What Exercises Can I Do With an Incompetent Cervix?

July 1st, 2010

I recently received an-e-mail from a mama who had just gone on bedrest with an incompetent cervix at 30 weeks.”What exercises, if any, can I do with an incompetent cervix,” she asked?

An incompetet cervix is one of the more common reasons pregnant mamas are prescribed bed rest. While the rates of incompetent cervix are thought to be low, no one is exactly sure how many women are affected by incompetent cervices during pregnancy. An incompetent cervix can manifest in one of three ways:

  • Opening of the cervical os more than 2.5 cm during the second trimester
  • Thinning and shortening of the cervix (effacing)  in the second trimester or early third trimester
  • Thinning or opening (funneling) of the cervical opening closest to the baby

The treatment for incompetent cervix is cerclage (surgically placing a stitch through the cerix to hold it closed), bed rest, or a combination of the two.

Being prescribed bed rest puts a mama at risk for blood clots in the legs, muscle atophy and overall loss of strength and cardiovascular conditioning. Most women who are prescribed bed rest should also be prescribed-or at least advised about-exercises that they can do to maintain muscle strentgth and tone as well as to reduce the physical effects if prolonged inactivity. However, it has been my experience that many women prescribed bed rest receive little or no instruction on what they can do to exercise their bodies while on bed rest. This is due in part because many obstetricians don’t know what types of exercises are safe for women on prescribed bed rest. A lucky few mamas will have a consultation or two with physical therapists. But the vast majority of mamas who go on prescribed bed rest will receive no exercise instruction. For this reason I produced Bedrest Fitness when I was pregnant during my second pregnancy.Bedrest Fitness is a set of modified prenatal exercises designed specifically for pregnant women on prescribed bed rest.

A mama with an incompetent cervix should avoid any movements or exercises that put pressure on the cervix and many women will be instructed to remain recumbant in bed or on the sofa. But if you think about it, that leaves your arms and legs free to move. Mamas on bed rest with an incompetent cervix should perform a variety of arm and leg exercises daily to maintain steady bloodflow and adequate circulation back to the heart-especially from the legs. Leg exercises should include:

  • Leg Ab/Adduction exercises
  • Passive double knee raises (provided Mama can do them using an exercise band or towel to draw her knees up and not engage her abdominal muscles. If mama feels any pressure in her lower abdomen, these should be avoided!)
  • Point/flex of toes to exercise the calf muscles
  • Ankle circles

Upper body exercises should include (using a towel or exercise band):

  • Modified flies
  • Shoulder extensions with arms extended forward and to the sides
  • Upright rows
  • Bicep curls
  • Triceps extensions (if allowed to sit up)

On Bedrest Fitness I included Cat/Cow stretches. Women with incompetent cervices can actually do these stretches, but in my experience they often are unable to gauge how much pressure they are putting on their cervices. So unless a physical therapist or fitness professional is present, I don’t recommend that mamas with incompetent cervices perform these exercises.The same is true of the modified crunches.

Bed rest can have a profoundly negative (albeit temporary) effect on a mama’s overall physical condition. Depending on how long she was on bed rest prior to delivery and the restrictions she’d been given, a new mama can find herself unable to hold herself upright or to even hold her newborn. But if she engages in a few very simple but targeted exercises while on bed rest, mama will find that she will be less deconditioned after delivery and recover more quickly.

If you or someone you know has been prescribed bed rest during pregnancy, order a copy of Bedrest Fitness. Even if Mama can’t do all of the exercises, she will preserve muscle strength and tone in the areas she does exercise. Mama can also download a free set of lower body exercises, stretches and Kegels when she signs up for the Mamas on Bedrest e-mail list.

8 Responses to “What Exercises Can I Do With an Incompetent Cervix?”

  1. Misty says:

    I have lost 2 children due to an incompetent cervix, at 4 and 6 months. I am now 5 weeks pregnant and will have a cerclage put in at 8 weeks. My md wants me on bed rest afterwards but hasn’t specified for how long. Thanks for your info. God Bless!

  2. dawn says:

    @misty my daughter lost my first grand baby due to this and is now six,weeks pregnant did they do anything for your second one toprevent It? I am a nervous wreck. THANk you

  3. Darline says:

    Hi Dawn and congratulations!
    Cervical Insufficiency or “Incompetent cervix” is a common occurrence in pregnancy and one of the major reasons women are placed on bed rest during pregnancy. It can be treated and the majority of women go on to have a healthy baby. If the mother has a history of loss as a result of CI, a cerclage-a surgical stitch- is often placed somewhere between 12-18 weeks gestation and often the mother is put on bed rest for a large portion (the remainder??) of her pregnancy. Some mothers have pessaries placed. These devices have been used for prolapsed organs and bladder incontinence in the past, but have been found to be effective in maintaining pregnancy in some women. However, not many practitioners use them for pregnancy preservation due to CI. Finally, some mamas are monitored and if their cervices become “too short” they are placed on bed rest.

    CI is a difficult situation as we are not usually sure why the cervix shortens and “ripens” ready for birth early nor is it usually anything that the mother has done. But be assured, it is treatable and the likelihood that your daughter will go on to have a healthy baby is quite good now that her health care provider is aware of this issue.

    BTW, I didn’t have CI, I lost my pregnancies due to luteal phase defect which translate to insufficient progesterone early on to sustain pregnancy. That too, is quite easily corrected with progesterone supplementation, which I took for the first 14 weeks of my second pregnancy (vaginally, yes, quite gooey!!) and have a healthy 6 1/2 yr old son as a result.

    The good news is that CI isn’t necessarily going to occur with this pregnancy, although the odds make it fairly likely. But again, with careful monitoring and attentive OB care, your daughter should be able to have a healthy baby! Best wishes to you all!!

  4. Simone holland says:

    This is great, I had a clerage with my daughter at 12 weeks and was on bed rest for a few months, lost alot of strength but was able to move about later in my pregnancy. All went well :)

  5. Cat says:

    I lost my first child at 23 weeks due to an icompetent cervix. I am now 6 weeks pregnant and will have a cerclage at 12 weeks, not sure how much bed rest the doctor will prescribe, but l am very hopeful that the cerclage will let me carry to 37+ weeks.

  6. Darline says:

    Hi Cate,
    Congratulations on your pregnancy! I know that this is a scary situation, but hang in there. A large percentage of women in our community are there due to Incompetent Cervix. Many of them go to term!!! I highly suggest that you hop on over to our Facebook page and start chatting with the mamas there. You’ll be able to get support, encouragement and tips and suggestions for making it through this difficult journey.

  7. Michelle says:

    Hello,

    I lost my sun 25.04.2013 due to IC and have been quite active with exercise since, do you think it will be ok to exercise during the first trimester?

    Thanks

  8. Darline says:

    Michelle,
    Given your history, I would suggest MARKEDLY reducing exercise to gentle walking or perhaps swimming. I would cut out any and all strenuous activity and any activities that involve a lot of pounding or jolting. Check in with your doctor/midwife. They may want you to completely restrict activity in the first trimester or for the entire pregnancy. Not knowing your entire history and not being your health care provider it’s hard for me to say. But If it were me, I would definitely reduce my exercise level, and most assuredly check in with my health care provider before continuing. Good luck and keep us posted on your progress!!

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