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LaKrystal Warren
LaKrystal Warren,
Category: OB GYN
Satisfied Customers: 45
Experience:  Physician at Contemporary Women's Care
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I am 37 years old 13 weeks gestation. between the ages of 17

Customer Question

i am 37 years old 13 weeks gestation. between the ages of 17 and 26 i have had 3 elected d&c's and 3 elected non surgical terminations all of which were uncomplicated. i am now pregnant and i have randomly spotted since the 4th week without cramping, all dark blood. i have recently stopped spotting until i had a non penetrating orgasm which produced some red blood and now it has turned brown. i am wondering if there is a link between my vascular cervix and having an incompetent cervix down the road. is cervical insufficiency in your experience inherited or frequently caused by d&c's? is it common? does my easily spotting cervix make it susceptible to being weak? i have had ultrasounds which were all comforting. i do have a non impinging fibroid which my ob does not think is an issue. i frankly feel embarrassed to call her about this as i am known as a worry wart. what do you think?
Submitted: 1 year ago.
Category: OB GYN
Expert:  LaKrystal Warren replied 1 year ago.

Hello, I am an OB/GYN and can help you with this. First, congratulations on your pregnancy! It is an exciting and scary time. The symptoms of spotting in pregnancy that you are describing are common in pregnancy and are not related to your prior terminations. Please do not let those concern you now. If they were going to cause any problems, it would have been with you getting pregnant. You are pregnant now and 13 weeks. Your chance of miscarriage is less than 2%. There are various reasons for spotting in pregnancy, but the most common is the bursting of small blood vessels caused by the placenta microscopically separating from the uterine wall as the uterus grows. Spotting when you wipe is not concerning and in the setting of a completely normal ultrasound, is not anything to worry about. There is no link to having a vascular cervix and having cervical insufficiency--it does not predict that in any way. All pregnant women have a vascular cervix because of increased blood flow to uterus and pressure on the blood vessels from the growing uterus. Cervical insufficiency is not caused by D&C's, nor is it inherited. Spotting from your cervix after an exam, after sex, or even with mildly vigorous activity is common in pregnant and non-pregnant women and does not mean you are more susceptible to having a cervical insufficiency. Fibroids are also very common and as long as they don't bother us, we don't bother them. We see fibroids very often during pregnancy and generally ignore them unless they are very (greater than 10 cm). It is normal to worry, but everything that you are describing is normal and sounds like you have a healthy pregnancy. You do not need to worry about prior D&C's or cervical insufficiency. There is no way to predict cervical insufficiency but you are not describing anything that is concerning for it. Good luck!

Customer: replied 1 year ago.
Thank you so much.
Expert:  LaKrystal Warren replied 1 year ago.
You are very welcome. Is there anything else I can help you with?
Customer: replied 1 year ago.
I have just a few random questions.
Decaf coffee and tea okay?
Spotting after sex should not be cause for concern?
Are there any indications of cervical incompetence?
I work as a nurse in an emergency room and I noticed by the end of the day my stomach is super bloated. my question is -will the extra gas from the bloating and constantly being on my feet for 12 hours at a time make my cervix weaker?
Expert:  LaKrystal Warren replied 1 year ago.

Caffeine is safe in pregnancy--up to 200 mg per day (one cup of coffee has about 100 mg--more if Starbucks and depending on the size), so you can have caffeinated coffee and tea up to the recommended daily limits.

Decaf coffee and tea are fine throughout the pregnancy.

Spotting after sex is normal and not cause for concern. It will typically resolve in one-two days at the most.

There are no indications of cervical incompetence and it is not something that we routinely screen for if a patient does not have a history of having a preterm delivery.

Increased bloating, increased pressure, and standing on your feet will not make yours or any person's cervix weaker. It is safe to work the same schedule that you did prior to pregnancy. Bedrest/staying off your feet is not necessary or recommended during pregnancy.

Cervical insufficiency is not that common and is not something that can be predicted, so try not to worry. Sounds like you are doing everything right!

Customer: replied 1 year ago.
Awesome. Thank u so much. I promise this is the last question. Working 12 hours a day 3 days a week on my feet with limited breaks won't compromise my baby in any way will it?
Expert:  LaKrystal Warren replied 1 year ago.

Not at all. There are no work restrictions or limitations. It is perfectly safe and fine to work a demanding job throughout your pregnancy. Good luck!

Customer: replied 1 year ago.
Thank you ma'am