North American Registry of Midwives (NARM) Practice Exam

Which of the following is a characteristic of a multigravida's cervix during labor?

1. It requires complete effacement before dilation

2. It starts to dilate without prior effacement

3. It remains unchanged until after delivery

4. It is more prone to tearing than a primigravida's cervix

The correct answer is: It starts to dilate without prior effacement

The characteristic of a multigravida's cervix during labor that is highlighted as correct is that it can start to dilate without prior effacement. This is an important distinction in understanding the labor process in women who have had previous pregnancies, compared to those who are experiencing labor for the first time (primigravidas). In multigravidas, the cervical tissue often has been more supplanted by previous births, which can lead to a different pattern of effacement and dilation. It is common for a multigravida's cervix to show signs of dilation even if it has not completely effaced, making this different from the typical pattern observed in primigravidas, where complete effacement is often necessary before cervical dilation begins. This understanding reflects the physiological changes that occur in the cervical tissue after multiple pregnancies, which can contribute to a more efficient labor process. The increased flexibility and prior modifications of the cervix allow for this early dilation to occur, reducing the overall time spent in the early stages of labor.