What Is Cervical Lip & How It Affects Childbirth

When a woman is giving birth, her labor can be affected because of a cervical lip. This means that the edge of her cervix, usually the anterior edge, does not fully dilate during the contractions. A cervical lip in labor is usually a result of the uneven dilation of the cervix in an elliptical rather than circular manner. It may be caused by an unfavourable position of the baby in the uterus. However, one can overcome it by trying different things like waiting for some time before pushing, changing positions, hydrotherapy, or manual reduction. You can also take some precautions like avoiding vaginal examinations during labor and not letting the baby’s pushing be interfered with. Follow your body’s instincts, and you may find that your body will resolve an issue independently. Make sure that you always feel comfortable and follow your medical aid’s advice properly.

What Is Cervical Lip?

The cervix is situated at the top of the vagina and is a part of the uterus. However, it is made up of a different kind of tissue and is present in the bottom portion of the uterus, extending to the top of the vagina. During labor, the muscles in the uterus begin to contract, shortening and pulling up the cervix. As the contractions progress, they become thin, and the cervix dilates fully. As the cervix dilates, the baby rotates and descends through the pelvis. Upon dilation, the cervix gets pulled up evenly. Sometimes, a portion of the cervix, usually the anterior lip of the cervix, will not get pulled up, leading to the cervical lip. The anterior lip of the cervix is the one closer to the pubic bone and prevents the baby from passing through. Therefore, the cervical lip occurs when the cervix gets caught up between the pelvis and the baby’s head, obstructing the birth.

Causes of Cervical Lip

There is no definitive reason for the cause of cervical lip. However, there are many theories about its actual causes, some of which include:

• Anatomy – Experts believe that cervical lip is common among most women because of their anatomy. The dilation of the cervix happens in an elliptical manner and not evenly in a circular manner, from the back to the front. 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 the anterior, i.e. the front part. This anterior lip usually goes unnoticed unless the woman has a cervical exam. If the cervical lip happens on the posterior lip, it is nearly impossible 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 circle. If the baby enters the pelvic brim with its back in line with the mother’s back, it will create an uneven cervix. Some women believe that the cervical lip is caused by 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 her dilated cervix, and the pushing sensation comes when the baby’s head pushes on certain nerves on the pelvic floor. Therefore, pushing is not related to the dilation of the cervix. However, if the woman pushes before the cervix is fully dilated, it may lead to a cervical lip. This is why when she begins to feel the pushing sensation, the doctor will check how far her cervix has dilated so that she can avoid causing damage to her cervix by pushing early. However, there is no conclusive evidence for the same.

How Can It Affect Childbirth?

A cervical lip can hijack the pregnancy as it prevents the baby from being pushed out without obstruction. The first stage of labor is the dilation of the cervix. The first stage is complete 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, a cervical or vaginal examination is conducted, and if a cervical lip during labor is observed, the woman will usually be asked to stop pushing for some time. Otherwise, it could cause cervical lip complications. This can be painful as she has to fight against her body’s instinct to push. She may be given medication or assisted in the birth, ranging from a vacuum to a C-section.

Remedies

There are many courses of action to be taken if you have a cervical lip during labor:

1. Wait before pushing

Patience is necessary, and sometimes, your doctor, midwife or doula will ask you to wait to see if the cervical lip resolves itself. Sometimes, the lip is caused by the baby’s head being in the wrong position, and once it moves into a better position, the labor will resume. You should also let the cervix dilate fully before you start pushing, even if you get the pushing sensation and you want to relieve yourself from the painful contractions.

2. Change Positions

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

3. Hydrotherapy

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

4. Pushing

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

5. Walking

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

6. Manual Aid

Sometimes, the above-mentioned options can take too long, and the pain may be too severe to cope with. You can then ask the doctor to remove the lip manually. The doctor can conduct a vaginal examination and then forcibly move the cervix over the baby’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 your doctor or midwife can coach your pushing efforts. While this is quite painful, it is effective and quick.

FAQs

1. Can a baby’s position in the womb cause a cervical lip?

Although it’s a common notion that a baby’s position in the pelvis causes a cervical lip, cervical dilation happens because the muscles at the top of the uterus shorten and pull back, which thins and opens the cervix. It is important to know that the baby’s head does not directly cause dilation; its position, however, can affect the shape of the cervical opening.

2. Can pushing early be the reason for a cervical lip?

Many people believe that women need to work hard when pushing during labor actively. Most healthcare experts suggest that when you feel the ‘urge to push,’ your cervix is fully dilated and ready for delivery. However, the sensation of pushing is triggered by the baby’s head pressing on certain pelvic floor nerves, known as Ferguson’s reflex, which doesn’t necessarily indicate full cervical dilation.

If the cervix is not fully dilated or the lip of cervix seems to appear, the pregnant woman is advised to stop pushing in order to avoid any damage to her cervix.

The cervical lip is fairly common and can be extremely painful. However, there are numerous ways to cope with the pain, and 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 your doctor’s or midwife’s advice carefully.

Also Read:

Cervical Mucus in Pregnancy
Cervical Incompetence when Pregnant
Cervical Insufficiency during Pregnancy
Does Cervical Length Matter during Pregnancy
Cervix & Cervical Position in Early Pregnancy

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