Pregnancy after cervical cancer surgery may seem like such an impossible dream. As long as you are diagnosed early enough and only undergo a LEEP or cone biopsies, you are probably able to have a baby. You may need help from a specialist to get pregnant and to monitor you during pregnancy, but it should still be possible.
One thing that is reassuring to know is that HPV is not passed on to babies during pregnancy or labor and delivery. HPV does not cross the placenta. So that's one thing you don't have to worry about!
Another thing that you shouldn't worry about is pregnancy causing the cancer to come back. Cervical cancer is not like some types of breast cancer that are estrogen-dependent. Pregnancy hormones do not cause cervical cancer. HPV may show up again on your Pap smear during pregnancy, but it usually disappears spontaneously after delivery. My Pap test during pregnancy was actually normal.
Complications from surgery can be an obstacle to conception, and may also affect your pregnancy, prenatal testing, and labor and delivery. Potential problems are cervical stenosis, decreased cervical mucus, and premature dilation or the so-called incompetent cervix.
Cervical scarring can cause stenosis, or stiffness, that makes opening of the cervix difficult and even painful. Sometimes even the small amount that the cervix opens for a menstrual period can be painful.
In my case, I had cervical scarring that made dilation stop at 2 cm. Completely stop. So after hours of regular contractions, my doctor said she was going to pop it open with her fingers. I took a deep breath, she reached in, and in 1 second, I went from 2 cm to 6 cm. All she did was stretch my cervix with her fingers, and that released the scar tissue.
If the stenosis is making it hard for you to even get pregnant, you can have intrauterine insemination (IUI). This is where the doctor passes a thin, flexible catheter past the cervix to deposit sperm into the uterus.
Loss of cervical tissue can also affect conception by decreasing cervical mucus. These secretions provide nutrients to the sperm. If this is preventing you from getting pregnant, IUI can also be done and bypass the cervix.
If you have a LEEP or cone biopsy (or in my case both), you have a shorter cervix than you did before. This may or may not be a big deal. For me, it turned out not to matter because I had a long cervix. But nobody knows for sure until you are actually pregnant if you have a cervix that is too short. If your cervix is too short, it is called an "incompetent cervix." The problem is that it isn't long enough or strong enough to hold the baby in during pregnancy and the cervix dilates prematurely. It can cause premature labor and possibly miscarriage or stillbirth. If you are close to term, it isn't so much of a problem.
If you have premature dilation, and it is caught in time, the doctor can place a stitch called a cerclage in the cervix to hold it shut. Bedrest may also be suggested.
If you have actually had a miscarriage due to premature dilation, doctors can put in the cerclage before you get pregnant. This is a specialty surgery for which you need to find a good specialist. After it's done, it's permanent, and you will have to have a C-section for birth.
The fact is that pregnancy after cervical cancer and treatment with LEEP, cone biopsy or trachelectomy will not be the same as a normal pregnancy. You will need to see a perinatologist starting early in your pregnancy to monitor your cervix, but for most women, nothing bad happens.
In fact, I enjoyed the extra attention because it meant I got more ultrasounds to see my baby! It was fun to see him every month. So in my experience, pregnancy after cervical cancer went really well. I'm not saying it was stress-free, but I actually went full-term without a cerclage.
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Do you have a great story about this? Share it! I know I'm not the only woman to have a baby after going through several cervical surgeries, so let's spread the hope! Or if you have questions, let me know.