WHAT IS A CERVICAL LIP?
Written by: Caroline Meyer
You may be in labour, everything seems to be progressing well and then you are told you have a cervical lip and must stop pushing. But what is a cervical lip? While the cervix is considered to be part of the uterus it is made from different tissue. The cervix is at the bottom part of the uterus and actually extends further down in to the top part of the vagina. During labour, the uterus contracts. This causes the cervix to pull upwards. As the labour progresses, the cervix will dilate fully. This is normally quite an even upward pull. Occasionally there may be an issue with one side of the cervix. This may be that the one side is not pulled up in to the lower uterus or is not present. This is known as a cervical lip.
While no labour is exactly the same, some patterns were noticed and this was laid out as the natural progression of labour. Labour starts with contractions far apart and the cervix starts dilating. This process can last some time and the cervix should be completely dilated by the end of the active stage. You then move in to the second stage where the actual pushing happens. This part of the labour is also supposed to last for a set amount of time. When the first or second stage goes on for a lot longer than it should you may be told that your labour is failing to progress.
At this point you will probably have an internal examination to see what is going on. When there is still some cervix in the way or even has become swollen in the area you will told not to push anymore. This goes against your natural instinct and can be quite painful. Your doctor may suggest medications, forceps or vacuum delivery, an episiotomy or even book an emergency caesarean to help progress the labour and the birth. This is not the optimal birth for most women, but at least with currently technology, interventions can be made to safely deliver your baby.
No one really knows what causes a cervical lip of this sort. Almost all women have an anterior cervical lip in the early part of labour. The cervix opens in an oval motion from the back part of the cervix to the front. At the beginning of labour, the cervix is pointing more to the back of the vagina. During labour, as it starts to dilate, it opens from the back to the front. The front is therefore the last part to dilate out of the way. This makes an anterior cervical lip harder to notice. A posterior lip does not get noticed very easily as the cervix is pulled up in the back first and it is harder to reach in a physical exam. The position of the baby’s head or how early you started to push is not likely to be the reason for the cervical lip. The position of the baby during delivery can however shape the opening of the cervix as the head pushes against it. If the baby enters the world with the spine facing the mum’s belly, the cervix is likely to be more circular. If baby enters with her back facing mom’s spine, the cervix is likely to open up in a less even shape.
Most times a cervical lip will resolve on its own. You can try moving around and changing your position often to take the pressure off your cervix. From standing, walking, going on hands and knees to leaning forwards or lying on your side in a foetal position. Try one or a few different ways to try and reduce the pressure and give your body time to resolve the cervical lip. Sometimes all it takes is for your baby to change position in the channel for it to resolve naturally. You can also try a birthing pool where you can float to reduce the amount of pressure on your cervix. It will also help you relax a bit during contractions. Move how you feel comfortable. Take long strides while walking around if you feel pain above your pubis when you are having a contraction. This may also help shift the cervical lip and allow for a natural birth without intervention. If you are walking around, ensure you have someone with you to support you, especially during contractions. In some cases, your doctor or midwife may actually assist in pushing the cervical lip over the baby’s head. This may take a few contractions to resolve and can be quite painful.
If all else fails, your medical caregiver will advise interventions to help resolve the cervical lip to bring your baby in to the world safely with as little added pain to you as possible.