cervix and proprioception

Hi folks,

Just some reflections as I wait out these last days/weeks.
First, one of my favorite "factoids": there is a sixth sense,
called "proprioception", which is our sense of where our
own bodies are and what we're doing. But, it doesn't seem
to extend to every body part. Most pertinently here, I
don't have any awareness of my own cervix unless something is
happening to it. So, I don't think it's covered by
proprioception. Which just makes it all the more
surprising when the baby thumps into it (ouch!)
and I'm suddenly aware of it...

I wonder if everyone is the same in this regard, and what
the generalizations are about which body parts are subject
to proprioception, and which we can only feel if, say,
the nerves there report pain....

Emily
--
DS 5/02
EDD Labor Day 9/5/05

in article , Emily at
wrote on 8/18/05 12:05 PM:

Hi folks,

Just some reflections as I wait out these last days/weeks.
First, one of my favorite "factoids": there is a sixth sense,
called "proprioception", which is our sense of where our
own bodies are and what we're doing. But, it doesn't seem
to extend to every body part. Most pertinently here, I
don't have any awareness of my own cervix unless something is
happening to it. So, I don't think it's covered by
proprioception. Which just makes it all the more
surprising when the baby thumps into it (ouch!)
and I'm suddenly aware of it...

I wonder if everyone is the same in this regard, and what
the generalizations are about which body parts are subject
to proprioception, and which we can only feel if, say,
the nerves there report pain....

Emily
--
DS 5/02
EDD Labor Day 9/5/05


Interesting post Emily.

If really accurate dilation information were needed, it would be so nice if
cervical proprioceptors could tell the woman and she could tell her midwife
or obstetrician.

Maybe some women can do this?

Here is an interesting study which explicitly indicates that midwives and
doctors generally use ONLY proprioception to sense cervical dilation...


Am J Obstet Gynecol. 1995 Sep;173(3 Pt 1):942-5. PubMed abstract
*
Accuracy and intraobserver variability of simulated cervical dilatation
measurements.
Phelps JY, Higby K, Smyth MH, Ward JA, Arredondo F, Mayer AR.
Department of Obstetrics and Gynecology, Brooke Army Medical Center, San
Antonio, Texas, USA.
OBJECTIVE: Our purpose was to assess the accuracy and intraobserver
variability of clinical cervical diameter measurements among obstetric
health care providers. STUDY DESIGN: Polyvinyl chloride pipes 1 to 10 cm in
diameter were mounted in cardboard boxes and used to simulate cervical
examinations. The boxes were designed so that the examiner had to rely
solely on proprioception to determine the inner diameter. RESULTS: A total
of 1574 simulated cervical diameter measurements were obtained from 102
different examiners in a two-part study. The overall accuracy for
determining the exact diameter was 56.3%, which improved to 89.5% when an
error of +/- 1 cm was allowed. Intraobserver variability for a given
diameter measurement was 52.1%, which decreased to 10.5% when an error of
+/- 1 cm was allowed. CONCLUSIONS: Cervical diameter measurements obtained
by digital examination are precise when an error of +/- 1 cm is allowed for.
Intraobserver variability is 50% and is an important consideration when
evaluating dysfunctional labor.


DEVICES FOR CERVIMETRY...

From a patent application...


"Currently, the gold standard of measurement for dilation, head orientation,
station, effacement and cervical consistency is the human hand. However,
this measurement method is not only unsanitary, it is also intrusive and
inaccurate. Since the accuracy and meaning of the measurements depends on
the person measuring (and even for a same person a 1 cm error is considered
normal), when shifts change, measurements change. In addition, it is
hypothesized that the cervix dilation increases momentarily during
contraction, and fetus head location and orientation changes. These
variations cannot be measured continuously in a reliable manner manually,
reducing the amount of information available, for example, the effect of
each contraction.
[0005] Various mechanical and electrical systems have been devised to
measure cervical dilation and/or fetus head location, for example as
described in "Cervimetry: A Review of Methods for Measuring Cervical
Dilation During Labor", Obstetrics & Gynecology Survey, Vol. 55, No. 5, 2000
and U.S. Pat. Nos. 5,222,485, 6,039,701, 6,246,898, 5,935,061 and 6,200,279,
the disclosures of which are incorporated herein by reference. These methods
include, for example, Obstetric gloves incorporating a measuring string,
finger mounted angular V calipers, Cervix mounted angular V calipers,
induction transmitters and receivers clamped to two sides of the cervix
opposite each other, a multi-switch membrane inserted in the uterus and
pressed between the cervical internal os and the fetal head and magnetic
filed position sensors.
[0006] A Ph.D. thesis By Robert Neal Wolfson, of September 1974, submitted
to Case Western University, Department of Biomedical Engineering and titled
"An Instrument for the Continuous and Quantitative Determination of Fetal
Descent by Measurement of Ultrasonic Transit Time (1975)", the disclosure of
which is incorporated herein by reference, suggests using ultrasonic waves
and triangulation..."
http://www.freshpatents.com/Birth-mo...ptan2004023619
3.php

Todd

I remember when I was a child and doing dancing, a teacher once said you
should know where your arms are, it doesn't seem to be something that is
automatic, ask a class of 8 year olds to stick there arms out horizontally
you'll get quite a variety of things happening, with a class of 12 year olds
they should be reasonably reliable. So it's something you learn with other
parts of the body, but I've never heard of anyone ever being able to know
without touching how dilated they are. Even feeling pain doesn't seem to
make any difference, the 3 VEs I had on the day Ada was born all felt the
same, one I was tight closed, the next 6cm, then fully dilated, I could feel
them all in exactly the same way, even though what was being felt was not at
all the same.

Anne

"Emily" wrote in message
...
Hi folks,

Just some reflections as I wait out these last days/weeks.
First, one of my favorite "factoids": there is a sixth sense,
called "proprioception", which is our sense of where our
own bodies are and what we're doing. But, it doesn't seem
to extend to every body part. Most pertinently here, I
don't have any awareness of my own cervix unless something is
happening to it. So, I don't think it's covered by
proprioception. Which just makes it all the more
surprising when the baby thumps into it (ouch!)
and I'm suddenly aware of it...

I wonder if everyone is the same in this regard, and what
the generalizations are about which body parts are subject
to proprioception, and which we can only feel if, say,
the nerves there report pain....

Emily
--
DS 5/02
EDD Labor Day 9/5/05


Hmmm, that's an interesting thought. Wouldn't it be nice if we could feel
what was happening down there? I like Todd's idea of telling the midwife
how dilated it is...much easier! Also would make visualization of the
cervix thinning and dilating easier when you're in early labor if you had
corresponding nerves. Actually, same goes for the uterus and other internal
organs....we know they are there but unless they hurt, we can't point to our
liver, etc.
FWIW, you also have no proprioception on the tip of your nose. I wonder if
that's why it's used during sobriety tests (touch your nose)? That ability
may be the first to go because you can't really feel your nose, just have a
sense of where it is based on feeling other parts of your face.

Neat subject line!

Amy

Interesting info, Todd. Though I have to say none of
the other methods suggested in the patent seemed (on
quick read) to be any less intrusive or unsantiary than
the current one.

As for letting the woman tell the midwife/OB where she's
at, I guess when it comes to deciding when to push, there's
the pushy feeling, but that doesn't help measure progress
along the way...

Emily

Anne Rogers wrote:
I remember when I was a child and doing dancing, a teacher once said you
should know where your arms are, it doesn't seem to be something that is
automatic, ask a class of 8 year olds to stick there arms out horizontally
you'll get quite a variety of things happening, with a class of 12 year olds
they should be reasonably reliable. So it's something you learn with other
parts of the body, but I've never heard of anyone ever being able to know
without touching how dilated they are. Even feeling pain doesn't seem to
make any difference, the 3 VEs I had on the day Ada was born all felt the
same, one I was tight closed, the next 6cm, then fully dilated, I could feel
them all in exactly the same way, even though what was being felt was not at
all the same.

Interesting. And it would seem that proprioception takes a while to
catch up with growing bodies, which is why some folks get klutzy after
a growth spurt and why I keep banging my belly on the kitchen cabinets/
drawers! (Ouch!)

Emily

"Emily" wrote in message
...
Hi folks,

Just some reflections as I wait out these last days/weeks.
First, one of my favorite "factoids": there is a sixth sense,
called "proprioception", which is our sense of where our
own bodies are and what we're doing. But, it doesn't seem
to extend to every body part. Most pertinently here, I
don't have any awareness of my own cervix unless something is
happening to it. So, I don't think it's covered by
proprioception. Which just makes it all the more
surprising when the baby thumps into it (ouch!)
and I'm suddenly aware of it...

I wonder if everyone is the same in this regard, and what
the generalizations are about which body parts are subject
to proprioception, and which we can only feel if, say,
the nerves there report pain....

I don't know. I think I have a pretty good understanding with my cervix. I
spent a bit of time talking to it and DD in the few weeks before she was
born, saying we were inducing early and she was going to have to be ready to
be born then, and it was going to be an easy labour etc etc. It worked that
time, but I doubt it's ever going to have to prove itself in a repeat
performance, so we'll never know! ;-)


--
Amy
Mum to Carlos born sleeping 20/11/02,
& Ana born screaming 30/06/04
http://www.freewebs.com/carlos2002/
http://www.babiesonline.com/babies/a/ana%5Fj%5F2004/
My blog: http://spaces.msn.com/members/querer-hijo-querer-hija/

V. wrote:
FWIW, you also have no proprioception on the tip of your nose. I wonder if
that's why it's used during sobriety tests (touch your nose)? That ability
may be the first to go because you can't really feel your nose, just have a
sense of where it is based on feeling other parts of your face.

I didn't know that about the tip of the nose. How cool!

Reminds me of a game that we used to play at summer camp: get
a bunch of people in a circle, and have them sit on hands and
knees, with their hands like this (where each letter represents
a different person):

.... B A C B D C E D F ...

(So that in between any one person's hands, there's two other
hands: one from the person on their left and one from the person
on their right.)

Then, you have to go around the circle and "tap" your hands so
that the "tap" moves around the circl. If you're person B above,
you tap your left hand, then wait for A to tap his right hand
and C to tap her left hand before you tap your right hand.
It's hard to do this smoothly, and I wonder if it's partially
our senses of vision and proprioception being at odds with
each other.

Emily

Mum of Two wrote:

I don't know. I think I have a pretty good understanding with my cervix. I
spent a bit of time talking to it and DD in the few weeks before she was
born, saying we were inducing early and she was going to have to be ready to
be born then, and it was going to be an easy labour etc etc. It worked that
time, but I doubt it's ever going to have to prove itself in a repeat
performance, so we'll never know! ;-)


Wow -- cool that it worked.

Emily

"V." wrote in message
...

Hmmm, that's an interesting thought. Wouldn't it be nice if we could
feel
what was happening down there? I like Todd's idea of telling the midwife
how dilated it is...much easier! Also would make visualization of the
cervix thinning and dilating easier when you're in early labor if you had
corresponding nerves. Actually, same goes for the uterus and other
internal organs....we know they are there but unless they hurt, we can't
point to our liver, etc.

I find the mother's intuition is usually accurate when she "knows" how far
dilated she is and when she is fully dilated or not...

Carl