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Friday
Jun302006

Word Search - posterior cervix

How did people get here?

With Grand Rounds and Mothering.com, I know how many of you happened upon me. I am linked to several other sites, but must say, the most interesting has to be the searches that lead to my blog.

My partner tends to say everything phonetically (mostly to drive me bonkers), so she said "Kuh-nocked" and "guh-nat," pronouncing each letter. Our entire family says "Tore-tiL-uhs" and "Kay-suh-diL-uhs" because of Napolean Dynamite. Google comes out "Goog-eL-eh." I can't even see it anymore without saying it like that! Just thought you should know.

The tracker I use, StatCounter, shows me how many people use which search engines. If you are advertising in search engines, you might be interested to know that 98% of the searches come from Google. 1% from Yahoo and 1% from AOL (people still have that?).

Those hundreds of Googles are the most interesting in the world to see. I figured I should "answer" some of the requests for information periodically. The picture of the amniohook came from a Google search - someone wanted to see what it looked it, so I put one up. Kind of fun, eh?

Some of the search words (or string of words) are odd and confusing how it came to my site, but I have heard others also having strange paths to their door, so I'm not alone. Some of the more odd include: definition cou de gras (sic), pictures of women stabbed inside the navel, temporary crown fell out again, fists up vaginas, mom examines penis and braless smoked piercings.

The grand majority are valid and many are looking specifically for me (as navelgazing midwife or by the name of a post I've written).

Because I strive to educate, I want to answer some of the search requests. Even if that person never comes back, I'm of the belief that if one person has the question, so will many others.

A common question is about posterior cervices.

Cervices (plural of cervix) are mobile in the vagina. They move from front to back, side to side and round and round. Non-pregnant, they tend to stay in the same neighborhood, but in pregnancy, the head's depth can bring the cervix front and center, or the head can come down while the cervix is still posterior (facing more towards the back of the vagina).

When we do a vaginal exam and find a cervix posterior, it means we feel the baby's head first and have to either reach around the head to find the cervical os or sometimes we "walk" the cervix up with our fingers.

One major thing a woman can do to bring her cervix more forward for an exam is to sit on her fists. I have women make a fist and then, keeping them upright, put them under her hips. That position almost always works wonders for finding a posterior cervix. Not always though.

When a woman is in labor, the uterus contracting brings the cervix forward - where it needs to be for the baby to come out. If a woman is having vaginal exams (or doing them herself), it's a pretty good indication of active labor, whether the cervix is anterior (nearer the front) or posterior. Anterior would signal active labor; posterior usually means there's some work still do to. Of course, there are always exceptions! But generally, this is the case.

Before labor, having an anterior or posterior labor has zero indication of anything. Your provider might say it's a great sign for it to be anterior, but I've seen many a posterior cervix in early labor bring a baby out a few hours after that exam. An anterior cervix can take its own sweet time dilating. Before active labor, I'd not give any credence to where the cervix is at all.

As far as I can tell, having the cervix move from posterior to anterior isn't any more work or cause any more pain during labor. Dilating is enough of an attention-getter!

One more point: If people keep their hands out of your vagina, they wouldn't know where your cervix is and it wouldn't matter one iota. The baby comes out. Really.

More Word Searches to come!

Reader Comments (12)

Ooh! You answer questions!

I have a question that's been bugging me since my happy, healthy 5 month old baby was born:

I had an extremely uneventful first pregnancy. Felt just fine, aside from a little nasea in the first tremester. Gained 30 pounds. Blood pressure stayed low. I made sure to get plenty of sleep, but otherwise didn't slow down much. Hoped for as little intervention during delivery as possible. I was getting uncomfortable around month 8, but once the kid dropped down out of my rib cage, I felt just fine (except that I couldn't tie my own shoes), and walked 2-4 miles a day doing errands. First babies in my family tend to arrive rather late, and I was in no rush to deliver.

A week post-term, at my OB's insistence, I went to the hospital for a NST and an AFI test. The NST showed the baby's heatbeat went up when moving, as it should. The AFI test was a "2". Everyone at the hospital--and my OB, over the phone, said the baby was in imminent danger and I needed to be induced. I could wait an hour or so for my husband to arrive, but that was it.

So I was induced with pitocin. Baby arrived vaginally 20 hours later (after all sorts of interventions), 6 pounds, 13 oz, high Apgar scores, and thickly covered in vernix.

They showed me the placenta, but they didn't show me any signs that it was degrading.

Everything I've seen says that when the AFI gets below 10, it's standard OB practice to induce labor. Is it standard midwife practice also? Would things have been different if I'd been seen by a midwife (assuming I had an AFI test at all)?

Of course, I wouldn't have wanted to do anything to endanger my baby...but I'm still wondering whether that induction was really neccesary. Do you have any experience with cases like this?

June 30, 2006 | Unregistered CommenterAnonymous

I do answer questions. I'll write a post answering your question soon. Look for "Low AFI"... that will be for you!

June 30, 2006 | Unregistered CommenterNavelgazing Midwife

Thank you for the info on the posterior/anterior cervix. My doc says my cervix is still "anterior." As I am reading, it seems that he may be mixing the terms up? I'm one cm dilated, soft and 50% effaced. During my exams, he has to shove his whole hand in my vagina to find the little bugger (cervix). It would seem to me that my cervix is posterior. Based on this info, do you agree?

December 8, 2006 | Unregistered CommenterAnonymous

Ha, ha. Guess how I got to your blog? By googling "posterior cervix"! Thanks for the answer. :)

August 30, 2007 | Unregistered CommenterAnonymous

I also googled the term posterior cervix. That was quite helpful. thank you very much:D

September 14, 2007 | Unregistered Commenternicole

Hello I hope you can help! I am 36 weeks with my baby #4. I have my babies realy fast, anyways I went to OB on Friday and she said I was 50% effaced and my cervix was posterior. I have had alot of cramping, bach ache, tiredness and diminished movement and Braxton Hicks as well as mucus since then. I had all other children in the 38th week with an exception of an induction at 37 weekswith my daughter. Anyways my question is is this prelabor? and if it is any ideas on maybe how much longer I will be before the real thing begins? I don't usually feel my contractions until I am between 7-8 cm dialated and we live very far away from hospital so am very nervous. PLEASE HELP

September 16, 2007 | Unregistered CommenterAnonymous

I'm not your care provider, so cannot offer help. You *can* ask your care provider about ideas of starting labor in the hospital so you aren't so nervous about being out of the hospital if labor goes really fast.

There is never any way for any of us to know how close or far anyone is... by feeling a cervix, by watching a woman or by guessing. We can *sometimes* go by landmarks and history, but we can't even always go by that.

I encourage another dialogue with your care provider about what options you have (rupturing membranes, an enema, etc.) in the hospital so you can precip there instead of in the car... even though car births *do* make for some amusing storytelling (I had one for my third birth).

I know this wasn't much help, but I hope it helped some.

September 16, 2007 | Unregistered CommenterNavelgazing Midwife

I want to know if having a posterior cervix is a pregnancy-by-pregnancy occurrance? I had a very posterior cervix and wouldn't of been an issue but everytime I went into the doctor to check my dilation it was EXTREMELY painful to get checked because of how far back my cervix was. They doctor's even commented on how it was VERY posterior. I'm hoping to get pregnant again in the future but I'm hoping that I won't have to go through that again... I would rather give birth!

October 8, 2007 | Unregistered CommenterAnonymous

I found this by googling posterior/anterior cervix. :) I'm also a regular on MDC.

March 26, 2008 | Unregistered CommenterAnonymous

Thanks... your explanation was very helpful.

June 1, 2008 | Unregistered CommenterAnonymous

I found you because I was looking for information about cervical changes in he last trimester.

My due dates is a bit fluid. I'm either due July 20 or August 16. So I'm either 34 or 37 weeks pregnant. If I'm 37 I'd expect something to be happening as both my other kids were born before 38 weeks.

My husband mentioned he's noticed that my cervix is a lot lower the last week.

If you have any more info about cervical changes in the last trimester I'd be interested to read about them.

July 4, 2008 | Unregistered CommenterMegan

Thanks for the info, especially the bit about cervical position relating to active/early labor; it was just the info I was looking for! :)

July 8, 2008 | Unregistered CommenterAngeline

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