What Is Cervical Effacement?

Cervical effacement happens when your cervix gets thinner, softer, and shorter to prepare for childbirth.

The cervix is the long, narrow opening to the uterus. During pregnancy, it's long and thick. As pregnancy comes to an end, and the body prepares for labor and delivery, the cervix ripens.

This article describes what effacement is, what it feels like, and how to address any complications. 

Cervix Softening Symptoms

You may not realize that you are experiencing effacement while it’s happening. Many people have no signs or symptoms.

Possible signs of effacement include:

• Pressure: You may notice pressure or cramping in the pelvis or lower abdomen.
• Discharge: During effacement, you may have an increase in cervical mucus coming from your vagina. As effacement progresses, you may lose your mucus plug, which is mucus that collects in the cervical canal during pregnancy. 
• Contractions: Braxton Hicks contractions are not strong enough to dilate the cervix, but they can cause effacement to progress. 

What Role Does Effacement Play in Labor?

Effacement is a critical factor in labor and delivery. When the cervix becomes soft and thin, it is a signal that the body is getting ready for childbirth.

The softening process of effacement usually starts a few weeks before labor. To measure your level of effacement, your healthcare provider will place a gloved finger through the vagina and into the cervix to determine how thick it feels.

Effacement is measured in percentages from 0 to 100. An effacement of 100% combined with cervical dilation of 10 centimeters usually indicates that the body is ready for birth. Regular labor contractions put pressure on the cervix, leading to effacement and dilation.

Measuring Effacement

Effacement is measured by your healthcare provider. You can expect them to start checking your effacement at about 36 weeks of pregnancy.

An effacement check will likely feel like a quick pelvic exam. Your healthcare provider will have you lie back and then place a gloved finger through the vagina and into the cervix. Your healthcare provider can check both effacement and dilation at the same time. 

It’s important to note that there is no precise way to determine your level of effacement. Your healthcare provider estimates the percentage based on what they feel. For this reason, an effacement measure may vary from healthcare provider to healthcare provider. 

Complications

When effacement does not progress normally at the end of pregnancy, possible complications can arise. 

Early Effacement

Also known as an insufficient cervix, early effacement occurs when the cervix starts to shorten and soften too early in pregnancy. Early effacement raises the risk of miscarriage, premature labor, and premature birth. Early effacement does not always have a known cause. 

Possible risk factors of early effacement include:

• History of early effacement in past pregnancies
• Multiple pregnancies (twins, triplets, etc.)
• History of miscarriages past the fourth month of pregnancy
• History of terminated pregnancies 

Signs of early effacement may include vaginal spotting, bleeding, abdominal cramping, and pelvic pressure. Treatment will depend on how far along into pregnancy you are and if you are experiencing any other complications. Your healthcare provider may recommend cerclage, a surgery to stitch the cervix closed until the end of pregnancy. 

Late or No Effacement

Late or no effacement happens when the cervix remains long and thick at the end of pregnancy. When this occurs, labor cannot progress. Pregnancies that go beyond 41 to 42 weeks have an increased risk of serious complications. 

To stimulate effacement, your healthcare provider may recommend one of the following medical interventions:

• Prostaglandins: Prostaglandins are chemicals that naturally occur in the body. They can be given either orally or vaginally to ripen or soften the cervix.
• Laminaria: Laminaria are slim rods that can be inserted into the vagina to stimulate cervical effacement and dilation. They work by expanding when exposed to water. 
• Catheter: A catheter is a thin tube with an inflatable balloon on the end. It can be inserted into the cervix to help effacement and dilation progress. Once placed in the cervix, your healthcare provider will expand the balloon to put pressure on the cervix.
  

Summary

Effacement is the process of the cervix thinning, shortening, and softening to open the vaginal canal for childbirth. The cervix is the opening to the uterus and usually remains long and thick until the end of pregnancy. Effacement is measured in percentages from 0 to 100 by a healthcare provider. Once the cervix is 100% effaced and 10 centimeters dilated, the body is usually close to being ready for childbirth. When effacement occurs too early or late in pregnancy, complications can arise. 

A Word From Verywell

Effacement is one sign that your body is ready for labor and birth. It is an exciting change that means you will hopefully meet your baby soon. Effacement can be a long process. It is possible that effacement can occur weeks before going into active labor. Stay in close contact with your healthcare provider at the end of your pregnancy and alert them of any changes in your symptoms.