Dilation of the purple club line
More and more parents are choosingOUT of the awkward routine vaginal examsI am workand prenatal(without medical indication) and opt for thepurple line extensionLabor Progress Evaluation Club. Research suggests that about 50% of vaginal exams during labor are inaccurate, and as labor progresses, they become more inaccurate. A new 2021 study suggests dilation is about 85% accurate and how deep the baby protrudes into the pelvis. Yes, dilation is important – everyone is obsessed with that number, but your baby's position (how high/low in the pelvis) is also crucial information. They may be fully dilated and the baby may still be high in the pelvis (not near the "outlet"). Ideally, when you're at the +2 "station" you feel that strong urge to bid.When you have an epidural that allows your body to push the baby down, pushing takes a lot of "work."
So why not consider alternative ways to assess progress that can reduce infection and discomfort and keep you out of bed and help you stay home longer? Combined with other signs, it's an easy way to teach yourself if you're dilated, before you go to the hospital.
So let's talk about the Purple Line!
Hobbs line: also known as the red-purple line in pregnancy
Also known as the purple line, the Hobbs line (named after the researcher who published the first article on the subject) has recently received much-deserved attention as an alternative, less-invasive method of assessing the progress of labor. It may even be more accurate than a vaginal exam, as some studies have shown that the overall accuracy of cervical dilation is only 48-56%, and the more dilated you are, the less accurate the VE (vaginal exam) will be. .
The purple line acts as a mercury thermometer; can sometimes look more like onered line between upper buttocksand the higher you go, the more progress you will have. As the length of the line increases, so does the dilation. It's good to know, right? red line between upper buttocks
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What is causing the purple line? Is pressure in the butt a sign of labor?
As your baby descends deeper into the pelvis, a red/purple or perhaps brown (depending on skin color) line will slide from the anus to the top of the birth cleft between the lower cheeks. This is believed to be caused by pooling of blood in that area due to pressure from the baby's head. A 2018 study suggests that it is seen more often when the water is released early in labor. Several studies suggest that up to 86% of parents will experience this phenomenon.
The main causes of purple lines are unknown, but many scientists have suggested that vascular congestion at the base of the sacrum may cause increased purple lines to appear. Clears with pressure and slowly recolors once pressure is released. These engorgements occurred due to increased intrapelvic pressure as the fetal head is lowered, which is believed to be a positive correlation between fetal head lowering and increased presence of purple lines. In addition, common changes in the shapes of the pelvis, where the rhombus of Michaelis retracts the bones during late labor, pushes out the ileal wings, and enlarges the pelvic diameter, provide another explanation for the presence of the purple line [ Bonilla et al. Alabama. , 2016].
Diamante by Michaelis Bulge
(Quickly to the side) Look at this amazing photo.Doulas of North Dallasshows the opening of the pelvis to help the baby move through the pelvis. This comet-shaped bulge is theDiamond of Michaelis, which includes three lower vertebrae that move out during the second stage of labor (thrust). The purple line is not mentioned in this image and it is hard to tell if it is there. I would love to know!
First mentioned in The Practicing Midwife magazine in 1988, the purple line is getting more and more attention in the world of childbirth—it's something your doula at home might be looking for.
“My midwife explained this to a student when she was transitioning. The student asked her if she would take a test, but she said that it was completely unnecessary as she could see that I was fully expanded through the lineage. Great!" - Mrs.
Purple line dilation image
Do yourself a favor and take a butt selfie today (before delivery) if you already have some sort of pigmentation there; you can then compare the lines on the big day if you're comfortable staying home late. Take it in the third trimester if you areget ready for your perineal massage.
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Always look for other signs that labor is progressing and don't rely solely on the purple line (indication of slimy birth, strong surges, or that your waters have released) and it's growing.Buttock pressure as a sign of progressive labor.
Images of dilation of the purple line of pregnancy
Why have you never heard of him? It could have something to do with some parents not being encouraged to go into labor and a significant number delivering on their backs, so it's not something most staff are looking for, or even don't know what to do. what are you looking for.
"I have a picture of my purple line! When I had my last baby, the midwife told us, 'Come on, you're at 10 cm.' We asked her how she knew when I asked if there was no EV and she said because of the line! "-Jennifer
“We discussed this when I was in labor on Saturday. Apparently I had the line and my birth photographer took some photos. Can't wait to see her!" -Aoife
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Obstetricians and midwives are often more familiar with the more subtle ways to monitor the progress of labor.Read more about cervical examsand how you can do it yourself at home before going to the hospital or birthing center.
Talk to your caregiver about your experience using the purple line to assess the progress of labor.
I look forward to the day we see something like that phrase in written birth preferences.
"Due to the inaccuracy of vaginal exams, the discomfort it causes, and the risk of infection, I prefer to have my contractions checked visually with a purple line."Maybe add it to these questions ifChat with your provider.
Purple line voltage graph
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Would you prefer this way of assessing the progress of your labor (along with other signs such as increased labor symptoms, inward focus, increased pressure, and other visual (and audible) cues)?
Tracy
resources
Hobbs 1998. Assessment of cervical dilation without vaginal examinations. Observing the purple line. The Practicing Midwife 1(11):34-5.
https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-10-54
https://repositorio.animaeducacao.com.br/bitstream/ANIMA/2655/1/2018_Nunes_Traebert_purple_line.pdf
Chicken KA, Bread BC. Accuracy of simulated cervical obliteration and dilation measurements among practitioners.Soy J Obstet Gynecol.2004;191(5):1797–9.
Letic M. Inaccuracy in the evaluation of cervical dilation and the progress of the follow-up of labor.Median Hypotheses.2003;60(2):199–201.
FAQs
What does the purple line look like dilation? ›
One of the most remarkable ways in which our body tells you that you are dilating is the so-called Purple Line! It is a purple or brownish line (mostly depending on skin color) that extends from a woman's anus upwards to the top of the cleft between her buttocks!
What is the purple line of labor? ›Purple line is one of the non-invasive methods to assess the progress of cervical dilatation and foetal head descent in labour (Shepherd et al. 2010). This line starts at the anus and moves up the cleft at the beginning of the second stage of labour (Byrne and Edmonds 1990).
Is the Purple Line Accurate for dilation? ›Direction of Purple Line
They conducted a study with 48 women in spontaneous labor and noted that the purple line was seen on 89% of the labors. Significant correlation was seen between the length of the purple line and cervical dilatation and the station of the fetal head (25).
Basically as the baby descends, a red/purplish (or perhaps brown depending on skin color) line creeps up from the anus to the top of the natal cleft in between the bottom cheeks. When the line reaches the top of the natal cleft, 2nd stage is probably a matter of minutes away.
How do you tell you are dilating? ›- Signs of Cervical Dilation. ...
- #1: “Lightening Crotch” or Vaginal Pain. ...
- #2: Backache and Menstrual Like Cramps. ...
- #3: Bloody Show – A Sign of Cervical Dilation. ...
- #4: Less Talking, But Possibly More Noise. ...
- #5: Intuition. ...
- #6: Less 'Politeness' – a Sign of Cervical Dilation.
It is not uncommon for the cervical ripening to take up to 24-36 hours!! It is also not uncommon to use different techniques to ripen the cervix. You may feel contractions during this process. If the contractions become painful, you will be able to request medication to relieve your discomfort.
What helps to dilate? ›Getting up and moving around may help speed dilation by increasing blood flow. Walking around the room, doing simple movements in bed or chair, or even changing positions may encourage dilation. This is because the weight of the baby applies pressure to the cervix.
Can you check your own dilation? ›Evans advises to not check your own cervix for dilation. It's difficult to do and you may cause an infection. “It can be difficult to check for cervical dilation, even for trained professionals,” she says. “Self-checking your cervix while pregnant is also very difficult due to your growing uterus.
How can you tell if you're dilated at home? ›Try to insert the tips of your fingers into your cervix. If one fingertip fits through your cervix, you're considered one centimeter dilated. If two fit, you're two centimeters dilated. If there's additional space in the opening, try to estimate how many fingertips would fit to determine dilation.
What does discharge look like when dilating? ›During the late third trimester, this plug might push into your vagina. You might notice an increase in vaginal discharge that's clear, pink or slightly bloody. This might happen several days before labor begins or at the start of labor.
What does it look like when your cervix dilates? ›
Discharging a brown or pink-tinged mucus is an early sign of cervix dilation. Effacement of the cervix causes small blood vessels to break. This causes the mucus to appear as pink or brown. It's important to seek medical advice about vaginal bleeding.
Can you dilate without contractions? ›Dilation and labor
Contractions help the cervix dilate and efface from the beginning stages to the full 10 centimeters. Still, you may be dilated slightly without noticeable contractions.
Evans advises to not check your own cervix for dilation. It's difficult to do and you may cause an infection. “It can be difficult to check for cervical dilation, even for trained professionals,” she says. “Self-checking your cervix while pregnant is also very difficult due to your growing uterus.
How much do you have to dilate before your water breaks? ›If your water (aka “amniotic sac,” “bag of waters” or “membranes”) hasn't broken on its own when you arrive at the hospital, and you're five or more centimeters dilated, your OB might recommend bursting the bag by hand—especially if your cervix seems to be making slow (or no) progress.
How long does it take to dilate from 1 to 10? ›When your baby is ready to begin the journey through the birth canal, your cervix dilates from fully closed to 10 centimeters. This process can take hours, days, or even weeks. But once you hit active labor – about 6 cm dilated – it's usually just a matter of hours before you reach full dilation.
Is it painful when cervix dilate? ›As cervical dilation increased, there were significant increases in self-reported pain and observed pain on all the cited measures. Pain was characterized as 'discomforting' during early dilation and as 'distressing, horrible, excruciating' as dilation progressed.
At what cm dilation do you lose mucus plug? ›The cervix generally needs to be dilated to 10 centimeters before it's ready for the baby to pass through. Your cervix can be dilated to a couple of centimeters for a few weeks before delivery. This softening can cause the mucus plug to be dislodged and come out.
Does it hurt when they check for dilation? ›Toward the end of pregnancy, vaginal tissue becomes more sensitive, so a cervical exam (which is not known for being gentle) can feel uncomfortable or even painful.
How quickly can you dilate? ›The active stage of labor can range from a woman dilating anywhere from 0.5 cm per hour up to 0.7 cm per hour. How fast your cervix dilates will also depend on if it's your first baby or not. Mothers who have delivered a baby before tend to move more quickly through labor.
What week does cervix start to dilate? ›If you have an uncomplicated pregnancy, your doctor or midwife will typically start checking for dilation after the 36-week mark, notes Ellson.
How dilated should you be to give birth? ›
Stage 2: Pushing and Birth
The second stage of labor begins once you are fully dilated to 10 cm. Your provider will let you know that it is time to start pushing your baby out. This stage can be as short as 20 minutes or as long as a few hours.