North American Registry of Midwives (NARM) Practice Exam

What is the primary difference between a primigravida's cervix and a multigravida's cervix at the onset of labor?

1. A primigravida's cervix dilates first, while a multigravida's effaces first

2. A multigravida's cervix dilates first, while a primigravida's effaces first

3. Both need to efface before dilation starts

4. Both dilate simultaneously

The correct answer is: A multigravida's cervix dilates first, while a primigravida's effaces first

The primary difference at the onset of labor between a primigravida's cervix and a multigravida's cervix is that a multigravida's cervix often dilates first, while a primigravida's cervix tends to efface first. In the context of labor, dilation refers to the opening of the cervix, whereas effacement involves the thinning and shortening of the cervix. For primigravid women, the cervix typically needs to undergo effacement before significant dilation can occur, as their tissues are less pliable due to first-time changes. In contrast, women who have previously given birth (multigravidas) may have already experienced changes in their cervical tissue and thus may show dilation before significant effacement occurs in subsequent pregnancies. This reflects the physiological adaptation of the cervix with repeated pregnancies, allowing for different labor progressions based on past experiences. In this context, understanding the mechanisms of cervical changes can help midwives manage labor expectations and provide appropriate support to mothers based on their obstetric history.