As you are sitting, waiting with a look of patience (although secretly inside you are as impatient as a child in queue at the grocery store) to find out the results of your latest perinatologist ultrasound results. After some quick measurements done by your perinatologist, for the second or third time in one appointment, you hear the words “I don’t want to worry you but your cervix has shortened.” Even though you have no idea what the cervix really does throughout the pregnancy, your heart stops and it is hard to heard the what is being told to you after these words. What is a cervix and why you should start taking precautions right away? Click for more information and my experience with a shortened cervix.
Just as probably all of you whom are reading this for the first time, you have sat in the perinatologist office and heard those two words that could possibly change your life, “shortened cervix”. It is scary, since not only do you not understand the perinatologist talking about a cervix, but if you are anything like me, you are leave the office thinking you are instantly going to go into preterm labor the next week.
What is a cervix and what is it’s role in pregnancy? The cervix plays a very important role in pregnancy, as it is what holds the vagina to the uterus. Normally this round, cylinder-shaped piece of cartilage covered in tissue is around 4-5cm when not pregnant. A healthy cervix will be around 2.5-3.5cm. Anything under 2.5cm is said (at least by my OB/GYB) to be too short and could cause pre-term labor. It’s basically the gate-keeper of your babies while pregnant, holding them in your uterus until it is time for them to come out during labor.
What does the cervix do during labor? Counting down to the days of the birth of your baby/babies, your cervix will go through many changes. You might have heard the term, “Effacement”? Well, effacement basically means your cervix shortens, normally around week 34, thanks to contractions of the uterus. Then right before birth, your cervix will open, called ‘dilation’, to around 10 cm. This opening is where your baby will soon come out of our uterus and into your vagina to enter the world.
What does it mean a “shortened cervix”? The cervix is normally a certain length, see above. So when it shortens, this means just as it sounds, the length of it has shortened. My cervix went from 3.6cm in week 20 to 2.26cm in week 23. Although my length was completely in the safety zone, my team of specialist for this pregnancy was worried I was going overboard and should slow down to assure it did not get worse. Again, anything under 2.5cm is dangerous and could be a sign for pre-term delivery (I’ve head 20% chance but I’m not certain). Now my cervix is back up to 2.91cm, after just one week.
Why causes the cervix to shorten? There are so many forums out on the internet explaining multiple reasons, so I asked my OB/GYN this exact question. He stated there are two reasons if otherwise you have a healthy pregnancy: 1. You have been doing too much activity and your cervix is ‘feeling the pressure’. 2. The weight of your baby/babies is too heavy and it is having a hard time keeping up, especially true in multiple pregnancies with smaller women. In my case, my cervix shortened, we assume, because of too much activity and the increase of the babies’ weight on my tiny framed body. It is said though a cervix can change from one day to the next, drastically.
What can be done about a shortened cervix? As with any modern medicine, doctors will prescribe different ‘cures’ to this threatening issue. In this case, your cervix should be monitored until the end of pregnancy. My team of specialists suggested the normal textbook approach of 1 week’s worth of partial bed rest (I like to call it ‘couch potato rest’) and a 200mg progesterone suppository nightly. For a singleton pregnancy, bed rest probably would have been recommended without the hormone, however with multiples situations can escalate rather fast so it is best to take the situation full force in the beginning. So, this meant I was to be lazy for one-full week (difficult for a busybody such as myself) and remove any activity that can not be done lying down. No lifting was allowed and the only time I was suggested to get up was to heat up meals, use the restroom and take showers. After the one week, I went to get an ultrasound once again and measure the twins health and length of my cervix. Thankfully my cervix went back up to a great length, everyone was thrilled, and no further action was taken. Reading forum after forum, I have heard of others having to go into the hospital to have an IV of magnesium sulfate or other steroids to help strengthen the baby/babies lungs if born prematurely. If shown earlier than 24 weeks, some mothers have had their cervix stitched closed and/or been up in the hospital until the birth of their tiny bundle/s. Again, it all depends on the doctors and situation.
Who gets a shortened cervix? Unlike other illnesses or prenatal issues, a shortened cervix really is not something anyone can control. It can not be measured at home, nor can it be predicted. Some women whom have had preterm babies due to a shortened cervix come around the second time and have a completely normal pregnancy. So if you have a shortened cervix, please do not feel as though it is you or anything you have done, it is just natural taking its course.
Does a shortened cervix absolutely mean pre-term delivery will occur? No! This is something I was very worried about and asked my team of doctors possibly too many times. Twins are naturally born early, induction is done no later than 38 weeks so preterm twins are very premature and can be set in the hospital NICU for weeks/months if too early. There is no reason though, as long as your cervix is being monitored and you are taking it easy to have a full-term baby/babies. In my case, I am going to take the hormone pill once nightly until I get close to my 38 weeks and continue with no outside exercise and not lifting more than 6lbs at a time. My team of specialists suggest anyone over 29 weeks to do the same with multiples, singleton pregnancies are completely different than multiples. My team is expecting I go until term if my cervix continues to stay at the 2.9cm measurement for a few more weeks. Note: A cervix will continue to slightly decrease as full-term comes closer, not in the 2nd trimester or early 3rd though.
Is cervix funneling and/or an incompetent cervix the same thing? No, these are completely different.
Can a cervix shortened if vegetarian and/or vegan? Dietary preferences have absolutely nothing to do with the length of the cervix.
When I heard my cervix had shortened, I was frightened for the safety of my twins, I’m not sure I slept one night during my week of mandatory bed rest. I felt helpless and clueless as to what was going on with my body, a healthy pregnancy until this very moment tossed a curve ball right in my direction. Thankfully I was able to take it easy and listen to my doctors, so things are back to a normal state. As far as I am careful and do not overdo it, I am in the safety zone (we hope). If you are in the same situation though, I hope this post will help you understand you did nothing wrong. In most cases, your cervix can grow as long as you are careful and listen to your doctors. Soon we will all have healthy, happy baby/babies to coo over and this moment of relaxation will be behind all of us.
Comment Section: I would love to hear from any of you with the same situation, how your doctors went about helping and anything else to share with others going through this same situation. We are all in this together, let’s help each other out and share our experiences.