January is Cervical Health Awareness Month in the United States, and it is important for childbirth educators and other birth professionals to share fact-based information about what people can do to take care of their cervix in order to have a healthy pregnancy and birth. 13,000 people a year are diagnosed with cervical cancer.

The Cervix

Starting off, people may not fully be aware of where the cervix is located and what functions it performs.  One of my favorite websites is The Beautiful Cervix Project which provides up-close images of a cervix as it changes throughout the cycle month.  The cervix is the bottom part, including the opening, of the uterus; it's sometimes referred to as the "neck" of the uterus. The cervix is internal, so a person can't see it from the outside or anywhere around the entrance to the vagina. The two main roles of the cervix are to open slightly to allow blood and tissue to pass through during a menstrual period and to dilate and open for birth. The cervix also is responsible for producing cervical mucous/fluid in various consistencies throughout a cycle. Cervical fluid plays a key role in the ability to get pregnant, as it helps transport sperm inside the uterus and ultimately to the egg for fertilization. The plural of cervix is cervices.

Cervical Health

When people talk about "cervical health," it primarily refers to the prevention of cervical cancer. Cervical cancer happens when cells within the cervix grow abnormally. Cervical cancer is a slow-growing cancer, but if left undetected and untreated, it can spread to other tissues and organs within the body. Most all cervical cancer is caused by "HPV" or human papillomavirus, which is the name of a large group of viruses, the most well-known of which causes warts (common warts and genital warts).

HPV is very common and many, if not most, adults have had it at some point in their lives without even knowing it. This is because some types of HPV can cause no noticeable symptoms or health issues and can go away on its own. People can get HPV by coming in skin-to-skin contact with an infected person, or by using a personal item (like a razor or washcloth) from a person who is infected. This means that people can also contract HPV through sexual contact.

When HPV does not go away on its own, it causes problems like genital warts and cancer. Most genital HPV cases do not cause cancer, but since most cervical cancer is caused by HPV, it's important for people to seek routine care and treatment. 

Prevention

The best source of prevention for HPV and cervical cancer is regular screenings via routine pap smears at with a health care provider. During a pap smear, the health care provider will scrape cervical cells that are then sent out for pathology review. If they are found to be abnormal, the health care provider will perform further analysis and possibly a biopsy.  

People can help prevent HPV in two main ways. The first is by wearing protection, like condoms and dental dams, during vaginal/penetrative, anal, and oral sex. This method is not completely protective against HPV, but it does reduce the incidence of it. The other method for prevention is by getting the HPV vaccine, which is approved for people up to age 45.  Here is a great fact sheet: Ten Things to Know about HPV and Cervical Cancer.

HPV, Cancer, and Pregnancy

Many people who have or have had HPV may be able to go on to have safe and healthy pregnancies, births, and babies. Even if a person has an active case of HPV during pregnancy, their care will likely remain routine. It is important, however, for pregnant people to let their health care provider know if they have or have had HPV.  

If someone is diagnosed with cervical cancer during pregnancy, their health care provider will work with them to determine treatment and course of action, which will depend upon many factors like how far progressed the cancer is, and how far along they are in your pregnancy. 

 The Office of Disease Prevention and Health Promotion has a very useful toolkit with many resources and further information.

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