There are three issues raised by your question:

1) What is an incompetent cervix and does this terminology have any relevance to someone with your history?

The classical definition of an incompetent cervix is the sudden and painless delivery of a non-viable fetus in the second trimester. Obviously this circumstance does not apply to you. There has been speculation in the medical literature about predicting such cervical failure such as with ultrasounds or even a hysterosalpingogram (an x-ray of the uterus). However, there is no consensus that incompetent cervix can be predicted in advance before the first loss. A patient with a well-established history of incompetent cervix is often offered a cervical cerclage at 12 to 14 weeks in a subsequent pregnancy. This entails placing a suture around the cervix in an outpatient hospital procedure. Since the benefit of cerclages are somewhat controversial and they carry a real risk of premature rupture of membranes, you do not seem to be an appropriate candidate for such an intervention. As a practical matter, the statement about your physical exam does not sound all that unusual, even for a first time mom. From this vantage point, it does not sound like you have any significant risk.

2) What did the health care provider mean when he/she communicated this?

Doctors and nurses occasionally "think out loud" and make seemingly innocuous statements that can engender anxiety in patients. I suspect that your physician did not have any real concern about your pregnancy and that this communication actually was an error of sorts. Either the health care provider should have said nothing or "Gee, your anatomy is a bit unusual, I am worried about such and such, and we should take these actions." All nurses and doctors that I know, including myself, occasionally make casual statements that engender anxiety in patients that we should not have said.

3) If you remain anxious, you should seek a clarification from your obstetrician.

He or she will probably re-iterate that there was never any real concern. If your anxiety remains, you can request closer follow-up. Simply state that you remain anxious and need further reassurance. Examples of closer follow-up can include either periodic cervical exams or ultrasound to be sure that the cervix is not continuing to open. It is worth emphasizing, however, that it does not appear that you have an incompetent cervix and that such problems are difficult to predict in advance.

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