While your baby is growing inside your uterus, it presses down on the opening to the uterus known as the cervix. Some women suffer from a weakened cervix during pregnancy, a condition known as an “incompetent cervix.” Although some women take issue with the term “incompetent” – and there’s probably a better way to describe it – it is the standard way to describe a condition that may complicate your pregnancy.
Your cervix is essentially a long opening to your uterus. Before you are pregnant, and throughout most of your pregnancy, the cervix is long and firm. There is a small opening at the end that fills with mucus (your mucus plug) when you are pregnant. At the very end of your pregnancy, your cervix becomes shorter and more open (effaced and dilated) to allow the baby to be delivered. An “incompetent” cervix is one that is abnormally short and weak, or has begun to efface and dilate prematurely.
A weakened cervix can result from previous surgery on the cervix, a malformation of the cervix, or a difficult birth prior to your current pregnancy. If you suspect you may be at risk for cervical problems, you should keep an eye out for troublesome symptoms such as period-like cramping, unusual discharge or bleeding, or a feeling of pressure down in your lower abdomen. If you are experiencing these symptoms, your doctor should be able to check the condition and length of your cervix through a pelvic exam or ultrasound during the early stages of your pregnancy.
An incompetent cervix is found in only about 1 in 100 pregnancies. However, if the cervix is truly weakened, it could result in premature birth or late miscarriage – and unfortunately, many women find out that they have this condition only after they miscarry.
If you are in the early stages of your pregnancy and you have been diagnosed with cervical insufficiency (often as a result of an earlier miscarriage), you may undergo a procedure called a cerclage. In the cerclage procedure, your doctor stitches a small band around the opening of your cervix to keep it closed. Your doctor may perform the procedure between the 14th and 16th week and remove the sutures in the 36th to 38th week. (Some variations on the cerclage are permanent and will require a cesarean delivery.) The procedure cannot be performed if your cervix is dilated more than 4 centimeters, or if your water has broken.
However, there are some questions about the efficacy of the cerclage procedure because of the risk of infection, ruptured membranes, or other complications. If your doctor does not perform a cerclage (or in some cases, even if she does), she may put you on bed rest for some or all of the rest of your pregnancy to keep the weight off your cervix.
Although it can be frightening to receive this diagnosis, remember that most moms who have been diagnosed with an “incompetent cervix” go on to have healthy babies. You can do your part by keeping yourself healthy throughout your pregnancy and staying on bed rest if your condition calls for rest. Before long, your cervix will have done the job it needs to do and your body will be ready to deliver a healthy new baby.