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Although all women are different, the “average” uterus is somewhat pear-shaped and measures about 3 inches (7.6 cm) in length in the average adult female. This does not mean that variations in shape and size never occur, or that any variation in shape and size is considered abnormal. Sometimes an ultrasound technician or obstetrician may make a comment about the size or shape of a patient’s uterus, referring to it as a "long uterus." There is no actual medical term or uterine abnormality that is known as a long uterus, but there are different shapes and sizes, as well as abnormalities that may result in an elongated uterus.
The uterus actually changes in shape and size during pregnancy. There are a few uterine abnormalities that typically aren’t detected until pregnancy, or until multiple miscarriages warrant further examination. Occurring in only a very small percentage of women, some uterine abnormalities that are indicated by the shape of the uterus include unicornuate and bicornuate uteruses, didelphic uterus, and T-shaped uterus. These conditions occur during fetal development and simply indicate that the uterus did not form properly. In some cases, an abnormally shaped uterus may be the cause of miscarriage.
A long uterus simply means a uterus that is longer than average. On the contrary, an enlarged uterus can indicate medical complications including misalignment, endometriosis, fibroids, tumors, or a complication or condition affecting surrounding organs, such as the bladder.
Most uterine abnormalities, especially those related to the shape and size of the uterus, have no symptoms. They are generally discovered as a result of pregnancy and imaging tests as part of prenatal care. In the event of other gynecological or obstetrical issues, such as ovarian cysts, abnormal pap smears, and other conditions, an abnormally shaped uterus may be detected during the course of diagnostic testing.
If you are aware of an abnormal uterine shape and are concerned about how it might affect pregnancy, you should consult an obstetrician. If you experience symptoms such as heavy bleeding, spotting, uterine pain, or irregular menstrual cycles, you should see a doctor. On the other hand, if you have heard the term “long uterus” or conversely “short uterus,” it most likely is in reference to comparative average length and not the sign of a reproductive problem. If you have any concerns about the size or shape of your uterus, talk to your doctor to help you alleviate any concerns.
@ElizaBennett - I had a midwife who was definitely more relaxed than, for instance, my sister's OB. She said that in some other countries, you *can't* see an OB (insurance will not cover it) unless you are a high risk case. Midwives do *all* healthy women, just like you were recommending.
You're right that women with all sorts of different shapes and sizes of female reproductive organs have babies - but sometimes things *are* problems. And when they are, a trained OB can save your life and your baby's life. After all, the first C-section wasn't done on a whim; it was done as the only way to save mom's life.
It's important not to get bogged down in these terms OBs toss around sometimes about the female reproductive system. Long uterus, small uterus, tilted uterus - none of it necessarily means that a woman won't be able to carry a baby to term and have a natural, vaginal childbirth.
OBs are trained to find problems, not to say, "Ah, it'll be fine." And there's not necessarily anything *wrong* with that, per se, except that pregnancy and childbirth aren't diseases!
I advise all healthy women to see midwives for their prenatal care and deliveries. It doesn't mean that you can't have pain relief during your labor if you want it, just that you are less likely to be told that something is "wrong" and needs treatment.