Cervical checks...need help learning

  1. I just started (new grad) in L&D,and am not getting how to check a cervix.I felt babies' heads when mom is 7+cm dilated,and thought I knew what I was doing.However,I am not using two fingers to estimate the distance(I'm not locating the "hole"that you'd find when using the dilitation chart.This is so frustrating...any suggestions,or resources you can recommend would be appreciated.Thanks.
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  2. 17 Comments

  3. by   all4babies
    I too, had trouble at first getting the cervical check. One doc told me to feel for what feels like the edge of a shirt collar - that helped some. Most of what the experienced nurses told me helped most, that being to take my time. I was so afraid to hurt the pt and embarrassed it was taking so long for me to check, that I would quit before finding the cervix. When you think about it, it's worse to be checked again and again, than to just take your time and get it right then. Try taking more time, find the "round protrusion w/an indentation in the center" for a non, or minimally dialated cervix. If the cervix is dialated, take your time and find the "hole" and feel all the way around the inside until you have completed the circle, then spread your two fingers, if possible. After checking, compare the width you believe the fingers spread with a dilitation chart. That's how I learned finally and like I said - take your time. Remember of course, this only covers the dilitation. You will get it - it just takes time and experience.
  4. by   is this heaven
    Thank you so much! I've only been on the job one month,but am so eager to learn....and frustrated by what I don't know.
  5. by   ayndim
    Quote from is this heaven
    I just started (new grad) in L&D,and am not getting how to check a cervix.I felt babies' heads when mom is 7+cm dilated,and thought I knew what I was doing.However,I am not using two fingers to estimate the distance(I'm not locating the "hole"that you'd find when using the dilitation chart.This is so frustrating...any suggestions,or resources you can recommend would be appreciated.Thanks.
    This may sound strange but have you tried checking your own cervix. I know you won't be dialated but it might help familiarize you with the cervix. I have checked my own when pg (ya ya but it is mine and I figure if I can have sex then my washed fingers are okay too). Even in the non pg state you will be amazed at the changes your cervix goes through depeding on where you are in your cycle.

    Sorry if a bit too icky (couldn't think of a better word)
  6. by   is this heaven
    but I didn't know how helpful it would be,given I'm not pg.Thanks....
    LOVE the quote in your post about episiotomy!:chuckle
  7. by   canoehead
    ...and people made fun of me for starting IV's on myself...sheesh.
  8. by   ayndim
    Quote from canoehead
    ...and people made fun of me for starting IV's on myself...sheesh.
    Do you really? I can't imagine. I hate IV's. In fact, I refused an epidural with #1 because I didn't want an IV. When I was induced with #2 because of prolonged ROM I didn't care. I am not sure if you IV comment is a joke because I couldn't imagine starting one on myself.

    Is this heaven -- I heard that somewhere. Can't remember where now but feel free to use it. It is one of my favorite sayings.
  9. by   JoniL&DRN
    Quote from ayndim
    This may sound strange but have you tried checking your own cervix. I know you won't be dialated but it might help familiarize you with the cervix. I have checked my own when pg (ya ya but it is mine and I figure if I can have sex then my washed fingers are okay too). Even in the non pg state you will be amazed at the changes your cervix goes through depeding on where you are in your cycle.

    Sorry if a bit too icky (couldn't think of a better word)
    I had a female PA several years ago who was prescribing a diaphragm for me and she had me "check" myself. She really believed that to use the diaphragm properly you had to be comfortable with yourself inside and out. This was a strange situation but I have to say it worked. She was in the room and was just very frank with me about it. I absolutely without a doubt know what a cervix feels like!
  10. by   L&D_RN_OH
    I too, have checked my own cervix. I agree with whomever said to use the dilatation chart. Once you have found the cervix, take a mental picture of how far apart your fingers are, then compare. Also, stick you fingers in everything. I know that sounds odd, but just try it. I'm talking pop bottles, mayo jars, anything that has a round opening. And it's easier to learn on pts who are further along in their dilatation. Especially if they have an epidural. And like someone else said, take your time.
  11. by   allevi
    I don't have a cervix anymore, due to hysterectomy, but even if I did I don't know that I could reach?

    We had a patient call in once and said she checked her own cervix, but she wasn't a nurse.
  12. by   is this heaven
    I think part of my problem is that I haven't checked many pts. in the 1-6 cm range,and have only palpated babies' heads.Pts. with epidurals are the people I check after my preceptor checks,and they've all been dilated above 6cm.

    Thanks for all your help:wink2:
  13. by   kastas
    LOL! This just made me think of the male L&D thread we had recently. :chuckle Don't think we could give them the same advice as we are seeing here. :chuckle
  14. by   canoehead
    Yep I sat down and started one in a tiny vein in my foot, just so I knew I could do it so long as I relaxed and took my time. I used to get all stressed out because of people watching and having a child in pain (I was in peds at the time) and my hands would shake, I'd sweat, and never have any success. It did wonders for my confidence.

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