Swollen Cervix During Labor
Maybe you’ve heard a story about someone whose labor was going just fine until transition or the urge to push, when the hardest part seemed to stall while becoming almost unbearable, and then they were told their cervix was swollen. Maybe they needed a c-section. Or maybe they got an epidural and didn’t push for 12 more hours (I’ve seen that)! Or maybe it happened to you…
Actually, it happened to me with my first two babies. Transition seemed like it was going on for so long. I asked to be checked, and my midwife said I had a slightly swollen cervical lip. There was a very painful, untenable kind of pinching/burning sensation above my pubic bone. My midwife strongly suggested, very much against my inclination, that I lie on each side through three contractions (which was the worst!) and take homeopathic arnica every few minutes. She offered compassionate and soothing touch while coaching me to melt into the bed. It was definitely the hardest part! Especially because I was feeling the urge to push. After that, the lip dissolved, transition finally ended, I was fully dilated, and got to push my baby out. Yaaaaaay! I was blessed with excellent advice and care. This situation doesn’t always go so smoothly.
I’ve seen variations on this theme unfold many times as a doula and as a midwife, most commonly for first time parents or first vaginal births.
Cervical Lip or Swollen Cervix?
I want to make a distinction between a cervical lip and a swollen cervix during labor. Because a cervical lip is really just the rest of the cervix that hasn’t yet finished opening and being pulled up and around baby’s presenting part, which is usually the head. Normal. Normally not a problem.
There’s a fabulous article about the overdiagnosis/problematizing of cervical lip called, “Anterior Cervical Lip, How to Ruin a Perfectly Good Birth.” Dr. Rachel Reed talks about how checking to make sure the cervix is fully dilated before “allowing” women to push can really mess things up. Most of the time, pushing with the body’s natural urge is best, whether anyone checks dilation or not. However, swollen or edematous cervix can contribute to a diagnosis of failure to progress, leading to a cesarean birth.
Occasionally, I have seen a mama start pushing with the urge to bear down, become frustrated because she felt no progress was happening, and then have a swollen cervical lip discovered. It’s not the presence of the lip that’s problematic. But when a bit of cervix becomes swollen, usually because it’s squished between baby’s descending head and the pubic bone, it really hurts! So, that kind of pain can be a problem in and of itself. Also, it’s usually an indication that we’re not on the path of least resistance - i.e. if we can help mama help baby find a more easeful orientation to the birth canal, then we can go ahead and have a baby.
Resolving a swollen cervical lip to reach full dilation
Spinning babies offers a lot of great resources to help us understand the relationship of the baby’s head/presenting part to the pelvis, especially as regards station or descent. They have great suggestions for trouble shooting in labor, helpful positions, release, etc. Don’t wait til you have a problem in labor to utilize their resources. There’s a lot that can be done during and between pregnancies to balance the pelvis and promote a smooth labor and birth.
In any case, here are some helpful positions for a swollen cervix in labor:
Try side-lying
Three contractions on one side, then switch to the other side for three contractions. Try to melt into the bed. This might be really really hard but worth it, as it was for me.
Hands and knees
is a good one to help baby rotate anteriorly. Manteada with a rebozo slung under the belly between contractions can help with rotation.
Knee-chest
can help bring the baby up out of the pelvis and then re-engage with a smaller, more ideal presenting diameter of their head coming down into the pelvis. The Miles Circuit page has a good image and description of knee-chest position.
Walchers
This might seem wild and crazy, but it just might work. Walchers helps open the pelvic inlet, making more space in the front-to-back diameter of the part of the pelvis the baby has to enter to descend.
Flying cowgirl
Emotional Release
Remember there’s often an emotional component, especially when our soft tissues are involved. When it comes to labor and birth, there nearly always is more to let go of, more to face and to embrace. Welcome the feelings that arise along with the sensations of contractions, stretching, pressure. Sometimes a good cry is just the thing. Here’s an article I wrote about the inner work of preparing for birth. And here’s a fabulous book on the topic.
Hands on/in Assistance
In some cases I’ve seen, I or another midwife has pushed the lip back over the baby’s head as a mom bears down, and that’s that.
Homeopathy
Remember the homeopathic Arnica for swelling! Gelsemium is another option for a problematic cervical lip.
To Push or Not to Push
Usually, when you can’t stop yourself from pushing, you’re ready to push. But sometimes baby’s head puts pressure on the rectal area (from the inside, of course), producing an “early urge” to push. This is more common with a posterior baby (the back of their head faces mama’s back) or when a baby has a hand or an elbow coming down alongside the head. Pushing too early can increase the risks of a swollen cervical lip or prolonged labor. You might have to stop pushing until full cervical dilation by blowing through the urge to push and practicing deep relaxation, which is easier said than done! On the other hand, I’ve seen early pushing that helped things along!
Let it all go
Truly, each birth is unique. Birth work is super humbling. There are no rules. What works one time may not work the next time. And something that was significantly problematic at one birth may be a mere hiccup at another. So, we tell stories. We share tricks. We discuss. And then we let it all go. As parents, we seek to connect deeply with our bodies, our babies, our instincts and intuition. And as care providers, we strive for a prayerful and attentive yet spacious presence at every birth.
FAQ
What causes swollen cervix during labor
Sometimes a little bit of the cervix gets impinged, or caught between the baby’s presenting part - usually the head - and the hard tissues of the pelvis - usually the pubic bone. It’s hard for blood to flow back from the cervix, and it starts to swell. Pushing efforts can exacerbate the situation.
What is a cervical lip during labor
A cervical lip is a small portion of the cervix that has not yet been pulled up into the lower uterine segment as it stretches open and around the baby’s presenting part - usually the head.
What can I give for swollen cervix
Homeopathic arnica, rest, and position changes can all help with a swollen cervix. Trying not to push can help too.
What is edematous cervix
Edematous means swollen. So edematous cervix means the same thing as swollen cervix.
Work with me
If your in or near the Baltimore area and want to have a home birth, reach out!
