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Ask A Midwife

Q. Hello,

I actually have two questions:

I have a protracted uterus (I hope that's right; my uterus tips backwards instead of forwards). I often have bad back aches during my period. Does this mean I can expect to a have back problems during pregnancy? Will I be more prone to back labor? Will my babies have a higher chance of presenting "sunny-side up"? Is there a higher risk of damage to my coccyx during delivery? Does my condition warrant a high risk definition?

I was on Depo Provera for 18 months. My last shot was in late June. In mid-October I had an "episode" of bleeding that wasn't really like a period. It lasted for 10 days and was not accompanied by cramps (my usual periods are 4 -6 days with brutal cramps for 2 or 3 days). I haven't had anything since, though my breasts have begun aching (quite badly) in the last few days. I can usually tell when I ovulate and I'm fairly sure I'm not pregnant at the moment (negative test at home, I was paranoid). My husband and I would eventually like to get pregnant sometime next year (which is why I went off Depo). I know it can take a year or more for cycles to normalize, but I was hoping there might be something I could do or take that would speed things along. Should I go on the pill to try to force my cycles to begin? Should I try blue or black cohosh? Should I just wait? The biggest trouble right now is I hate not knowing if I'm fertile or not because I hate using condoms! :-)

Christi

A. Christi: First of all, a posterior tilted uterus will have nothing at all to do with your labor. A tilted uterus refers to the direction of the curve of the uterus in a non-pregnant women: either forward, mid line or posterior or retro-verted. Once you are pregnant, and the baby is at about 20 weeks size, you'll have a nice round belly, and the uterus doesn't tip in any direction.

You are right, you might have more low back pain and pressure during your periods. This might get better once you have a baby, or might become more of a problem as you get older. I have a Retro-verted uterus too, and I've had two wonderful sons.

"Sunny side up" refers to the baby's position at birth. so, totally unrelated to the position of your uterus when you aren't pregnant. Damage to your coccyx would be due more to the size of your baby and potential trauma during pushing stage.

As far as depo provera, sometimes it takes awhile for normal cycles to be established, so just keep track. A good book for learning about fertility is: Taking Charge of your Fertility by Toni Weschler. Once you learn the signs, then you might be able to know when to try to get pregnant (or avoid pregnancy).

Good luck, and I hope I have answered your questions....

Pat Sonnenstuhl is a semi-retired nurse midwife with over 30 years of experience in health care (first as an RN, then as an ARNP, CNM). She has experience with hospital nursing/midwifery and home and birth center midwifery.

Two areas of special interest to her are GBS and nutrition.

She is about empowerment, and helping folks find their own answers, what is right for them, not what is right for her. But, she wants you well informed.