Cervical Lip During Pregnancy

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When a woman is giving birth, labor can be affected because of a cervical lip. This means that the edge of the cervix, usually the anterior edge does not fully dilate during the contractions. A cervical lip is seen because of the uneven dilation of the cervix in an elliptical rather than circular manner.

What is the cervical lip?

As the cervix gets near full dilatation, sometimes a bit of cervix on one side is still present, while not on the other side. This is known as the cervical lip or lip of the cervix. This is most commonly an anterior lip which is thought to happen when the cervix gets caught between the pelvis and the baby’s head.

What is a cervical lip during pregnancy?

The cervix is located at the top of the vagina and is a part of the uterus. It is made up of a different kind of tissue and present in the bottom portion of the uterus, extending to the top of the vagina. During labor, the muscles in the uterus start to contract, shortening and pulling up the cervix. As the contractions progress, these become thin and the cervix dilates fully. During cervix dilation, the baby is rotating and descending through the pelvis. Upon, dilation, the cervix gets pulled up, leading to the cervical lip. The anterior lip of the cervix is the one close to the pubic bone which prevents the baby from passing through. Therefore, the cervical lip occurs when the cervix gets caught up between the pelvis and the fetus head, obstructing the birth.

cervical lip

Causes of the cervical lip

Anatomy

Experts believe that the cervical lip is common among most women because of anatomy. When labor begins, the cervix points towards the back of the vagina, and dilation continues, it opens forward. Therefore, the end of the cervix is moved aside and becomes anterior which is the front part. This anterior lip usually goes unnoticed unless the woman has a cervical examination. If the cervical lip happens on the posterior lip, it is nearly not possible to detect.

Position of the baby’s head   

The baby moves through the pelvis during dilation. If the baby enters the pelvic brim with its back in line with the mother’s belly, the cervix will dilate in a circular manner. If the baby enters the pelvic brim with its back in line with the mother’s back, it will make an uneven cervix. Few women believe that the cervical lip is caused due to the uneven exertion of pressure from the baby’s head.

Pushing too early   

Some believe that pushing the baby too soon can cause cervical lip. During labor, the woman has to push the baby out of the dilated cervix and the pushing sensation comes when the baby’s head pushes on certain nerves on the pelvic floor. So, pushing is not related to the dilation of the cervix. However, if the woman pushes before the cervix is fully dilated, it may cause a cervical lip. This is why when women begin to feel the pushing sensation, the doctor will check how far the cervix has dilated so that damage to the cervix can be avoided by pushing early. However, there is no evidence.

How can it affect childbirth?

A cervical lip can hijack the pregnancy because it prevents the baby from being pushed out without obstruction. The first stage of labor is the dilation of the cervix and completes when the cervix is fully dilated and the second stage which is the pushing stage can begin. This is referred to as the active stage. Both stages last a certain amount of time and when the body doesn’t progress in these stages, intervention is required. First, cervical or vaginal examination is conducted and if cervical lip during labor is observed, the woman will usually be asked to stop pushing for some time. This can be painful as one has to fight against the body’s instinct to push. Medication or assistance in the birth can be given, ranging from vacuum to a c-section.

Remedies for cervical lip during pregnancy

Wait before pushing   

Patience is necessary and sometimes, the doctor or midwife will ask to wait to see if the cervical lip resolved itself. Sometimes, the lip is being caused due to the baby’s head being in the wrong position and once it moves into a better position, the labor will resume. Also, let the cervix dilate fully before starts pushing, even if you’re getting the push sensation and want to relieve it from the painful contractions.

Change positions   

Change the position into something that will take pressure off the cervix or rotate the baby if it is in an unfavorable position. Go on hands and knees, lean forward, bring the knees to the chest or lie on the side. These positions will also help the baby rotate into a more optimal position for the birth.

Hydrotherapy

A tub of water can help feel more relaxed and weightless. Floating on the back reduces pressure from the cervix. This will help relieve pain while wait for the cervix to dilate. Some hospitals make use of pools during labor as don’t have tubs. Also, a shower can be used but it isn’t as relaxing as a pool or tub.

Pushing

It is extremely painful to fight the body’s urge to push and if the body pushing spontaneously, then it will not stop. In such a case, please give in to the body’s urge to push as fighting it will only cause more pain and then there will be a need for interventions. If there is a painful sensation above the pubic bone each time having a contraction, it means that the cervical lip is being nipped against the bone and take a position that will relieve pressure off of the cervix or apply pressure to the area above the pubic bone.

Walking

Taking long strides when having contractions can help shift the cervical lip. As, this can be extremely painful, so it is better to take assistance from someone while walking. If cannot walk, lift each foot one by one, stamp it down, and then squat.

Manual aid   

Sometimes, the above-mentioned options can take too long and the pain may be too severe to cope with. Ask the doctor to remove the lip manually. The doctor can conduct a vaginal examination and then forcibly move the cervix over the fetus’s head so that it can come down more easily. It will take more than just one contraction for the baby to come down but the doctor can coach the pushing efforts. While this is quite painful but is effective and quick.

Conclusion

The cervical lip is fairly common and can be extremely painful. However, there are numerous ways to cope with the pain. Once the lip is gone, labor will progress in a normal manner. Sometimes, labor may even proceed despite the lip being present. Just be patient and follow the doctor’s advice carefully.

References

Birth terminology explained: cervical lip (lamaze.org)

What is a cervical lip? How can it hijack your birth? | bellybelly

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