Cancellation is the process of thinning and flattening the cervix to prepare for childbirth. Braxton Hicks contractions activate the cervix to begin effacement, which is measured during the first stage of labor. If the cervix doesn’t show signs of effacement, doctors may recommend treatment to encourage softening.
The term cancellation is most often used to describe the process the cervix goes through to prepare for childbirth. The cervix is located in the lower part of the uterus, where it extends into the vagina. The cervix is usually shaped like a small, squat cylinder with a central opening that stays tightly closed most of the time. During menstruation, the cervix opens slightly, called dilation, to allow menstrual fluid to pass through. Removing the cervix means that it is flattening and thinning to allow for even more dilation before delivery so that the fetus can pass through the vaginal canal.
Clearing the cervix is a gradual process. Towards the end of pregnancy, many women experience Braxton Hicks contractions. These contractions are sometimes called false labor but are thought to be a component of cancellation. Usually painless and sometimes unnoticeable, Braxton Hicks contractions cause the uterus to contract for a few minutes at a time. The contractions, in turn, activate the cervix to begin the erasure thinning process.
Before effacement, when the cervix is thick and taut, it is considered 0% effaced. When the fetus is ready to pass through the vaginal canal, the cervix is paper thin and 100% effaced. The portion of the cervix that extends into the vagina is usually about 1 – 1.5 inches (2.54 – 3.8 cm). Therefore, when the cervix is 50% effaced, it has shortened and thinned to approximately 0.5 – 0.75 inch (1.3 – 1.9 cm). This is measured during the first stage of labor by periodic examinations. As the effacement progresses, so does dilation, both of which occur during the first stage. Once both annulment and dilation are 100%, the second stage of labor begins and the woman begins to push.
Sometimes women reach the end of their pregnancy without the cervix showing any signs of effacement. In this case, a doctor may recommend a vaginal suppository or other treatment to encourage the cervix to soften. This triggers undoing and stretching. However, this type of procedure is usually reserved for women who are considered late. It’s always best to let the birth happen naturally, but if a woman goes beyond what’s considered the appropriate gestational period, doctors can start inducing pregnancy earlier by softening the cervix. Most doctors don’t consider a late fetus until the 40th week of pregnancy.
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