Age 29 – Pregnancy, Postpartum and IUD

This is the cervix of a 29 year old woman during her second pregnancy and early postpartum.  Her first baby was born vaginally. She has never had an STI, abnormal Pap, or gyn procedure done. Before getting pregnant, she had used a variety of birth control options: birth control pills, Depo-Provera injections, Implanon subdermal implant, condoms, and the vaginal ring.  She chose a Paraguard IUD as birth control after her baby was born (seen in the postpartum photo below).  Her cycles average 30 days and she tracked her fertility signals to help her get pregnant.

 
The photos are labeled with the gestational age (calculated from the date of the last menstrual period, LMP) of the pregnancy.  A full term pregnancy averages 40 weeks (36-42 weeks is a normal range).  She went on pelvic rest for preterm labor two months before the baby was born at 39 weeks.  You can see a little spotting from her contractions and cervical softening during the photos when she was on pelvic rest. She delivered a healthy baby vaginally at 39 weeks gestation.

 

Age 29 - preg and postpartum (4.3 weeks preg)- WV

Four Weeks, 3 Days Pregnant

 

Age 29 - preg and postpartum (7.5 weeks preg)- WV

7 Weeks, 5 Days Pregnant

 

Age 29 - preg and postpartum (11.5 weeks preg)-WV

11 Weeks, 5 Days Pregnant

 

Age 29 - preg and postpartum (16.5 weeks preg)-WV

16 Weeks, 5 Days Pregnant

The redness around the os is normal during pregnancy as the increased estrogen can cause the cells which normally line the cervical canal to protrude outward and surface of the cervix.  This is called cervical ectopy or cervical erosion.  The clear and whitish fluid may be partially from semen from intercourse the night before or normal cervical secretions.

 

Age 29 - preg and postpartum (20.6 weeks preg)-WV

20 Weeks, 6 Days Pregnant

 

Age 29 - preg and postpartum (26.6 weeks preg)-WV

26 Weeks, 6 Days Pregnant

You can see some leukorrhea (whitish discharge) covering the cervical os.  This is common and normal during pregnancy.

 

Age 29 - preg and postpartum (30.5 weeks preg)-WV

30 Weeks, 5 Days Pregnant

Around this time, the woman had some signs of early labor.  To avoid early dilation of the cervix, her practitioner recommended she go on pelvic rest, which means no sexual activity or orgasms that may cause the uterus to contract and the cervix to dilate prematurely.

You can see some red spotting near the os that was likely caused by these early dilation contractions.  Also, the os looks slightly more open than the previous pictures.  The woman reported that when she touched her cervix, it felt softer.

 

Age 29 - preg and postpartum (34.5 weeks preg - bedrest)- WV

34 Weeks, 5 Days Pregnant

The woman continued on pelvic rest.  You can see that the os is rotating posterior, meaning it is angling more downward and back towards her butt, which is normal for late pregnancy as the uterus expands.  The os is even more dilated and there is a little red spotting.

 

Age 29 - preg and postpartum (6 weeks postpartum)- WV

6 Weeks Postpartum

The woman delivered her healthy baby vaginally at 39 weeks gestation!  This photo is taken 6 weeks after delivery. The os has closed back up completely.

 

age 29 - preg and postpartum - PP after IUD - WV

6 Weeks Postpartum, IUD insertion

The woman chose to get the Paraguard IUD inserted into her uterus as her new method of birth control.  You can see the short white strings of the IUD hanging out of the right side of the os in the photo.  Her os is a slit shape, which is common for women who have given birth vaginally.