Zen and the Art of Cervix Maintenance

I had my sonohysterogram today. The good news: everything looks good! That’s what was expected, though, as I’ve had two before and no reason to suspect any changes.

So, I consider myself able to deal with cervical pain well. Like all of us, I’ve had countless vaginal ultrasounds and internal exams. I’ve had HPV and a colposcopy and biopsy. That was a unique and strange pain. I’ve had a cervical ectopic pregnancy in which my OB tore my fetal sac from my cervix with forceps, mistaking it for miscarrying tissue, causing a hemorrhage and immense pain. This is my third sonohysterogram, and the previous two included me coughing to push out my cervix to meet a needle being injected into it.

Today one of the medical fellows, instead of my regular doctor, performed the procedure, and she brought with her a university medical student. I didn’t realize this was a student until I realized the fellow was talking her through doing my ultrasound. Then the student put in the speculum. I could tell it was kind of at a funny angle. Ouch. Then she said, “I’m going to pull out the speculum now,” and I lied there, waiting to feel that relief as the speculum is unclamped, or closed, or whatever it is they do, and instead I felt her just pull it right out, but angled kind of upwards, and the pain was excruciating that I screamed! This has never happened to me before. Totally bizarre. At least it was brief, and she’ll never forget how to take out a speculum properly again.

The experience is making me think way too much about my cervix, though. I think that I am going to have an incompetent cervix and need a cerclage and I am not sure how to advocate for myself.

I don’t know if the biopsy is enough of a risk factor for incompetent cervix, but the cervical pregnancy incident is what gives me worry. After the cervical pregnancy, my cervix felt different. I could feel a bump on it that was not there before. I figured it was just still healing until two months after the ectopic pregnancy, my OB asked me if I’d ever been told I had a cannula in my cervix, or a lesion. She said many women had them and they are totally normal and nothing to worry about. I told her my cervix still felt funny after my ectopic pregnancy, and she said that was what she was referring to. That was when I had my first sonohysterogram – to look at my cervix, and all was deemed normal. I asked her if I’d need to be concerned about an incompetent cervix later, and she said no. At the time, I felt relieved, but lately I’ve read the firsthand accounts of women who have had second trimester losses from incompetent cervixes, and I just think there’s no way in hell my cervix can still be competent.

The OB who told me everything was okay is and was part of the practice of the OB who tore the tissue from my cervix, so I think the party line of that entire group is to claim I am okay until proven otherwise to avoid lawsuit. I’m not interested in suing; I am interested in determining if my cervix will make it through a pregnancy and not finding out the hard way. To this day, my cervix still feels odd – it still has the bump and oddly enough, there are times when my cervix feels soft everywhere but that bumpy area – it will remain firm sometimes when the rest of it isn’t. My cervix used to feel very smooth and very round. Now the shape feels odd, maybe it’s just the bump, and it also feels narrower altogether.

Dr. M, my fertility specialist, is the head of the recurrent pregnancy loss program at my clinic, and this is an area of her study. When I finally do get pregnant I am going to bring this up with her and press the issue hard. Since preventing pregnancy loss is her specialty, and why she is my doctor in the first place, I am hoping she will take my concerns seriously. I believe that I may need a cervical cerclage and I don’t want to risk finding out too late. In the meantime, I am going to seek out some groups of women who’ve had incompetent cervixes or cervical ectopics and find out if there is any overlap. Of course, cervical ectopics are rare but I’m sure those with an incompetent cervix will have good knowledge to pass on. I don’t know how I’d get through this without the internet.

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