I was diagnosed with an incompetant cervix and have read a lot of differing opinions. Usually the cervix starts to open, from the inside out, called funneling. I've read that it can be totally painless, and the only way to tell it is happening is with an ultrasound. My personal experience was not painless, I had definite contractions, about 3 per hour. My doc said to go to ER if I had more than 3 per hour. I never had that many, but ended up going to ER at 20 weeks, 2 days into my contractions. The first day I hadn't dialated at all, at least from the outside. The day I went in to the hospital, I was dialated, not sure how much, as the amniotic sac was coming through the cervix and obstructing the OB's view.
My thinking on it is this: if something feels different, get to the doc and have it checked out. It could have saved me and my family a lot of trauma. I know that with my next pregnancy I'll be headed to the doc if I get a mosquito bite, and I'm not a fan of doctors in general.
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Lenore
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