I was pregnant with our first baby. Everything was going great. We had just found out we were having a baby girl, and we had already picked out her name. I was planning my baby shower, which would be held on the other side of the country as I lived in California with my military husband and the rest of my family was on the east coast.

Everything was going great.

Until it wasn’t.

Intimacy is an important part of our marriage, and fortunately for me (and my husband!), my libido did not decrease as a result of pregnancy. In fact, it increased. We took proper precautions during sex to ensure that I was safe and the baby was safe, but after one daytime romp in the sack, we ended up rushing to the hospital.

Our afternoon delight was met with a huge pool of blood. Bright red, scary, and enough to completely ruin our sheets and soak through our mattress. On the way to the hospital, all I kept thinking was, “Oh my God. I’m only 22 weeks. They won’t even try to save her.” It was one of the scariest moments of our lives.

We were rushed up to labor and delivery where the first thing the doctors did was check for her heartbeat. It was there, and it was strong. Next they checked to see if I was in preterm labor. I was not contracting and according to a transvaginal ultrasound my cervix was closed. Phew. I felt like we dodged a bullet.

“But your cervix is a little short,” said the resident doctor (who, as it turns out, was at a housewarming party the week before for one of my husband’s colleagues. And now he had a wand up my vagina. Embarrassing is just one way to put it).

As a first-time mom who went to a Catholic high school where sex education was not even discussed as an option, I had no idea what this even meant. I didn’t know cervixes were of different lengths. I didn’t know they opened and closed. I wasn’t even really sure where my cervix was or what exactly it did.

What is a cervix?

Your cervix is a small opening at the bottom of the uterus that connects the uterus and the vagina. When you are not pregnant, your cervix is pretty short and closed. However, during pregnancy, your cervix will lengthen to prepare for birth. It stays closed until you start getting closer to labor in which it will begin to dilate. In addition, it will also start to shorten again as you get closer to labor. In fact, shortening, thinning, and dilation of your cervix is how your midwife or doctor will determine how close you are to delivering your baby.

However, some women have a shorter cervix to begin with, and short cervixes are often a factor in preterm labor. This is because if a cervix starts off shorter than normal, the shortening that occurs as you get closer to birth can cause it to be too short too early- resulting in preterm labor and birth.

How do you know if you have a short cervix?

Many people don’t even know they have a short cervix before they are pregnant for the first time. There are no outward signs or symptoms unless you have carried a child before. If you have carried a child before, the signs of a short cervix include:

  • Spontaneous labor before 37 weeks
  • Previous second-trimester miscarriage
Additional signs of a short (aka incompetent) cervix can be found during your second trimester. These signs include:

  • Unusual cramping
  • Pelvic pain or pressure
  • Bleeding
  • Backache
  • Vaginal discharge change

Of course, these symptoms in and of themselves are normal for pregnancy. But you can always ask your doctor to check the length of your cervix if you feel it's necessary, especially if someone in your family has a short cervix as it could be genetic.

A doctor will measure your cervix by doing a transvaginal ultrasound. If you have signs or symptoms, they will often do this at the beginning of your second trimester. If your cervix is less than 25 mm, you will be diagnosed with a short cervix.

However, cervical measurements are not a normal part of prenatal treatment, so if you do not have a genetic history or signs of a shortened cervix, your doctor may offer to measure your cervix. You can always ask them to, but it may not be covered by your insurance.

What causes a short cervix?

As mentioned above, a short cervix may be genetic. You may want to ask your doctor to check your cervix length if your mom or someone in your family has a short cervix and has a history of preterm labor or second-trimester miscarriages. In addition, a short cervix can be caused by trauma to the cervix during a medical procedure like a dilation and cutter age (this is very rare, though), trauma to the cervix during a previous birth, cervical rupture, or exposure to the hormonal drug diethylstilbestrol in utero.

What can happen if you have a short cervix?

The biggest reason a short cervix is an issue for pregnant women is that it can cause preterm labor.

Preterm labor is labor that occurs before 37 weeks of gestation. It can cause several complications including stillbirth, low birth weight, long-term physical and mental disabilities, lack of development of a baby’s lungs, and death. It can also cause issues with eating and gaining weight after birth, as well as a host of other medical issues. It can also cause a traumatic birth experience for the mother. Many baby’s born preterm will have a stay in a neonatal intensive care unit.

The Society of Maternal-Fetal Medicine reported that a short cervix increases the risk of preterm labor six-fold in women with a singleton pregnancy. It increases the risk of preterm labor eight-fold for those carrying multiples. Researchers have found a distinct and clear correlation between a short cervix and preterm labor.

This same report states that women with very short cervixes — of less than 15 millimeters (mm) — accounted for 86% of cases of preterm labor before 28 weeks and 58% of cases of preterm labor before 32 weeks.

It is very important to consult with your doctor if you believe you have short cervix. If you are found to have a short cervix, do not panic though. There are several things you and your doctor can do to help keep your baby safely growing in your belly for as long as possible.

What to do if you have a short cervix

If you are found to have a short cervix, or one that is opening too early, there are a few options to keep you and your baby safe.

Cervical cerclage is a strong stitch that helps keep the cervix closed. Your doctor will remove the stitch between 36 and 38 weeks of pregnancy.

You may be asked to take progesterone. You can take it either as an injection or a vaginal suppository. Progesterone is a hormone that has been found to help reduce the risk of preterm birth.

Bed rest is another option, but one that most women do not want to take on- especially if they have other children at home. There are several different “levels” of bed rest- it can mean simply no sex or strenuous activity to more restrictive bed rest where you are only able to get up to use the restroom or get yourself food.

A short cervix can be a scary thing to experience during pregnancy. It can put you at risk for preterm labor, as well as make it riskier to carry subsequent pregnancies to term.

Even though my cervix is short, I was able to carry my daughter through the rest of the pregnancy with no limitations. She was born exactly on her due date.

I did have three miscarriages in between my first and second daughter, one of which was due to my short cervix. My second daughter was born 3 weeks early but I stayed active during her pregnancy as well.

My third daughter was born a month early, and within three hours of going into labor. It was a traumatic birth experience, but one that I have learned to love over time. I had two subsequent miscarriages after her birth, but I am not certain if they were due to my short cervix or not.

A short cervix is not the end-all for a pregnancy. There are several options to help you carry your baby as long as possible so they can “cook” all the way through. If you think you have a short cervix, ask your doctor to check you out. A simple and quick transvaginal ultrasound will help you determine the best course of action for you, your body, and your baby.

Image: Tolikoff Photography/Shutterstock