How to judge effacement??

  1. 0
    Just looking for some tips on how to judge effacement. I feel like I'm always doing it wrong!

    Thanks!
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  3. 5 Comments so far...

  4. 0
    That is a tough question to answer. Every woman's cervix is different of course. Some start out with a very long one.....2.5 to 3 centimeters. Of course if we find this long object that feels like a top to a coke bottle and can not insert a finger, she is "long, thick and closed"

    It helps to have one person examining and measuring the progress or lack of to compare each measurement. It is hard to jump in and judge effacement if you don't know what kind of cervix or length of that she started with.

    Of course, at the end when the cervix is "paper thin" as on of our old OBs used to say.....you know she is 100%.

    It is harder with a multip as dilation and effacement can occur simultaneously and can feel "mushy".

    I would say it is just something that comes with experience over time. Then someone else can follow you and disagree anyway. Put all the parameters together to get the whole picture and effacement is just a small part of the assessment.
  5. 0
    After 25 years of checking women, i have come to the conclusion that except in the case of preterm labor, you just need to know if the cervix is thick, thin or somewhat effaced.
    I tend to use thick, 50%, 80% for those that feel thin but not paper thin and 100%.
    What does it really change in your management?
    Don't sweat it, it is all subjective anyway.
    We have one MD who told me he has caliper-like fingers and can tell the difference between 35 and 40% effaced. I say hogwash
  6. 0
    I agree w/the above. Numbers are subjective here and I do laugh when a dr or someone else judges a cervix 20% effaced or some other equally obscure number. I think "say what?". Really, it takes practice, practice and more practice. Have an experienced nurse check with you, if need be, when unsure. Esp if women have epidurals and are not ruptured, you should be able to do this a lot.

    You will get the hang of it, if you are patient. Judging effacement and station come only with a lot of practice, no shortcuts exist for learning some of these things. Good luck!
  7. 0
    Quote from PegRNBSN
    After 25 years of checking women, i have come to the conclusion that except in the case of preterm labor, you just need to know if the cervix is thick, thin or somewhat effaced.
    I tend to use thick, 50%, 80% for those that feel thin but not paper thin and 100%.
    What does it really change in your management?
    Don't sweat it, it is all subjective anyway.
    We have one MD who told me he has caliper-like fingers and can tell the difference between 35 and 40% effaced. I say hogwash
    I find the effacement thing so subjective - in the uk we used partially or fully effaced- I tend to us thick -50 or 80 since being in the states with good out come!
  8. 0
    We have a doc who will in all seriousness pronounce someone 35% or 56 %. If he is in a good mood, we tease him. Like everyone says, really doesn't weigh too much in the scheme of things whether it is 45% or 50%. Lots of other parameters to factor in to get the whole picture of progress or lack of. We could write a book. Only problem, no one would want to read it.


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