If your healthcare provider mentions that you have a “tilted” uterus, you may wonder exactly what that means and how it can affect your pregnancy. While most women have a uterus that tilts forward, as many as one woman in every five is born with a uterus that tilts back toward the spine. The direction of the tilt doesn’t mean there is anything wrong with the uterus. It’s an anatomical variation, something you are generally born with, like being left or right handed. In some cases a tilted uterus has been associated with painful menstruation or pain during intercourse but most women experience no symptoms at all.
Having a tilted uterus was previously thought of as an impediment to becoming pregnant, but most women with a tilted uterus do not have fertility problems. There might be another factor to consider such as scar tissue associated with an underlying condition such as endometriosis or pelvic inflammatory disease (PID) that can make it harder for a woman with a tilted uterus to conceive. Women who have a tilted uterus and find it difficult to conceive may be advised to try different positions during intercourse. Without extenuating circumstances a tilted uterus should not interfere with becoming pregnant, having a healthy pregnancy or create unusual problems during delivery.
Nothing needs to be done to correct the slant of a tilted uterus because the organ is designed to be quite flexible. Even if the uterus starts out tilted toward the back, as the baby grows the uterus lifts out of the mother’s pelvis and naturally moves forward. This usually happens at the end of the first trimester.
In some rare cases, the uterus does not lift out of the pelvis, resulting in a condition known as uterine incarceration. In this obstetrical complication the uterus becomes wedged into the pelvis around the time it should naturally move forward. This is a very rare but treatable condition, affecting as few as 1 in 3,000 pregnancies. Symptoms include an inability to empty your bladder that start around the third or fourth month. Finding it difficult to urinate can put an expectant mother at an increased risk for a urinary tract infection. If you experience these symptoms, talk to your healthcare provider and ask about the best possible treatment. In most cases the uterus will naturally reposition itself to accommodate the growing child.
Having a tilted uterus is not associated with a difficult labor. Women who began their pregnancy with a tilted pelvis are not more likely to have a C-section or any other labor complications.
However childbirth can in some cases change the tilt of the uterus. After childbirth the uterus will usually return to its normal position, but weight gain and stretched ligaments can exert pressure and affect the postpartum position.
A surgical procedure called a uterine suspension was previously used to cut away scar tissue and tighten ligaments to support the uterus tilting forward. Today that surgery has become rare as a tilted uterus is seen as a normal variant and not a potential problem.