September 2014 Moms

Since you all went to med school...

I have a curiousity question. Since we know all women are different and every baby has different size/shaped heads why do we have to get to 10 cm? I mean if a babies head is smaller does your cervix have to get all the way to 10cm? And if you have a larger baby head do you dilate past 10cm? How does your body know, well that's 10 cm cue urge to push. I was thinking about the birth of DS and I didn't have the urge to push and he had a large head. So I began to wonder maybe I started pushing before I was really 10cm which I know can cause to swelling. Then I thought well why would I swell at 9cm but not at 10cm. What magically happens that when pushing at 10cm it's fine. I am way overthinking this but you know when you get something in your head and can't get it out. I think I will ask dr at my appt but I feel like she will give the standard mom answer, Because it does.



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Re: Since you all went to med school...

  • I'm probably wrong but I *think* 10cm refers to when there is no more cervix around the baby's head - but that it varies for everyone, I'm sure.
                                                                                      
  • criscbish said:
    I have no idea, but at my prenatal class last week I learned that baby's skull has 4 plates that collapse into each other to fit on its way out. So we don't really give birth to the whole head (it's a bit compressed), which is why my instructor told us that the head can look funny (like cauliflower) when it's starting to come out.
    I knew about the plates but maybe that's why they head only needs 10 cm.


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  • Also, some people feel the urge to push much sooner than 10cm.  I think, like most things, that's really just an estimation.  Much like 1cm is 'fingertip'....well whose fingertip are we talking here?! They just have to define these things so that they have some sort of protocol, I'd imagine.
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  • Just wanted to add that being at 10 cm doesn't mean you have the urge to push either.  With DS I was 10 cm around 1 pm.  I didn't feel the urge to push because he wasn't low enough.  I was given the option to try pushing anyway or wait until I felt the urge.  The nurse told me that with an epidural sometimes pushing too early can lead to hours of unproductive pushing.  So I waited.  I didn't have DS until 4:48 pm and only pushed for about 20 minutes.

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  • I think even people who have premies/ smaller babies still have to get to 10 cm first. Labor isn't easier with a smaller baby! Though, pushing might be :)
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  • Based on my professional opinion as a professional wedding photographer, I'm guessing that the ready to push at 10 thing is an estimate based on an average and the number 10 is also an estimate. Like you said, everyone's body and all babies' heads are different in comparison. It's probably just an average level of "readiness" if that makes sense. 

    I would just pay close attention to what my body and my support team (midwife, nurses, OB, whatever route you're taking) are telling me.

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  • I just always thought 10cm was the max out and if baby's head doesn't fit, well there are other ways to get him out these days, I suppose.

    Interesting q though - I never gave it much thought.

     

     

     

  • NinjaZia said:
    I don't think docs are up there with measuring tape to define the "10 cm".  10 cm is a general guideline based on how many fingers-width open the cervix is, which varies depending on the size of the woman's cervix and the finger size of whoever's checking.  That's why you'll get different numbers depending on who's checking, so it's not definitive.  What IS definitive is being fully dilated and ready to push.  I imagine that pushing before transition could cause a whole host of problems, regardless if it's a small baby, but I'm not a doc so you'd have to ask the "what if" question to someone qualified.  :)

    ETA: Don't stress about big-headed babies. Plenty of big babies come out fine from "small" moms. Your body was designed to do this, even if sometimes a little "help" is needed from the doc.
    I'm not worried. My DS had a large head and while it took 3 hours to push him out it was fine. But that is really what I am wondering is how do they know you are fully dilated if each person is different. Just a general wonderment not something I am concerned with really.


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  • Imagine that the cervix is a turtle neck sweater...it is long and closed, as you pull the sweater over the baby's head the widening direction is dilation as you squish the length down that's effacement. When the turtle neck piece is beyond where you can feel it with your fingers that's complete. 10 centimeters is rather irrelevant. And all exams are "relative" to finger size of the examiner except complete, that's pretty exact. You either feel an unobstructed head or not.

    Centimeters of dilation may mean more during evaluation of progress.

    As for pushing there is an actual reflex involved if unmedicated during labor. That feeling when someone is saying "I gotta push NOW" is because of a natural reflex from perineal nerves. Sometimes the baby can be very low prior to adequate dilation hence an early urge to push when the cervix isn't ready...which can lead to complications.

    Passive descent to a lower station is common and helpful to women with an epidural.

    Hope that helps!

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  • Oh and the order of dilation/effacement and descent varies depending on the woman and her number of deliveries.

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  • @teenybean-That is helpful. I think I actually get the "your complete part now." Thanks!


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  • In the Lamaze childbirth video I watched, it was explained that 10cm is essentially when there is no more dilation. It may not actually measure exactly 10cm.

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