Cervical Ripening (Labour Induction)

What is Cervical Ripening?

When you go into labour, the shape of your cervix changes to allow your baby to be born.  The process by which the cervix becomes thinner and softer is called cervical ripening or cervical effacement.  This article will discuss cervical ripening, how it’s measured, when it occurs, and why it’s important for labour induction.  Cervical ripening techniques (including acupuncture and acupressure) for labour induction will also be discussed. 

How is Cervical Ripening Measured:

In the beginning of pregnancy, the cervix is generally about 3.5 – 4 cm long.  However, it becomes softer, thinner, and shorter as you approach delivery.  This allows the baby’s head to come lower into the uterus, and eventually pass through the fully effaced cervix into the birth canal (vagina).  Cervical effacement is measured from 0 to 100 percent.  If your cervix is longer than 2 cm, you are 0% effaced.  50% effacement is when your cervix is about as long as the neck of a Mason jar.  When your cervix has completely thinned out, and is as thin as a piece of paper, you have reached 100% effacement.

When Does Cervical Effacement Occur?

You may experience cervical effacement days or even weeks before you go into labour.  This tends to be more common for first time mothers.  However, if you’ve given birth before, you may experience cervical effacement only a few hours before going into labour. 

Cervical Effacement vs Dilation:

Cervical effacement is different to cervical dilation.  While effacement describes how thin the cervix has become, dilation refers to how open the cervix is (from 1 to 10 cm).  Effacement tends to occur before dilation for first time mothers.  But dilation may occur first for mothers who’ve already had children.  However, you must be fully (100%) effaced as well as 10 cm dilated before attempting to give birth to your baby. 

Cervical Ripening for Labour Induction:

Labour usually occurs around the 40th week of pregnancy.  However, some women do not go into labour even when they reach week 42.  This is considered a post-term pregnancy, which may be dangerous for your baby.  In this situation, your doctor may suggest medically inducing your labour.  Induced labour may also be recommended in other situations, to protect the health of your baby or yourself.

A crucial part of labour induction is cervical ripening.  The cervix must be fully effaced for you to give birth.  If your cervix hasn’t effaced naturally, medical intervention can help to start this process.  Some techniques used to promote cervical effacement and dilation include applying medications called prostaglandins, using an osmotic dilator, or a rubber catheter.

How Can Chinese Medicine Help?

Traditional Chinese Medicine is a valuable option when it comes to labour induction and cervical ripening.  Treatment techniques like acupuncture and acupressure are not only natural and minimally invasive, but they rarely present the risk of unwanted side effects.  Researchers have found that both acupuncture and acupressure can effectively increase cervical effacement, as quoted below.

“Acupuncture at points LI4 and SP 6 supports cervical ripening at term and can shorten the time interval between the EDC and the actual time of delivery.”

“The results showed that acupressure is a safe technique and leads to cervical ripening. Thus, regarding the desired results that were achieved when mothers applied acupressure themselves, it could be suggested that it is beneficial for mothers to be trained to apply this method at home.”


Overall, cervical effacement or ripening is a natural part of labour.  But when this process doesn’t happen naturally, your doctor may suggest labour induction treatment. Cervical effacement is a vital step in labour induction, which can be brought on through medications or artificial dilation methods.  However, acupuncture and acupressure are also effective and natural techniques that can help promote cervical effacement safely.


Marcin, A. (2020, February 12). Everything You Need to Know About Cervical Effacement. Healthline. https://www.healthline.com/health/pregnancy/cervical-effacement?utm_source=ReadNext

Rabl, M., Ahner, R., Bitschnau, M., Zeisler, H., & Husslein, P. (2001). Acupuncture for cervical ripening and induction of labor at term – A randomized controlled trial. Wiener klinische Wochenschrift, 113(23-24), 942–946. https://pubmed.ncbi.nlm.nih.gov/11802511/

The Healthline Editorial Team. (2016, March 28). Management of Induced Labor. Healthline. https://www.healthline.com/health/pregnancy/management-labor

Torkzahrani, S., Ghobadi, K., Heshmat, R., Shakeri, N., & Jalali Aria, K. (2015). Effect of acupressure on cervical ripening. Iranian Red Crescent Medical Journal, 17(8). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4586896/