North American Registry of Midwives (NARM) Practice Exam

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What is the typical condition of a term primigravida's cervix prior to labor?

100% effaced and 2 cm dilated
50 to 60% effaced and 1 cm dilated
30% effaced and 3 cm dilated
Full dilation and no effacement

The correct answer is: 50 to 60% effaced and 1 cm dilated

A term primigravida, or a woman who is pregnant for the first time and has reached full term, typically presents with a cervix that is partially effaced and slightly dilated before labor begins. The correct condition often observed is approximately 50 to 60% effaced and around 1 cm dilated. This stage indicates that the cervix is undergoing the necessary changes to prepare for labor but has not yet reached the complete effacement or dilation required for active labor. Effacement refers to the thinning of the cervix, while dilation refers to the opening of the cervix. In the early stages of labor, especially for first-time mothers, the cervix can take longer to reach full dilation, hence the common findings of partial effacement and minimal dilation. In other scenarios, such as full dilation and no effacement, the cervix would be at a stage beyond what is typical prior to the onset of labor. Similarly, being 100% effaced or 30% effaced with greater dilation indicates conditions that aren't typical for a primigravida just before labor commences. Understanding these cervical changes is crucial for midwives in assessing the readiness of a woman for labor.