Incompetent Cervix at 27 Weeks – My Experience, Bedrest, and Pessary

When I was diagnosed with an incompetent cervix at 27 weeks pregnant in my first pregnancy, I was absolutely shocked.

The pregnancy had been a real breeze for me until then.

I was fortunate to not really have to deal with any bad pregnancy symptoms. I wasn’t nauseous, was able to eat well, and was allowed to keep working out.

The only bad thing I remember about the first trimester was the fatigue.

And from 20 weeks onward, I was dealing with lots of sometimes intense Braxton-Hicks contractions. But nowhere near where I would start to worry.

And then at 27, almost 28 weeks, I was diagnosed with an incompetent cervix and it completely changed the remainder of my pregnancy experience.

Symptoms that Signaled my Incompetent Cervix

I realized something was wrong when I went to the bathroom. I was at 27 weeks 4 days pregnant that day. During one of the million times per day that I had to pee, all of a sudden something stuck to the toilet paper.

And I realized that my mucus plug, or at least a good part of it, had just come out.

It was Wednesday evening when this happened, and fortunately I had my next OBGYN checkup scheduled for the following day. So I tried not to worry too much and take it easy for the rest of the night and the next day until I could see my doctor.

I knew losing my mucus plug this early in the pregnancy was not a good sign. But at the same time, I could not imagine what could’ve caused this.

Diagnosis for my Incompetent Cervix

The next day at the doctor’s office, I told my doctor what happened. He immediately suggested to check my cervix and do a transvaginal ultrasound.

Since week 12 of my pregnancy, I hadn’t had a transvaginal ultrasound anymore. The doctor told me this was the best way to measure the cervix.

It measured at somwhere between 2.4-2.8cm, which is below the normal threshold of 3cm, as my doctor explained.

Closer to the end of the third trimester, the cervix is supposed to shorten and eventually disappear and open up. But not this early on, according to my doctor.

He diagnosed me with the condition of incompetent cervix and asked me to go to the hospital the next day. There, specialists would take over to better assess my condition and provide their recommended treatment.

Risk Factors for Incompetent Cervix

My doctor was surprised that I ended up with an incompetent cervix during my otherwise very healthy and well-developing pregnancy.

Apparently I did not really fall into any of the categories that are at risk for an incompetent cervix.

He mentioned it often affects women who are carrying twins or multiples, who had previous trauma to or surgeries on their cervix.

But often, it happens for no apparent reason, like it did in my case.

Treatment for my Incompetent Cervix

Being diagnosed with an incompetent cervix means you are at a higher risk of a premature birth.

And of course, that thought is scary. Being born too early comes with its own set of risks and potential health conditions.

So the goal of my treatment for the condition was to ensure my pregnancy would last as long as possible and get the baby as close to full-term as possible.

This meant supporting my cervix and preventing it from shortening even more and opening up prematurely.

My doctors opted to prescribe four things: a pessary, moderate bed rest, progesterone therapy and blood pressure medication.

Pessary

A pessary is a device that looks like a thick ring made from plastic, which is placed around the cervix to support it.

When I went to the hospital, the doctor was deciding whether to use a pessary for my treatment or do a cerclage.

A cerclage would have meant to undergo a small procedure where the doctors would put a stitch in my cervix to close it up.

I was honestly happy they chose the pessary instead.

It only took them less than a minute to insert the pessary. The procedure reminded me a lot like inserting a menstrual cup. It was painless, quick, and once in place I couldn’t feel it at all.

The only downside of having a pessary were the restrictions that came with it. I was not allowed to have any sexual activity, go swimming, or even take a bath anymore. Basically anything that could lead to bacteria getting trapped which could cause an infection.

Under normal circumstances, the pessary would have been removed once I reached 37 weeks of pregnancy. But I ended up having a breech baby and a c-section at shortly after 37 weeks, which didn’t allow for the removal before then.

Moderate Bed rest

In addition to the pessary, the doctors also ordered moderate bed rest for me.

Moderate bed rest meant no physical activity, no heavy lifting, and pretty much to take it easy as much as possible.

I was not even supposed to go on walks, which was hard because we had a dog at home who needed lots of exercise.

But I was glad it wasn’t complete bed rest, which would have meant laying in bed or on the couch all day.

I was still making my own meals, walking around our apartment, but ended up spending most of my time on the couch.

I also wasn’t allowed to work anymore – even though I had an office type of job that didn’t require more than working at my desk on a laptop.

So I had a lot of free time all of a sudden. This was nice because it allowed me to relax after months of grinding to finish my MBA before the baby was born while also working.

Progesterone Therapy

In addition to the moderate bed rest and the pessary, my doctor also prescribed the use of progesterone.

Progesterone is the hormone that sustains a pregnancy.

By taking additional progesterone, the doctors wanted to ensure my body would sustain the pregnancy for as long as possible and not suddenly go into labor.

Blood Pressure Medication

The final element of the treatment included the use of a blood pressure lowering medication.

Now, I wasn’t ever suffering from high blood pressure, especially not during pregnancy.

If anything, the opposite was the case, and I was used to low blood pressure most of the time.

But apparently, according to my doctors, the use of this medication has shown improvement in the prevention of premature contractions.

Basically, by prescribing a medication to keep my blood pressure in check, the doctors ensured that I wouldn’t start having contractions too early.

I had to take the medication until I reached 35 weeks of pregnancy.

I honestly never felt a difference being on or off the medication. It didn’t really affect me. I still felt lots of Braxton-Hicks contractions, but at least my real labor didn’t start until after 37 weeks of pregnancy.

Conclusion

The diagnosis with incompetent cervix put an end to my worry-free pregnancy experience.

But luckily, I was able to deliver my daughter full-term at 37+4 weeks of pregnancy, and she was and is a healthy and happy baby.

Nevertheless, the amount of worrying during those last 10 weeks of my pregnancy are something I wish I could have avoided.

The treatment, besides the bed rest, wasn’t difficult to deal with. Nevertheless, not knowing when or if the baby is going to come early regardless, is quite stressful.

I am currently pregnant with my second baby, and I learned now that the guidelines have changed. My doctor won’t check my cervical length after 24 weeks of pregnancy.

Apparently, after that point a shortening is naturally to start and any treatment after that point hasn’t shown much difference in the occurrence of premature deliveries.

At the end of the day, all I know is taking the precautions taken in my first pregnancy didn’t hurt. And this time, I will worry less and trust my body.