Age 25 – Pregnant & Ectropion

This is the cervix of a 25 year old pregnant woman during pregnancy. She has had two vaginal homebirths before this pregnancy, the last almost two years ago. You can see that she has an ectropion cervix. The red area you’ll see around the os is shallow, vascular, mucous-producing endocervical epithelium (what is usually on the inside of the os) which has grown out onto the face (exterior portion) of the cervix.  This is a variation of normal and often expands during pregnancy as the cervix tends to evert.

You will notice that she is a few centimeters dilated throughout her pregnancy, which can be normal for a multiparous woman. No cerclage was needed. During her previous pregnancy, her dilation seemed to vary; at 37 weeks, she was 3 cm dilated and a few days later she was 1 cm.

During week 15, there was about 1.5 tablespoons of bright red bleeding from cervix. It stopped quickly and blood that pooled in vagina clotted well. Bright red bleeding from the cervix during pregnancy is not usually normal. This woman is taking Lovenox (blood thinner) for pulmonary emboli that was diagnosed at 12 weeks pregnancy, which may have lead to this bleeding since she had recently had intercourse.  Post-coital bleeding with an ectropion cervix is common.

At 27 weeks, 2 days, this woman began having contractions between 2-4 minutes apart, lasting all night with severe, but consistent crampy feelings. The lower portion of her uterus (near the pubic bone) would get tight like a basketball while she laid down. When she stood up, her entire uterus would get tight, with the crampy feeling more toward the cervix. So, she remained lying down and the crampy feeling lasted about 24 hours.

When she checked her own cervix, she noticed her cervix felt shortened as compared to a few days before. The midwife confirmed that she is about 70% effaced and still 1 cm dilated. The midwife did not want to insert her finger into the os to check the dilation so as to not stimulate more contractions. This woman feels that if she may be closer to 2 cm dilated because the “smile” of the os felt wider. The cervix remained posterior.

After turning her footling breech at 35+6 weeks by using techniques on, this woman was induced with pitocin due to low amniotic fluid levels.  She used “Hypnobabies” hypnosis techniques, hydrotherapy, sounding, massage, and movement to deal with the contractions for the first 30 hours. She then received a low-dose epidural when she was at 5 cm and, after breaking her water, dilated fairly quickly. The mother was able to breathe slowly as her baby crowned so her perineum skin would stretch easily. She caught her own baby (with an absentee doctor) in the hospital! Both the baby and the mother are healthy.