Motherhood is all consuming.

Having babies, nursing, feeling the fear of loving someone that much, and there's this baby on your chest, and boom, your entire life has changed.

It's a privilege of being your child's safest space and watching your heart walk around outside of your body.

The truth is.

I can be having the best time being a mom one minute, and then the next, I'm questioning all my life choices.

I'm Lo Mansfield, your host of the Lo and Behold podcast, mama of four Littles, former labor and postpartum RN, CLC, and your new best friend in the messy middle space of all the choices you are making in pregnancy, birth, and motherhood.

If there is one thing I know after years of delivering babies at the bedside and then having, and now raising those four of my own, it is that there is no such thing as a best way to do any of this.

And we're leaning into that truth here with the mix of real life and what the textbook says, expert Insights and practical applications.

Each week we're making our way towards stories that we participate in, stories that we are honest about, and stories that are ours.

This is the lo and behold podcast.

Alright, you guys get ready for it.

Today we are talking about.

The cervix and the cervical exam and before you run away going, yeah, not interested in this.

I just wanna say, hang on a second.

This conversation actually is surprisingly interesting.

I always feel like such a dork because I say like, I love talking about the cervix because it just does a lot of things and it's actually really valuable to understand.

but the conversation even like collectively or socially in the birth world, I think has become really interesting and so.

I wanted to get in here and have, and a quick conversation like this is not gonna be a 45 minute episode about the cervix.

I want this to be a quick hit bite of education for you because I think that this information is super important and I wanna be able to, to keep sending you back to this and saying, Hey, if you have, if someone has some sort of convo online or on Instagram about what you should and shouldn't do in this regard, here's this podcast.

Here's, here's this podcast can remind you of what is and isn't true, and ultimately like that you get to decide about all this.

Okay?

So the conversation socially, collectively, however you wanna say that.

On Instagram, I actually, I've been in this conversation for a long time, right?

Because, like I just told you, I like talking about the cervix, which means I'm in this conversation.

But years ago I had kind of a real.

My most viral reel up to that point of being on social media.

I think it got like five or 6 million views back at a time when it was kind of a really big deal to get millions and millions of views, it was about this topic.

And my real was about having a 37 week cervical exam and essentially saying like, who's still telling us that we have to do this?

Like you don't have to do this.

the real as they do when they go viral was just flooded with comments who are for these cervical exams, who are against these cervical exams, who felt like their cervical exam actually helped like.

Save, if you will, their labor because they needed it for X, Y, z reason.

There were people talking about cervical exams being abusive.

Informed consent.

Uninformed consent.

The comments, were all over the place.

And that's to be expected when something goes viral.

But I also think it shows that this conversation is maybe like more interesting than it appears at the surface, and that there is something to be said in all of this.

what, what I think that needs to be said, and I'll just tell you right now, this end game for this episode, you can hear this and you can walk away, is that you understand that cervical exams are a choice.

But I think that the environment that we're in, this birthing world that we're in is.

Is kind of yelling.

A lot of you can say no.

You can say no, say no, say no, and we've forgotten.

To also say that you can say yes, that this is your choice, that you should know what a cervical exam is, what it tells you, what it doesn't tell you what the pros and cons are, and then you can say yes or no.

So that's the end goal.

That's where we're gonna lay on this plane is that you walk away and you go, okay, now I have my own information to make my own decision, regardless of social media and all the educators yelling at me to deny them or telling me to say yes, because that's what my provider wants me to do.

Like you can fall anywhere you want on this spectrum.

You get to choose.

All right, so one of the first things that I really like, just wanna do at a basic level, and this might sound silly because.

Maybe you're saying, are you kidding me right now?

But is just define what's the cervix like, why does it matter?

And if it's your first baby who, like you may have no idea.

I don't think any of us think about our cervix until we are going through childbirth.

Right?

And so if that's you, really quickly, the cervix is the lower portion of the uterus.

The uterus is like the big organ that your baby grows inside of and gets.

Huge and fills your belly and the uterus, contracts and pushes down.

When we're in labor, it pushes like the force from the uterus pushes baby down and through the body, and when the baby is leaving the uterus, they go through the cervix.

You might hear someone call the cervix, the neck of the uterus.

You probably won't ever hear that term, but just in case it is, it's kind of like the neck, if that helps you kind of visualize it better in your head.

Right now, the cervix exits into the vagina, also called the birth canal, especially when we're talking about the birth process it's kind of sandwich between the bladder and front.

Which is, feels very tiny when you're pregnant and needs to be emptied every 12 seconds.

then the rectum behind, so the cervix kind of sits down there at the exit point for all of this stuff.

The cervix itself, and this is where childbirth it, we get so specific with the cervix.

Makes a ton of change before a baby is born.

So we have dilation and effacement.

It opens, it thins, and then the cervix actually moves where it's at in your own body through your labor.

It move, it changes, its consistency changes, and then the station of your baby.

Changes within your pelvis, and we check on that during a cervical exam too.

So that is, the station isn't really specifically related to your cervix, but it gets checked on during this exam.

And so those are the five things.

Sts dilation, effacement position, consistency, and station that all are getting checked on if someone were to have a cervical exam during labor.

All of those things have to change in some way for your baby to be born vaginally.

So.

They all have value.

This conversation matters, and that is why a cervical exam then becomes part of the labor birth pregnancy conversation as well.

One thing I'll also mention to you related to.

The cervix is that in general during pregnancy, it should be thick and it should be long.

And I'm saying long because effacement measures, its, its thinness and it eventually like thins out and totally d disappears.

But we want it to be thick and close in a certain length.

There's a range of a cervical length, but if we were to see a cervix opening or getting, the thickness kind of shortening.

Too soon that can start to be a concern for like preterm labor or preterm birth.

So typically we're not checking on that.

The expectation is just that all of this stuff works.

But if you have a history of preterm labor or some indication that your cervix might be thinning or shortening too soon, that is something that we're gonna be paying attention to.

So it's not really part of the cervical check conversation I'm having with you right now.

We're talking about more.

The ones at the end of pregnancy during labor where we wanna see the cervix making change.

But in general, the cervix, we want it to be a certain way for the first, let's say eight, eight-ish months or something.

And then we expect to see change.

And if something's changing earlier, that's gonna be checked on by our care team.

It's kind of a different conversation.

You're not necessarily going to say no to someone checking on a cervix at five months because there's signs that it might be shortening or funneling or something like that.

That's also gonna be done like via ultrasound or in other ways and by other means.

So separate combo, but relevant in general to how we want the cervix to be.

And then essentially what we want it to do later on at the.

Right type, if you will.

Okay, so what's a cervical exam?

That's all about the cervix, what it can do.

The cervical exam is the opportunity for someone to actually check the cervix and see if it's doing any of those things that we just talked about.

Is it changing?

Is it moving?

What is going on in there?

Typically a cervical exam is offered around 37 weeks.

That's gonna be the first time you're offered.

And this is a manual exam done by a provider.

It can be doctor midwife, it can be a nurse, typically in your prenatal appointments.

'cause that's when they're first typically offered.

It's gonna be done by your provider, so probably your doctor or your midwife.

But it's a sterile procedure, which sounds like a little dramatic.

But just meaning put on a sterile glove, you lay down and then they go ahead and they check your cervix and see what they can feel.

I will say just like tips for having one done, if you are able to, which not all of us are at nine, 10 months pregnant, if you can kind of like put your feet together and let your knees fall open, that's kind of.

An easier position for them to reach the cervix and get to it.

then if you can prop anything kind of under like top of your bottom base of your spine, that kind of can like lift your pelvis and your hips up off of like the table or wherever you are a little bit, that can often help a provider get to the cervix as well.

So like a, a bed pan, we use those a lot more in the hospital.

We have those laying around.

A rolled up towel, something like that.

I have heard, and I actually have made the suggestion myself, that you can like put your hands in a fist behind your back and lift as well.

Lift your pelvis and kind of your bottom up.

That way for a lot of people, that is a very vulnerable position because it's like your hands are trapped and you're being checked on as well.

So that wouldn't be my first suggestion, but it is another way to kind of lift your pelvis up a little bit for those exams.

So if you feel comfortable doing that, that's an option as well.

So prenatally is when these are typically first offered 37 weeks, 38, 39, certainly as you get closer.

And then these are offered during labor or they are part of the labor process.

And then cervical exams are often part of the triage process.

So that could be part of your labor process.

But if you were to go in.

I don't know, at 40 weeks for a labor check.

'cause you've been in contracting for eight hours at home.

That's often gonna be part of the process.

Hey, we'd like to check your cervix, see if you're dilated at all.

If you definitely are.

Hey, they're gonna keep you.

And if you're not, maybe they have you walk, do some things around the unit and wanna check you like two hours later.

the reason for that, especially in OB triage and in labor, is that.

When we see the cervix changing over time, that's a pretty good indication that someone is in labor or things are changing.

So if we check the cervix and just have like a singular check at one moment in time, it doesn't tell us a ton.

So like if we check it at your 37 week appointment, find out you're dilated.

And that's that it tells us that you're dilated at that moment, but it doesn't really tell us where you'll be an hour later, a week later or a month later.

Whereas if you kind of have the two more, like this triage process that I just mentioned, check once and then checking in a couple hours later and we see change, that's a little bit better picture of, okay, there is something happening right now when it comes to.

Who performs it.

I mentioned already that it can be a provider or nurse.

I think it's nice for you to know that often in the hospital, it is going to be your nurse more often than your provider.

This can depend on who your provider is or, their relationship with their patients, how much they get to be on the floor versus in the office, all of that.

But most often where I practice is that the nurses do a ton of these and then they can.

Call and relay what's going on to the provider and let them know.

And then if it changes their decisions, changes, plan of care, then the nurse can go ahead and, you know, take care of whatever comes next after relaying that information to your provider.

So definitely expect nurses to be very involved in the cervical exam process when you're at the hospital or you're in triage.

Okay, so let's go back to those five things I mentioned that can be looked at during the cervical exam.

If you remember, that was dilation.

Effacement position, consistency, and station.

So dilation is the one that gets all the fanfare, right?

We're going zero to 10 centimeters.

We want the cervix fully open for the baby to come out and through.

Everyone wants to know, am I dilated?

Am I dilated?

Am I dilated?

The zero might also be referred to as closed.

If someone were to say like, your clothes thick and high, that means your cervix is closed, your cervix is not a face, and then high would mean the station of your baby is really high.

Which is like, again, kind of going back to the earlier conversation.

It's what we wanna see in earlier pregnancy when we don't want that cervix doing anything.

We want you to be closed.

Thick and high.

And then conversely, if someone's like, yay, they're complete.

That means your 10 centimeters dilated, your a hundred percent of face that cervix is gone.

That's kind of that opposite end of the spectrum.

Now, effacement, that vocabulary I just mentioned is a percentage number, and so it's about the thickness or that length of the cervix as it kind of like.

Thins out and then the length kind of disappears as well.

It thins and kind of then pulls like up around the baby's head, if you will.

And the effacement is a percentage number that goes between zero and a hundred.

So when you're 0% a face, your cervix is fully thick.

That's, again, that's like how we would want you to be at six months pregnant.

And when you're a hundred percent a face, the cervix is totally thin and gone.

So if you're 10 centimeters and a hundred percent a face.

Cervix is gone, which is great, right, for having a baby.

Anyway, and then the next one is position.

And so this is where the cervix is at in the maternal body.

So it can be posterior, which is like way more towards the back, mid position or anterior, which is like right up at the front, like very easy for a provider to check because when they go ahead and check you, it's just right there.

They don't have to kind of like reach behind or.

I'm gonna use the word the quote, like, go get the cervix, which can, it can feel like that in earlier cervical checks, or maybe like a 37 week one, or the one at the start of an induction.

Often that position of the cervix can be really far back in your body.

It hasn't rolled forward yet, and the provider, it can feel like they have to like really reach for it and go get to it, which, yes, can be uncomfortable for you.

So good to know that sometimes those earlier exams can feel that way.

And then a later exam if you were or to have one or wanted to have one, that later exam might feel a little bit easier.

Okay.

Consistency is the firmness or the softness of the cervix.

So just kind of like how does it feel to the provider?

then the station, I mentioned this briefly, it's not actually about the cervix, it's about where the baby's head is at in relation to your pelvis.

And those numbers go from about like negative three, negative four to zero, which is like kind of the middle through the pelvis.

And then plus one, plus two, plus three is the baby's coming like down and coming out when we get to like the plus three number.

And so that's that last kind of portion of the cervical exam.

And when you hear the numbers together, this is typical.

You'll hear like two.

She's two centimeters, 50% of face and minus three station.

That's that station at the end.

So it's two centimeters dilated.

A face is that middle number, station is the third one, and then you rarely are going to hear them report about the position or the consistency, but I want you to be aware that those are being checked as well.

And that they're all part of the cervical exam and can be used to, yeah, to make choices.

That kind of brings me to the last little thing about all these numbers for me is that question of what numbers matter the most, and I would say that you can't answer that question or that.

I will tell you that one thing matters more than the others.

And that is because progress, when we're talking about labor, progress can be measured in a lot of ways.

And I already told you, dilation gets like all of the fanfare, right?

How dilated are you?

How dilated are you?

And then I would say effacement is the next big thing.

Like are you dilated?

Are you a face?

But all of these other things can indicate that progress is being made, even if dilation hasn't changed.

And I like you to hear that and know that.

So just like.

Put that away, that progress could be indicated.

If baby has come down a station and the cervix is soft and it wasn't prior, like those can be signs, Hey, something's happening in there.

Even if we don't see the big, you know, two or three centimeter change that we were hopeful for.

So just remember that that progress.

It's not about one of these solitary numbers and that that number is the most important.

It can be about all of this collectively, or it can be progress can be indicated by change in just one of these as well.

And in that moment, well then that number matters the most, right?

Because it showed you some change.

And so that that answer of what is the most important, I just don't know that there's an answer to that.

Or you have to say all of them at any different time.

You know, like an, it depends type answer.

All right.

Last thing is putting all these numbers together.

I won't go too much in the weeds with this 'cause we get into all of these numbers and how to use them like you use them to make choices inside of your body or birth, but it, the Bishop score is a tool that we can use.

Where we give a score to each of those five things that we just talked about, that score, we add those scores together, and the score that we then get, like cumulatively can tell us how ripe or favorable your cervix is for induction.

so this becomes incredibly valuable to know all of these numbers, to know this cumulative score when we're talking about introducing.

Pitocin and Pitocin is used like anywhere between like 30 and 50% of labors depending on what like research or evidence you're looking at.

And so that means we need to have good information before we're saying yes to Pitocin.

Pitocin, I feel pretty comfortable saying is overused, but certainly I want you to know that the Bishop score can be part of how you and your team together are deciding.

Should we go ahead and use Pitocin?

Is my body ready to introduce or add Pitocin into my labor?

And this Bishop score is part of answering that question.

The last thing I would say that I want you to hear with that is it's not your job to, to tell your provider, Hey, don't forget to check my Bishop score.

Like they should be doing it.

They are doing it.

But if you wanna be a part of that conversation, you should be.

And if you know these numbers and you know what they mean, it's gonna help you have a really good convo in that.

I think it's time to start Pitocin conversation if that comes up or whatever that looks like for you.

you can say.

Will you like, will you share with me what my bishop score is?

How do you feel about it?

Does that make you feel good about adding Pitt right now?

Does that make me unfavorable and should we try something else?

Like it's just gonna make you a lot more educated to have a really good conversation if that were to come up in your labor.

The conversation of, I think Pitocin and like introducing interventions, I think helps us decide to, or leads us to the part of the conversation here that I wanted get to really, which is like, so do you say yes or no?

Because that's what we're hearing on either side, right?

Is like, is the cervical exam something I should or shouldn't do?

Or sometimes everyone seems like is just telling you stop doing them.

Right?

so to answer that question, we need to understand the, the pros and cons, right?

Like what is it telling you?

And.

What could it potentially do?

Like what are the cons or possible considerations there, and how do you weigh those two things?

And before we get into specific pros and cons, I know I've kind of like hinted at this, but I wanna reiterate that the cervical exam itself doesn't tell us.

A lot.

It tells us what's going on in that specific moment in time.

And if we were to have a prior exam to compare against, it can tell us what has happened, like between those two things, right?

And so it can indicate progress or change and sometimes we need to know that information.

But I think it's important to remember as you work through pros and cons is, is that the cervix is not a crystal ball, right?

And so it doesn't, like if you leave your 38 week appointment and you're three centimeters dilated.

It doesn't really tell you anything.

It doesn't tell you your baby is or isn't coming.

It doesn't tell you you should or shouldn't go on that overnight trip or whether your partner like should or shouldn't go on their work trip.

It just tells you when your provider checked you that afternoon, you were three centimeters, so that can be anxiety producing.

For some, it can give people peace.

That's why I think you kind of get to decide some of this, but just know that it doesn't tell you anything beyond.

What you get to know like in that moment.

The other thing I think it's helpful to know is that the cervix can change really, really quickly.

So a lot of times people do get checked, they wanna know, and then they're super discouraged because it turns out they're one centimeter and they, they're 41 weeks and they were hoping they were three or something like that.

I just want you to hear that it also changes really fast.

So I told you it's not a crystal ball and that applies too.

Am I definitely going into labor or am I not?

Or is it gonna be quick or soon?

Like.

It doesn't tell us any of that.

One of my best friends goes from like zero to 10.

She's done it three times in hours.

Even her first baby, they did not wanna admit her at the hospital, which I have to say I understand as a nurse who's been there.

'Cause she was one centimeter when she got there and had her baby.

I mean, in my head I'm like, thank goodness they kept her, or she convinced them, or they were looking at other signs of labor in her because her dilation was not telling them the full story and she had her baby like an hour later.

It's such a fast labor, so it just doesn't really tell us a lot.

And so make sure you hold that knowledge close as you decide.

Do I wanna get checked?

I do, or I don't wanna get checked.

That you can't use it.

Try not to pin like a lot of hope or anxiety on it, especially in these.

You know, 38, 39, 40 weeks where, where it can change, but it might not, that's all normal if you will.

Okay?

So pros, if we're gonna hold that and remember all of that, one of the biggest reasons that you might wanna say yes is ' cause you just wanna know.

And I just told you if this is gonna cause you angst, like maybe that's a reason to, to not choose it.

If it's gonna give you a lot of peace, just remember that it doesn't fully tell you everything, but wanting to know is valid.

So if you are 38 weeks pregnant and you are dying to know if you are dilated.

Then you can say yes to it with joy and informed consent.

'cause that's what you wanna do.

And I just want you guys to hear that because I feel like people invalidate that as reason.

But if you know the pros and cons and then you're saying yes, please, that's a great reason to do it.

Another reason we've talked about this a little bit with the bishop score is if finding out what the cervix is.

Whatever moment in time if knowing that will change your plan of care.

Sometimes, and sometimes it will.

It might be because of progress.

It might be because there's something going on with baby and if you're close to delivery, maybe we can just go ahead and push instead of C-section.

Like there are decisions like that where.

A quick cervical check in that moment might actually help you make a decision for A or B or yes or no.

And so that can be a time to say yes as well.

talked about the bishop score introducing Pitocin.

That's another time where a cervical exam.

Has a lot of value for a labor process.

So that's another reason, or a pro or someone might say, yep, this is something I need right now.

I think another one is just, this is going to kind of like big umbrella, but if there's a medical reason to be in there looking, and, and I mentioned this at the beginning of, you know, we want the cervix to be long and thick and earlier in your pregnancy, so if there's an indication it's not.

We don't wanna pay attention if there's another medical reason to be in there.

There are other reasons where we might wanna say like, what's going on in there?

Is this labor, is it not?

Is it preterm labor?

Like those might be reasons to check as well.

so that's another reason that someone might be saying, yes, please, like I, I want to know this information will help me and my team make a decision and choice about what we should do next.

And then another kind of last one I would say is that.

Knowing an exam, having an exam can establish a baseline and sometimes that can be valuable.

If that baseline is needed to know what's coming next, maybe that baseline is needed in triage.

And otherwise they aren't gonna keep you because.

You're exhibiting or they see no other signs of labor and maybe the baseline becomes valuable so they can compare.

Maybe the baseline is needed because progress isn't happening, and they're gonna say, we have failure to progress unless there's a cervical examine.

And they can say, actually, wait, there's been progress.

There are times where that might be.

The tool that is needed to indicate what is or isn't going on now, I think that that can be used too often and sometimes used almost like weaponized.

But I also think it's very important to say there are certainly times where, where that is the tool that's needed to kind of maybe keep moving your labor process forward.

Okay.

That gets us into the cons though, or the considerations we wanna have in this regard, which obviously there's two sides to this coin, right?

And it's why a lot of people, I think are saying you can say no, you can say no, it's 'cause there are cons.

So it's helpful that people know them because otherwise they may have been having them in years past and not realizing like, oh, I can say no and there's reasons I might wanna say no.

So one of those we've already talked about it, is that they can be uncomfortable and that's enough reason for a lot of people to say like.

I don't want one, and I know I mentioned this a little bit, but they can be more uncomfortable earlier in pregnancy or earlier in labor.

So you might find like, I don't really want one now, and then you're nine centimeters and it's actually not gonna be that uncomfortable at all because the cervix is right there and you're close and for whatever reason you wanna know.

And so you're, you're.

The comfort level may change and your decision making process about that could change.

When we're talking specifically about that being a con to getting one, the other thing is that they can increase anxiety or cause worry.

So I've already told you in multiple ways that these don't tell us what's going on.

And so if knowing those numbers are gonna make you worry, fearful, sad, anxious.

And otherwise, like you don't need to know, then that could be a reason to say, I don't wanna know because I'm just gonna be so bummed if I'm one centimeter or the reverse of, I don't wanna know because if I'm dilated and I thought I wouldn't be, it makes me feel so nervous tonight.

You know, you can decide based on like, will that be a con to know this value?

How will it impact me?

So that's gonna be part of the process for a lot of people.

Like we've already said, they're not always predictive.

They don't guarantee anything.

So to use that as a pro, sometimes it's like, well, let's find out where you are and that'll help know when this baby's coming.

That's not true.

And so if that lingers, your vocabulary's being used.

It's not true.

It certainly doesn't mean you have to say no, but just know that that is a consideration in this conversation too.

then there's a risk of infection.

We have to say that just each time we introduce a cervical exam, especially if your waters were broken and we're talking about more in labor, the risk of infection is present and can increase each time we go in there.

And then I would say risk of water breaking.

It's small, but I've actually seen it happen.

And I still remember the provider coming out and saying, her water just broke and she had been checking someone in triage and the water broke, which then means they're staying and it's time to have a baby.

And in most instances, that's not really what we want.

Right?

'cause that was not a body that was in labor and it accidentally.

Then water broken and it means here we go.

Right?

And so that, that is a risk.

It's a small risk.

Does not happen that very often, but it is possible.

So I think you need to know that as well.

Okay.

Really quickly, if you are someone saying all of this means like, yeah, I don't want one, but what do I do instead?

Or like, what are the alternatives?

I think a big thing here is gonna be around the, about the care team and the people around you, but there are other ways to know and see labor progress.

Obviously we can look at contraction pattern, like if you're in the hospital and be paying attention to that.

Watching your body cues, seeing, like looking at fetal activity if you were on the monitor.

Sometimes we can see things that indicate like.

Baby might be really low in station, like there's probably some dilation and progress being made.

Emotional signpost is a big one.

I love those.

I talk about those a lot.

And you can listen to my episode on emotional signposts as well for more on what I mean by that.

But all of those things can be used to look at someone and make the.

Like are they in labor decision without only saying, I gotta check your cervix.

That's the only way I know.

So ideally the care team is one that is utilizing all those tools, especially if you're saying, I really don't want my cervix checked right now.

They can look at and assess these other things and make smart decisions with you and for you.

And then I would say, talk to your providers about this prenatally too.

Particularly if you're thinking, I just don't want this.

And just have those combos about, I don't want one in triage or like if I come in in labor.

Is there something, you know, I suggest telling the triage nurse, or can we give you a call first?

Just kind of feeling that out of what the process will look like, not just your provider's opinion on it, but also like how it will go at the hospital that you're going to have your baby at, how things like that might be received.

And see if your provider can give you some good feedback about how to navigate that because they're familiar with.

Nurses and triage at these facilities that you're gonna have babe at and you are not.

Right?

So you could feel so good with your delivering provider, but then the nurse in triage is gonna be someone you've never met.

And so I, I would hate for you to get there and think my provider's on board with everything that we've chatted about, but now there's new person isn't.

And so sometimes prenatally having those conversations can help you figure out what it'll look like.

When you do get to the hospital to have baby, if that's where you're going.

All right, you guys, big takeaways as we kind of wrap this up here is, I don't need to go back through all of this.

I think you got these short snippets.

Cervical exams are optional.

These numbers are tools.

They don't tell us everything, but at times they tell us.

Something, multiple parts of the cervical exam matter.

It's not just dilation, although that one is really fun to see change.

You can trust your body, you can trust the timeline that your body is establishing.

When we talk about cervical exam and progress and how the two go together.

then I think that I really want you to hear is that being informed in all of this will help you then decide that you can be the person who says yes, that you can be the person that who says no.

You can be the person who changes their mind anywhere in between.

So if you feel like all the inputs are saying, you need to be denying this, you need to be denying this.

Or the flip is everyone saying like, stop saying no all the time because what's the big deal that I want you to hear?

There's just all that gray space in the middle.

And the biggest thing, going back to that very first point I told you when we first got started.

Is that you get to decide and whatever you decide, that is your choice and that is your right.

And there is not a right and there's not a wrong.

This is just about you being a part of all of this.

Thank you so much for listening to the Lo and Behold podcast.

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