My friend, the irritable uterus
There are a lot of fun terms thrown around in pregnancy but one of our personal favorites is: “irritable uterus”.
You can’t help but picture a uterus personified as Tommy de Vito (Robert de Niro’s character in Goodfellas) going through his classic rant:
“I’m funny how, I mean funny like I’m a clown, I amuse you? I make you laugh, I’m here to $%&*-in’ amuse you? What do you mean funny, funny how? How am I funny?” — Tommy de Vito (as played by Robert de Niro)
In pregnancy, this phenomenon (also called “uterine irritability”) is used to describe non-labor inducing contractions that occur frequently, sometimes painfully but sometimes painlessly, without any real consistency or pattern.
They are not true labor contractions in that they don’t lead to cervical change, a requirement for labor and ultimate baby expulsion. This big ‘ol muscle is simply twitching. Annoying, yes, but often a result of something as basic as dehydration, stress, or even a full bladder.
Should I be worried about contractions caused by uterine irritability?
Most likely not.
One study showed that a group of surveyed women, who exhibited contractions due to uterine irritability, had a higher percentage of preterm births as compared to the general population (18% vs. 11%). But, beyond this weak association, there isn’t any solid evidence showing a direct causal link between a twitchy baby oven and babies born before 37 weeks.
This is not to say there is no link, but rather a need for better data. Initiation of labor and the role that the uterus plays remains relatively mysterious. We simply do not have the data to understand how these seemingly benign contraction patterns may lead to complications like preterm birth.
Where did the silly name “irritable uterus” even come from?
Ok, here is the fun part (well, “fun” because we are huge nerds):
In 1851, a Dr. McKenzie wrote a piece in the London Journal of Medicine describing the condition. He started by remarking on the dueling titles of the time— hysteralgia and irritable uterus. The latter coined by a Dr. Gooch in 1831 (and, in my opinion, a welcome change from a term that associates our most impressive female organ with hysteria.)
In the early 1800’s, “irritable uterus” was actually used to describe a condition in non-pregnant women and unrelated to contractions.
And, as wont to doctors of the day when describing lady issues, it all comes back to our mental state: “It by no means accords with our observations, that those who are ‘sensitive in body and mind’ are more obnoxious to the ‘irritable uterus’ than those of an opposite temperament” — Dr. William Dewees, The American Journal of Medical Sciences, 1830
A solution to treat the pain from the irritable uterus of 1830? Four to six leeches.
So, with this history in mind, why is it so hard to find a better adjective? Is the uterus truly “irritable” when it is in this state?
What does your irritable uterus say?