Effacement

Definition

Effacement is the progressive thinning and shortening of the cervix that occurs before and during labor, expressed as a percentage from 0% (thick) to 100% (fully effaced, paper-thin).

Relationship With Dilation

In primiparas, effacement often completes before significant dilation, such as in multiparas, effacement and dilation progress simultaneously, both must reach completion (100% effaced, 10 cm dilated) before delivery.

Assessment

Cervical effacement is assessed by digital vaginal exam; report as 0 to 100%. The cervix normally measures about 2 cm. At 50% effacement it is about 1 cm, 100% it feels paper-thin.

Nursing Considerations

Combine effacement, dilation, and fetal station to describe labor progress. Monitor fetal heart rate and maternal vital signs. Provide comfort measures (position, breathing techniques, epidural as requested). Avoid excessive cervical exams to reduce infection risk, especially with ruptured membranes.

NCLEX Relevance

Recognize effacement, dilation, and station as the three measures of labor progress.