…..and nothing happens! But is that really true? In my early days of doula-ing, I was sitting with a client during one of our prenatal visits. She had a question about Braxton Hicks contractions and was concerned they would turn into preterm labor, or that she wouldn’t be able to tell the difference between them and actual labor contractions. We had a discussion about her concerns and we formulated some great questions to ask her provider at her next appointment. But I did reassure her that Braxton Hicks contractions are much different than labor contractions. They feel different and they have a different effect on the uterus and cervix. So when I began writing my curriculum for my Childbirth Prep Class, I knew I had to include some great visuals of contractions and effacement (or thinning out of the cervix) and discuss why this was all so important.

The Balloon and Ping Pong Ball

Below you’ll see a video. Its just me and my props, and some music lol…But before you watch it, let me explain what is showing.

The orange balloon is representing your uterus. The top of the balloon is representing the fundus, which is the top of the uterus and it is opposite your cervix which is the opening, or bottom, of the balloon. Inside the balloon is a ping pong ball (ya’ll don’t wanna know how hard it was to get that ball into the balloon) and it represents your baby’s head.

The first set of squeezing I do in the video is simulating Braxton Hicks contractions. They can begin as early as 6weeks of pregnancy but aren’t typically felt until much later. They can be intense but aren’t usually described as painful. As labor approaches, the cervix becomes “ripe” and can be somewhat effaced (thinned out), and may even dilate one to a few centimeters. Notice how I am squeezing the sides of the balloon/uterus and the effect it has on the bottom of the balloon/cervix. The opening has gotten a little shorter and there’s slight dilation. These Braxton Hicks contractions are doing some work, but they aren’t labor contractions.

Labor contractions begin at the top of the uterus (not the sides). And because the uterus is a muscle, the contraction causes the muscle fibers to….well, contract… The contraction starts at the top and sort of ripples all the way down to the bottom. Each contraction is essentially gently squeezing baby and applying pressure, via the baby’s head, onto your cervix.

Now, watch what happens when I simulate labor contractions by squeezing the top of the uterus.

See how the cervix is now relatively thinned out and some more dilation is occurring? If I were to continue squeezing, the cervix would become 100% effaced and open to allow the ping pong to begin to crown and eventually come out.

Rubber bands and Your Cervix

Next up you’ll see I have a rather thick stack of rubber bands. This is your cervix at 0% effaced, or 0% thinned out. Your cervix has to make it to 100% effaced in order to have a baby. It is a process, and it happens during labor. For a first time mother, it is very common for your cervix to be 50-60% effaced and maybe 1cm dilated. This is usually the result of BH contractions. Notice how difficult it is to stretch this thick stack of rubber bands (try it at home). Your cervix cannot dilate, or stretch, when it is thick. If you’re wondering, a thick cervix often feels like the tip of your nose.

Next, I remove a few of the rubber bands, and the stack is a little easier to stretch. But it still has quite a bit of resistance. Watch what happens when I remove all but one rubber band…. voila! We have a stretchy cervix! Dilation can and will occur beyond just a few centimeters, and sometimes happens rapidly. Both cervical effacement and dilation play an important role in labor.

Join us for our next Childbirth Class and learn how to work with those labor contractions to maximize their effects.

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