Check dilation without cervical exam

Checking for progression during labor and even during pregnancy has always been done by performing vaginal exams. Routine checks to check for dilation during pregnancy are unnecessary, they tell us nothing, and they carry risks that outweigh the benefits.

But what about checking for dilation during labor? Is it necessary? Are there other options besides invasive vaginal exams?

• Checking for dilation during labor is the standard routine care. It’s done by inserting fingers into the cervix to check for thinning and dilation of the cervix. This can be painful during labor and can also cause problems like:
  • Accidentally breaking the bag of waters
  • Introducing bacteria and risk infection to you and baby
  • You might have not progressed quickly enough for the care provider, you are left feeling like your body doesn’t work and now you are asked to start the cascade of interventions to speed up labor, which can lead to a cesarean birth
• All this is not fun and some studies have shown that the overall accuracy for cervical dilatation is between 48% to 56% with 1 cm error, to 89.5% to 91.7% and this accuracy is reduced with the increase of cervical dilatation
• Another method of checking for progression that is less invasive is checking The Purple Line

The Purple Line

• ON WOMEN OF COLOR, THIS LINE CAN LOOK GRAYISH/SILVERY
• A study showed that checking for progression using the purple line is reasonable and a lot less invasive. It showed the purple line appeared in 75.3% of women during the active phase of labor and appearance of the purple line in the prediction of labor progress had 90.2% sensitivity
• The appearance of a line of red/purple discoloration is seen to arise from the anal margin and extend between the buttocks reaching the nape of the buttocks at the onset of the active stage of labor. There is a correlation between the length of the purple line and cervical dilatation and the station of the fetal head. So the higher up the line goes, the closer you are to having your baby!

According to the appearance of the purple line in most of the cases and its high sensitivity and specificity, we can use it as a non-invasive complementary method for clinical assessment of labor progress. But not everyone will have a clear or visible purple line

Labor progresses at its own pace and we shouldn’t feel pressured into vaginal exams. The World Health Organization encourages birthing people who are low risk to be left alone to labor without time constraints to limit unnecessary interventions and they emphasize that the number of vaginal examinations should be limited where it is necessary

Written by BadAssMotherBirther
Photos by Portland Birth Photographer Natalie Broders