases the risk of infection, which is a major complication that puts both the woman and the baby at risk. It may also make the birth more difficult. It is particularly dangerous to use artificial instruments to rupture the amniotic sac, as this can introduce bacteria into the uterus and cause infections.
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Does sitting on the toilet help you dilate?

You can make progress with minimal energy. – Laboring on the toilet allows you to be in a supported squat. When we squat, our pelvis opens up by 30 percent, which gives our baby extra space to engage with our cervix and keeps our labor progressing smoothly.

1. When we sit on the toilet, we naturally let our pelvic floor relax.
2. When we allow these muscles to soften, all of the hard work our uterus is doing pays off by allowing our cervix to thin, dilate, and get us closer to meeting our baby.
3. When I believe someone still has progress to be made during labor, but they need time to rest, I put them in this fantastic active rest position.

Which brings me to my next point There’s nothing like confining ourselves to the bathroom to let people know we need space. The darkness, closed door, and removal from the main birthing space allow you to find your labor zone and maybe even catch some zzz’s. Find a loved one and lean forward onto their chest, really sinking into the rest in between contractions and getting an extra hit of oxytocin. As previously mentioned, being on the toilet places our body into a supported squat, which is an excellent position to be if our baby isn’t in the best position for them to make progress. While some babies just want to be born facing the ceiling, many babies can benefit from rotating toward your back. While using the toilet during labor can be a sure-fire way to get a little privacy, it is also an excellent place to receive support when it feels needed. While sitting on a toilet, your support team can use numerous comfort measures to help you relax even more between contractions and guide you through each wave.

1. Birth team members can apply pressure to your lower back to help with increasing force as your baby descends.
2. Need even more lower back support? Add a heating pad into the mix.
3. Resting forward allows for cool washcloths on your neck, helping with hot flashes and nausea.
4. Your team can massage your legs and shoulders to help you relax other body parts that need to be passive.

The support you can receive while sitting on the toilet is endless. As you can see, I’m a huge fan of the toilet. I truly believe it is an irreplaceable tool during labor. You can ask any family I’ve worked with and they will tell you, they were on the toilet at least once during their time with me. Knowing what hidden comfort tools, like the toilet, can be used during labor can be challenging.
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Does sitting help dilate

3. Sit on a birthing ball – According to Brichter, sitting on an exercise or birthing ball in neutral wide-legged positions prepares the body for labor by increasing blood flow, opening the pelvis, and encouraging cervical dilation, You can also try birth ball exercises such as circular hip rotations, rocking, and gentle bouncing.
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How long does it take from 1cm to 10cm in labour?

When to contact a midwife – Contact your midwifery team if:

your contractions are regular and you’re having about 3 in every 10-minute periodyour waters breakyour contractions are very strong and you feel you need pain relief you’re worried about anything

If you go into hospital or your midwifery unit before your labour has become established, they may suggest you go home again for a while. Once labour is established, your midwife will check on you from time to time to see how you’re progressing and offer you support, including pain relief if you need it.

1. You can either walk around or get into a position that feels comfortable to labour in.
2. Your midwife will offer you regular vaginal examinations to see how your labour is progressing.
3. If you do not want to have these, you do not have to – your midwife can discuss with you why she’s offering them.
4. Your cervix needs to open about 10cm for your baby to pass through it.

This is what’s called being fully dilated. In a 1st labour, the time from the start of established labour to being fully dilated is usually 8 to 12 hours. It’s often quicker (around 5 hours), in a 2nd or 3rd pregnancy. When you reach the end of the 1st stage of labour, you may feel an urge to push.
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How long does it take for the cervix to dilate from 1cm to 10cm?

Stage one – This stage has three phases. In the first phase, the cervix dilates to 3 cm, The baby drops lower into the pelvis, and this increases the levels of prostaglandin in the body, which stimulates dilation. The mucus plug that has sealed the opening of the uterus during pregnancy will fall away.

1. Capillaries in the cervix can rupture during this stage and cause bloody discharge known as the bloody show.
2. This is normal.
3. The next phase is active labor, when the cervix will dilate further.
4. Some doctors mark the end of this phase when the width of the cervix reaches 7 cm,
5. Others use contractions as a guideline.

The final step in this stage, called the transition phase, lasts until the cervix dilates to 10 cm,
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How long can you stay at 1cm dilated?

Dilating to 1 centimeter does not necessarily mean that labor is only hours or days away. The cervix can be dilated to 1 centimeter for weeks before the beginning of labor. This extent of dilation only signals that the cervix is starting to prepare for labor.

1. Most pregnant women spend some time wondering when they will go into labor, especially as the due date draws near.
2. When the opening of the cervix starts to widen, this is called dilation, and it is one sign that labor is approaching.
3. Dilation is typically measured in centimeters (cm).
4. During active labor, the cervix fully dilates to 10 cm.

In this article, we look at what dilation is and what dilating to 1 cm signals. We also describe other signs that labor may start soon.
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How long does it take to go from 4cm to 10cm?

How many centimetres do you dilate an hour? – Until relatively recently, the definition of the length of ‘normal labour’ was based on a study published in the 1950s by physician Dr Emanuel Friedman. Friedman’s study was based on his observations of 500 first-time mums and described the average amount of time it took them to dilate per centimetre in labour.

He plotted his results on a graph which then became known as ‘Friedman’s Curve’. Until the early 2010s, Friedman’s Curve was still used traditionally by doctors and midwives to define a ‘normal’ length of labour. However, more recent research indicates the findings of Friedman’s study are no longer relevant in modern maternity care.

Many labour practices have changed since then and therefore it should no longer be used. Researchers found, on average, cervical dilation was not rapid from 3cm, as Friedman’s Curve once suggested. For all women (first-time mothers and those who had given birth before), progression was only rapid after reaching 6cm.

The average time it took to dilate one centimetre in active labour (from 6cm) was half an hour (faster for experienced mothers).95% of women took less than 2 hours to dilate one centimetre during active labour. Most hospitals and health care providers have now updated guidelines to acknowledge these new findings.

Most, h owever, have not changed their definition of active labour as beginning at 6cm, and so it still stands at the traditional 4cm.
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