I bet you didn’t know that January is Cervical Health Awareness Month (honestly, I didn’t either until recently, so I'm getting this information to you just under the wire!). You probably don’t spend too much time wondering about the health of your cervix. Let’s face it, other than your annual checkup and how far you’re dilated when you’re in labor, your cervix doesn’t come up for discussion too often. But, if you want to have children someday or you’re actively trying to conceive now, you need to be aware that cervical problems can affect fertility.

For example, did you know that cervical mucus can be “hostile”? Granted, it’s an over-the-top name, but it’s actually pretty accurate. Cervical mucus is vital in helping sperm travel from the vagina into the uterus, and it can be negatively affected by infection or past trauma such as procedures/surgeries to the cervix. Since some infections and most cervical trauma are completely asymptomatic, you may not even know there’s a problem until you have trouble getting pregnant.

You also can run into problems with recurrent miscarriage because of an incompetent cervix. If your cervix is too weak to support your growing uterus, miscarriage or premature labor and delivery can occur – a heartbreaking and frustrating outcome, especially if you’ve already struggled with infertility.

Additionally, your cervix may be compromised because you are a “DES daughter.” What’s that? From 1941 to 1972, many women were prescribed a drug called diethylstilbestrol (DES) to prevent miscarriage. Unfortunately, what the medical establishment realized was that DES was detrimental to both mother and child, increasing the risk of breast cancer in the mom and causing abnormalities in the reproductive systems of the babies. “DES daughters” – offspring of the women who took DES – face an increased risk of clear cell adenocarcinoma (CCA) of the vagina and cervix (although it’s still very rare), as well as reproductive tract structural differences that may cause infertility and/or difficulties with pregnancy. The youngest of the "DES daughters," however, are now 38, so this will eventually become a non-issue as these women move out of their childbearing years.

What can you do to reduce the odds that a cervical issue will cause infertility? Early detection is key, so make sure you have an annual checkup with your OB/GYN, and don’t let embarrassment hold you back from being open with your doctor about your health. Talk about any concerns you have or issues you suspect with your doctor – make sure you give them all the tools they need to help you protect your fertility and be as healthy as possible. If you need more information, check out the National Cervical Cancer public education campaign or the National Cervical Cancer Coalition. Or, I am always available to answer any questions or concerns you may have – email me at esimckes@fertilitypartnership.com or call me at 800.BabyToday.

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After more than 20 years as an obstetrician/gynecologist and fertility specialist, I’ve been honored to be at the births of many healthy babies. But also in those 20+ years, I’ve cared for many women – and their partners - who have had to endure the heartbreaking pain of miscarriage, stillbirth or death of an infant. Some doctors might say that they’ve gotten used to helping women deal with such devastating losses, but I can’t. I don’t think I ever will. I get to know my patients so well that they feel like family to me, and when they go through that kind of agony, I want to be there by their side to support them and help them walk through the pain.

On October 15, we pause to commemorate National Pregnancy and Infant Loss Remembrance Day, and to remember all the babies – all the dreams – lost to mothers and their partners. My message to anyone who has suffered such a loss is a simple one: pregnancy and infant loss is devastating. You will never forget the baby or babies you’ve lost, no matter how many more children you go on to have. But you will go on. You will walk through the pain. You will laugh again. You will be able to look at a pregnant belly or a baby again without crying. But you will never forget, and that’s okay.

Find the support you need when you need it. Cry when you need to. Throw things when you need to. Speak up when you’re not getting what you need from family, friends or your doctor. If your doctor isn’t giving you the information, help or support you need, find another one – remember always that we work for you. Take care of yourself – physically, mentally, emotionally and spiritually.

And if and when you’re ready, give yourself permission to hope again like these strong and brave women did. Today, they pause to remember as well – just as they do every day – but they also commemorate their courage in walking through the pain.

If you’ve ever suffered a pregnancy or infant loss, I hope you give yourself permission to remember and mourn today, but I also hope you come out of this day with a renewed resolve to do whatever you need to do to continue healing – whether it be trying again for another baby or finding peace and contentment with the family you have. No matter what your choice, know that there are medical and counseling professionals ready to help – and while we will remember with you, we also will do all we can to help you continue down the family path you choose.

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Donna Nichols is one of the most courageous and inspiring women you'll ever meet. Here's her story, courtesy of KTVI-TV, about battling the physical and emotional trauma of nine miscarriages before finally giving birth to two beautiful baby boys. Thanks, Donna, for sharing your story and giving hope to many other women dealing with the sorrow of recurrent miscarriage.

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