Mumbai-based Mitali Patil (name changed), 27, had a vaginal birth, but her recovery was painfully slow. She bled for almost two months post-delivery and experienced much pressure and pain.
“Since I was breastfeeding, I did not ovulate for the next 14 months after the birth of my baby girl. But during this recovery period I felt that my cervix was extremely tender, especially post-sex,” she says.
When Patil visited her gynaecologist to share this problem, she found that she had a ‘torn cervix’ or what is medically called an ‘insufficient cervix.’
What is a cervix?
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A cervix is the narrow, tubular end of the uterus that goes into the vagina. When you are not pregnant, this cervix is slightly open at the end to allow sperms to enter the uterus and also to ease out menstrual blood.
When you are pregnant, secretions fill up the canal and form a protective mucus plug.
During a normal pregnancy, the cervix remains long, closed and firm. By the third trimester, it begins to loosen up, grows longer and dilates, to prepare for the impending pregnancy.
What is a torn cervix or insufficient cervix?
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If you hear the words ‘torn cervix’ or ‘insufficient cervix,’ it means that the cervix has dilated before time. In such a case, the following problems are likely to occur:
- It can cause you to miscarry during the second trimester
- Labour typically begins between 16 and 24 weeks
- It can cause the water to break before 37 weeks
- It can result in preterm delivery
Although a torn cervix does not really have a specific reason, there are certain reasons that could lead to this problem.
Causes of a torn cervix?
- If you are pregnant with more than one baby
- If you had a torn cervix or insufficient cervix during your previous pregnancy
- If you have had miscarriages in the past, especially during the fourth month
- If you have had late-term abortions
- If you have not had a fully developed, normal cervix
While these complications may cause a torn cervix, it is usually difficult to identify this medical condition. You may have no symptoms or mild symptoms between 14 and 20 weeks. So here’s how you can spot a torn cervix:
- Pelvic pressure
- Lower backache
- Premenstrual-like cramping
- Increased vaginal discharge
- Spotting or light bleeding
Remember that there is no way to screen a torn cervix, however, your doctor may prescribe ultrasounds or routine pregnancy scans that begin in the 16th week of pregnancy. This is to measure the length of the cervix and check if it is loose.
Treatment of a torn cervix
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If your doctor has suggested an ultrasound and finds that you have a torn cervix or that it is dilating, then she may advise you to some bed rest. You may also be given the following instructions:
- You would be advised to avoid having sex
- Your doctor may also suggest a cerclage (a cervix stitch). This is usually done for the duration of the remaining pregnancy and you may also be given a medicine for stopping miscarriage. These stitches are removed at the end of the pregnancy before the labour begins.
- In some cases, experts also recommend progesterone medicines instead of a cerclage
If you have been recommended a cerclage, it does not mean that you will go through the same in your next pregnancy as well.
However, in any case, you must consult with your doctor to understand the basic problems and ways to deal with them, since each pregnancy is different for different women.