When it comes to childbirth, there's a widespread misconception that labour progress hinges on a single number: dilation. It's easy to understand why so many women, partners, midwives, and doctors fixate on this aspect, but the truth is, assessing labor involves so much more than just watching the centimeters slowly tick away.

Let's dive into the remarkable intricacies of labor progress, the pitfalls of putting too much emphasis on dilation, and how to have meaningful conversations with your care providers.

The Dilation Dilemma

The fixation on dilation stems from a misunderstanding that childbirth follows a linear, predictable path. We often hear stories of women laboring for hours and progressing merely one or two centimeters, only to suddenly leap from six to ten centimeters in the blink of an eye.

This may seem bewildering, but it underscores a crucial truth: our bodies aren't machines operating on a rigid schedule.

Vaginal exams, the primary method used to measure dilation, are far from objective. There's no one-size-fits-all approach to this. Every care provider brings their unique perspective, influenced by their experience and their fingers to be frank. There is no magic, retractable tape measure attached to a Midwife or OB's fingers.  

The Bigger Picture

To truly assess labor progress, one must consider a holistic view. Dilation is just one piece of the puzzle. There are several other essential factors to take into account:

Behaviour

How is the labouring woman behaving? Is she comfortable, focused, or showing transitional behaviour?

Membrane Rupture

(aka waters breaking)

Have her waters broken? If so, what's the colour and odour of the amniotic fluid?

Bloody Show

Is there any sign of the body and cervix changing? Like a bloody show or loss.

Baby's Well-Being

How is the baby responding? What is their position, and what's their heart rate?

Contractions

What are the contractions doing? Are they regular, intense, duration and frequency?

Other signs of progress/transition

Is the rhombus of Michaelis visible, or can you see the elongated purple line? These are some physical changes that happen when baby moves through the pelvis and the cervix dilates!

Even a vaginal exam = more than dilation

Even if a vaginal examination is deemed necessary and you consent to it, it's still about more than just dilation. It's a whole picture which needs to come together and includes the thickness of the cervix, its softness, how low the baby's head is, and what position both the cervix and the baby are in.

If there is one thing I want every reader to take away from reading this it's right here:

Don't let that one number (dilation) dictate your capability or your understanding of progress. The hard work you're putting in is about so much more than dilation. Embrace the intricacies of childbirth. It's not linear and it's a unique journey for each woman. Let go of the fixation on numbers, and trust your body's wisdom and the expertise of your care providers. Your labour story is about so much more than just a number; it's about you, your strength, and the incredible journey into motherhood.