Your body undergoes a tremendous amount of changes during pregnancy. While many of these transformations are easy to see (hello, growing belly!), others aren’t.
The position of your cervix is one of these bodily changes. While it’s possible to check your cervix at home, the only way to get an accurate assessment — especially if you’re pregnant — is to have a doctor or midwife perform a cervical examination.
A cervix in a posterior position tilts toward your back or bum, while an anterior cervix tilts toward your front side.
The majority of women have an anteverted uterus, or an anterior-facing uterus, and therefore the cervix is normally posterior, according to Robert O. Atlas, MD, FACOG, chairman of the Department of Obstetrics and Gynecology at Mercy Medical Center. “It’s less usual to have a retroverted uterus, which usually has an anteriorly positioned cervix,” he says.
However, if you’re pregnant, the position of your cervix will likely change as you get closer to your due date.
Typically, you can expect the cervix to remain in a posterior position for most of your pregnancy. It’s not until the end, or closer to weeks 37 or 38, that the cervix will begin to prepare for childbirth and move forward into an anterior position.
If your doctor says you have a posterior cervix, don’t worry — you’re not alone.
The cervix is the lowermost portion of the uterus, and for the majority of your pregnancy, you can expect to have a cervix that tilts in a posterior position, behind the baby’s head, says Kecia Gaither, MD, MPH, FACOG, director of perinatal services at NYC Health + Hospitals/Lincoln.
Around week 37 or 38, your cervix should begin to make its way toward an anterior or forward position to prepare for childbirth. This subtle shift is a signal that things are progressing, as the normal position of your cervix is posterior or pointed toward the back. During this time, your cervix will also shorten and soften.
As your due date nears, your doctor will be looking for signs that your cervix is moving forward to face the font. They should be able to easily feel the cervix when it’s in an anterior position.
Once you reach week 38, the time with your doctor becomes all about labor and delivery. At this point, your baby is nearing full term, and your provider will continue to check your cervix and the position of the baby.
If your cervix is still posterior after 38 weeks, Atlas says to not panic. Most likely, labor is not coming immediately, but everyone’s labor progresses differently.
“Checking a cervix for dilation may be more uncomfortable for a woman with a posterior cervix, but this is just because it’s hard to reach,” says Lauren Demosthenes, MD, OB-GYN, and senior medical director with Babyscripts. To determine how ready you might be for labor, Demosthenes says doctors often use a Bishop score.
“The components of the Bishop score include cervical dilation, effacement (thinning), consistency (firm or soft), position (anterior or posterior), and fetal station (how high is the baby).” If the cervix is still in a posterior position, you’ll receive a lower score.
But Demosthenes says not to worry about that too much. It just means that your body may not be as ready for labor as someone with an anterior cervix, and more than likely, the cervix will rotate around to anterior during your labor.
Ideally, your cervix will move into an anterior position before you start laboring. In general, Demosthenes says your body will prepare for labor on its own, and the changes to your cervix will happen.
If the cervix has begun to dilate, or open to accommodate the baby, Atlas says a doctor or midwife can manually move the cervix anterior, but it’ll return to its original position. He also points out that it’s unnecessary to move the cervix to an anterior position to go into labor, as your body will do the work.
As your pregnancy progresses and your body begins to ready itself for delivery, Gaither says a number of cervical changes occur, including:
- The cervix becomes softer.
- The cervix begins to efface, or thin out.
- The cervix “moves” from a posterior position to an anterior position.
Finally, during labor, Gaither says the cervix dilates fully enough to allow baby’s head to descend from your uterus into your vagina and out of your body.
If you’re not pregnant, but your doctor says your cervix is in a posterior position, you might wonder whether this is normal. The good news is yes, this is normal.
For the most part, there are no significant concerns about having a posterior cervix when you’re not pregnant. In fact, these positions are merely observational (much like being left- or right-handed) and don’t mean much.
That said, there are some minor issues you should know about if you have a posterior cervix outside of pregnancy. According to Demosthenes, a posterior cervix may make it more difficult to perform a pap smear examination.
Along those lines, it may make inserting an intrauterine device (IUD) more challenging, but not impossible.
When you’re ready to start trying for a baby, Demosthenes says having a posterior cervix shouldn’t affect fertility or childbearing.
Pregnancy is an exciting time for parents-to-be, but it can also cause anxiety and worry if everything doesn’t go as planned. If your due date is approaching and your cervix is still in a posterior position, try to relax and let your body do the work.
If you have concerns or questions, make sure to call your doctor or midwife, or bring them up at your next appointment. They can talk you through the process, and hopefully, calm any fears or anxieties that you’re experiencing.
