Neha Arti 
If you have a tipped uterus during pregnancy, you might have a list of questions.
What caused it? How will it affect my pregnancy?
First off, it’s good to know that having a uterus variation is fairly common. About 1 in 5 women have a tipped uterus. Although it can cause some pregnancy annoyances, it usually doesn’t cause complications.
Read on to learn more about having a tipped uterus during pregnancy.
What is a Tipped Uterus During Pregnancy?
A tipped uterus is what it sounds like: A uterus that’s tipped. Typically, the uterus is in a vertical, forward position. However, some people have a uterus that’s tipped back toward the pelvis. A tipped uterus is also called a retroverted, tilted or backward uterus.
Causes of a Retroverted Uterus in Pregnancy
You may be born with a tipped uterus or it may happen over time. Causes of a tipped uterus include:
- Genetics. Some people are born with a tilted uterus.
- Scarring. A retroverted uterus can also be caused by scarring in the pelvis from conditions like endometriosis, fibroids, uterus infection or pelvic surgery.
- Previous pregnancy. Scarring can also happen from pregnancy, tipping your uterus for the next pregnancy. This happens when the ligaments around your uterus become stretched and don’t return to normal after birth.
- Menopause. A tilted uterus can also happen down the road during menopause when your pelvic ligaments weaken.
Tilted Uterus Signs
Most people don’t experience signs of a tilted uterus. That means some people don’t know they have the condition.
Signs of a tilted uterus include:
- Pain in your lower back or vagina during intercourse
- Difficulty or inability to urinate
- Incontinence
- Difficulty inserting tampons prior to pregnancy
- Pain during your period prior to pregnancy
- Urinating more frequently
- Urinary tract infections (UTIs)
If you have these symptoms, let your doctor know. There typically isn’t a need for treatment for an inverted uterus. However, although rare, it can an incarcerated uterus, which requires management.
Tilted Uterus Diagnosis
A tilted uterus can be diagnosed with a pelvic exam, which will show the position of the uterus. When the doctor is unsure whether you have a tipped uterus or pelvic mass, a rectovaginal exam may be used.
A tilted uterus may also be diagnosed with an ultrasound. This is why many people find out they have a tilted uterus during pregnancy.
Having a Tipped Uterus During Pregnancy
Having a tipped uterus during pregnancy doesn’t typically affect your ability to have a healthy pregnancy. With that being said, it can cause some different challenges:
- Bladder pressure. You may notice more pressure on your bladder in the first trimester compared to the average pregnant person. This pressure can cause you to urinate more frequently or have trouble urinating.
- Tilted uterus back pain. The increased pressure can also cause back pain.
- Harder to see on ultrasound. As we’ll discuss later, it can be more difficult to see your baby on an ultrasound when you have a tipped uterus during pregnancy. For this reason, a transvaginal ultrasound may be used in the first trimester.
Uterus Straightening
Most commonly, your uterus will grow, causing it to straighten and lift out of the pelvis. This usually happens around the end of the first trimester or in the second trimester.
Incarcerated Uterus
Not every tilted uterus tips forward. Although rare, when your uterus remains tipped back, it can become trapped, called an “incarcerated uterus.” This increases your chances of miscarriage.
When the doctor knows about an incarcerated uterus early, they can manage the condition and reduce the chance of miscarriage.
After Pregnancy
After birth, your uterus may return to a vertical position or it may be retroverted. There are a few factors that determine this, including how much the ligaments around your uterus have stretched.
Even if your uterus is retroverted after birth, it typically doesn’t impact your health and you can go on to have successful future pregnancies.
Tilted Uterus Sonogram Difficulties
As mentioned above, a sonogram with a tilted uterus can be more difficult. When you have a tilted uterus during pregnancy, it can be harder for the ultrasound technician to pick up your baby on an ultrasound. That’s because your uterus puts your baby a little further away from the probe, making her harder to detect.
When there’s difficulty detecting your baby, a transvaginal ultrasound may be used in the first trimester to check how your baby is developing. A transvaginal ultrasound is like an internal ultrasound. It involves a wand—called a transducer—being placed inside your vagina, which sends sound waves back, allowing the image to be placed on the screen.
If you have a tilted uterus, you may also need to wait longer until you can reliably hear your baby using an at home fetal doppler.
Tilted uterus sonogram problems are likely to disappear by the second trimester because your uterus will most likely tilt upright.
Tilted Uterus Back Pain and Exercises
Back pain is already very common during pregnancy. However, some people may experience tilted uterus back pain because of the added pressure their uterus position puts on their lower back. You may also experience more back pain during labor if you have a tilted uterus.
Sometimes, your doctor can manipulate your uterus into a normal position. To hold it in the normal position, exercises can be used to strengthen the ligaments that hold the uterus. Doctors may recommend the tilted uterus exercises below.
Kegels
Kegels are an exercise that strengthens your pelvic floor. Many people use Kegels to get better control over their bladder. During pregnancy, they can also be used to increase your chances of having a less painful labor. Ideally, when your muscles are strong, they’re better able to withstand pushing, leading to less pain.
Kegels are sometimes called “invisible” exercises because you can’t see the muscle working. It involves squeezing and relaxing pelvic floor muscles. To do a Kegel:
- Find the right muscle and envision it while performing the exercise. It can help to imagine the muscle you use to stop the flow of urine. To see if you’re using the right muscle, you can insert a clean finger into your vagina and see if the muscle tightens.
- Once you’ve found the correct muscle, squeeze it and hold for a few seconds.
- Release the muscle.
- Repeat. You can increase your repetitions as you get more used to the exercise.
You can also watch a video explanation on how to do Kegel exercises.
Knee-To-Chest Stretches
This exercise can also help shift your uterus into the normal position.
Remember: In the second and third trimesters, laying on your back for too long could reduce blood flow to your baby. Although short exercises are typically okay, don’t spend too long on your back!
To perform the knee-to-chest exercise:
- Lie on your back.
- Bend your knees with your feet flat on the ground.
- Bring your right knee up to your chest, holding behind your thigh with your hands clasped for about 15 seconds.
- Gently release your knee back to the ground.
- Repeat on the left leg.
Watch this video on how to do knee-to-chest exercises.
Pelvic Contractions
Pelvic contractions can help your tipped uterus shift forward. As with other exercises that require you to lay on your back, make sure not to stay in this position for too long!
To perform pelvic contractions:
- Lie on your back with your arms to your side.
- As you take a deep inhale, lift your butt off the floor about an inch.
- Hold for a few seconds.
- As you exhale, release your butt back to the ground.
Watch this video on how to do pelvic contractions.
Summary: Tipped Uterus During Pregnancy
If you realize you have a tipped uterus during pregnancy, you’re not alone. Since a retroverted uterus doesn’t usually cause symptoms, many people don’t realize they have a uterus variation until they’re expecting.
A tipped uterus can be diagnosed during an ultrasound or pelvic exam. In the first trimester, some people experience back pain, bladder pressure and frequent urination from a tipped uterus during pregnancy. It can also make it harder to detect your baby on a sonogram.
In most cases, a tilted uterus during pregnancy doesn’t affect you or your baby’s health. And you can usually expect your uterus to shift upright in the second trimester.
In rare cases, a retroverted uterus can lead to an “incarcerated uterus,” which requires management.
Do You Have a Fetal Doppler Yet?
Fetal dopplers are at-home devices that allow you to hear your baby’s heartbeat while they’re still inside the womb! Many parents say they create magical bonding experiences!
If you have a tilted uterus during pregnancy, you may need to wait a little longer to hear your baby’s heartbeat—but it will be worth it! Once your uterus shifts into a vertical position, it can be easier to hear your baby, too.
Bond with Baby Through Heartbeat. Get Your Fetal Doppler Today!
