After giving birth, it takes time for a woman’s cervix to close, return to its pre-pregnancy state, and heal. The cervix is the narrow, lower end of the uterus that dilates during labor to allow the baby to pass through the birth canal.
Immediately after delivery, the cervix remains dilated to 6-10 centimeters. Over the next few days and weeks, it gradually closes and shortens until it returns to its non-pregnant size of 2-3 centimeters. The time frame for complete cervical closure varies from woman to woman.
How long does it take for the cervix to close after birth?
For most women, the cervix takes about 4-6 weeks after delivery to fully close, shorten, and return to its pre-pregnancy firmness. However, this healing process occurs gradually:
- After 24 hours: The cervix shrinks to about 2-3 centimeters dilated after the first day postpartum.
- After 7 days: Over the first week after giving birth, the cervix continues to narrow but remains slightly open at 1-2 centimeters dilated.
- After 2 weeks: The cervix is generally less than 1 centimeter dilated at the 2 week mark.
- After 4 weeks: The cervix is closed completely in most women by 4 weeks postpartum.
- After 6 weeks: By 6 weeks after delivery, the cervix has returned to its non-pregnant state of being closed, firm, and 2-3 centimeters long in the majority of women.
However, every woman heals differently based on factors like the extent of cervical dilation during labor, the type of delivery, and postpartum recovery. Some women may take a shorter or longer time for their cervixes to completely close after giving birth.
What causes the cervix to stay open longer after birth?
In some women, the cervix takes longer than normal to close after delivery. A cervix that remains partially open for longer than 6 weeks postpartum is termed “delayed cervical closure.” Some factors that can contribute to delayed cervical closure include:
- Long labor requiring greater cervical dilation
- Vacuum- or forceps-assisted vaginal delivery
- Episiotomy or perineal tear
- Infection like endometritis
- Hematoma or bleeding into cervical tissue
- Repeated cervical exams during labor
- Cervical or vaginal trauma
- Previous cervical surgeries or procedures
Additionally, delayed involution or shrinkage of the postpartum uterus can put pressure on the cervix, causing it to remain open longer.
In most cases of prolonged cervical closure, the cervix eventually returns to normal with time. But some women may require monitoring and intervention to help the cervix heal.
Signs of abnormal or incomplete cervical closure
It is normal to have some vaginal discharge (lochia) or light spotting in the first 4-6 weeks postpartum as the uterus sheds its lining. However, the following symptoms may indicate abnormal or incomplete cervical closure:
- Heavy, bright red bleeding after the first 1-2 weeks
- Foul-smelling lochia discharge
- Lower abdominal pain
- Fever or chills
- Continued strong menstrual-like cramps
- Feeling of vaginal fullness/bulge
- Prolapse of uterine tissue through the dilated cervix
If any of these warning signs occur or the cervix remains open with no signs of closing after 6-8 weeks, contact your healthcare provider. You may need to be evaluated for complications like infection, hematoma, or poor uterine healing.
Does the cervix close faster after C-section?
Many women wonder if the cervix closes faster after a C-section compared to vaginal delivery. During a cesarean section, the cervix stays closed and is manually dilated after the baby is delivered through the incision in the abdomen.
Here is a comparison:
Cervical closure after vaginal delivery
- The cervix has to dilate to 10 cm during labor.
- Takes average of 4-6 weeks to close, as the cervix has to recover from significant dilation.
- Increased risk of bruising, swelling, trauma that can delay full closure.
Cervical closure after C-section
- The cervix remains undilated.
- Takes average of 3-4 weeks for complete closure since no dilation occurred.
- The closed cervix experiences less trauma, enabling slightly faster healing.
Therefore, the cervix does tend to close about 1-2 weeks faster on average after cesarean delivery compared to vaginal birth, owing to the absence of labor dilation. However, this can vary widely based on how long and strenuous the labor was before a C-section and the individual healing abilities of each woman’s body.
Tips to help the postpartum cervix close
The following tips can help facilitate cervical closure and healing after giving birth:
- Rest as much as possible early on while the cervix starts closing.
- Avoid strenuous activity, heavy lifting, and exercise for at least 4-6 weeks.
- Take sitz baths to soothe perineal soreness.
- Use ice packs to reduce swelling and discomfort.
- Finish entire course of antibiotics if given for infection.
- Go for postpartum check-up around 4-6 weeks to ensure cervix has closed.
- Delay resuming sexual intercourse until the cervix completely closes.
- Practice pelvic rest by avoiding inserting anything vaginally.
- Wear a panty liner or pad for lochia discharge while the cervix closes.
- Try natural remedies like calendula, goldenseal, vitamin C, and turmeric to promote healing.
Alert your doctor about any symptoms like bleeding, pain, discharge, or fever that could indicate potential complications inhibiting cervical closure.
When to see a doctor
Consult a healthcare provider if:
- Heavy bleeding continues beyond 2 weeks postpartum.
- Foul-smelling lochia discharge occurs.
- Symptoms like fever, chills, abdominal pain, or uterine tenderness develop.
- Significant vaginal discharge persists after 4 weeks.
- Normal activities cause discomfort or pain.
- The cervix remains open with no signs of closure after 6-8 weeks.
Prompt evaluation and treatment of any complications can help get the cervical closure process back on track.
Conclusion
On average, the postpartum cervix takes about 4-6 weeks to close, shorten, and heal after vaginal delivery. This cervical remodeling process is quicker after cesarean delivery, averaging 3-4 weeks since no labor dilation occurred. However, every woman heals differently based on birthing factors. Staying rested, keeping the area clean, and avoiding sex/tampon use until the cervix completely closes can help facilitate normal cervical closure after birth. See a doctor if heavy bleeding, foul discharge, pain, opening, or other healing issues occur. With time and care, the postpartum cervix can return to its pre-pregnancy state.