Published Aug 26, 2002
Hi, me again :) How far does a woman have to be dilated before you can tell what station the baby is at? I assume you tell station by putting your finger through the cervix? If I'm totally off please let me know!!
USUALLY: Pretty much dilated enuf to stick your finger thru, and attempt to ballot the head. If it's ballotable, then it is less than zero, for sure....more like -1 or higher. The more dilated she is, the more I can tell by feeling the entire presenting part and caput (if any). However a woman does not necessarily need to be dilated at all to assess station-----
Especially w/a well-effaced closed cervix when the presenting part is zero station or lower. I have seen babies be 0 to +1 or more yet behind a closed cervix. often, these women will complain they feel as if they are carrying a basketball between their legs...for good reason. Hope this helps. No two women are the same which can make accurate checks a challenge in some cases.
I was under the impression that ballotable is synonymous with floating, that is, if you can push the head away, it is not engaged or wedged in the pelvis. If you can push the kid away, he or she is a minus 3 at least....Our ob chief says you can't decide what station the baby is at without feeling the spines ( ugg, the ever elusive spines), however, we are usually right on. Then there are the times when the caput is 0 or -1 and the head is at least a minus two.....As for effacement, I just try and explain that to a patient by having them visualize a turtleneck shirt before you pull it over a bald head. Thick before you start and then the turtleneck thins out as you begin to pull it over your head.
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