Room Issues: The Womb

Our OB/Neonatal nursing expert, Heidi Creston is back to discuss uterine anatomy. Now, why is this a good topic for writers? I sense the men blushing out there. They’re fearful this is one of those times when the women get together and begin to discuss dreaded “female issues”. Trust me, this post is very tame and a high area of conflict in any novel can be infertility issues. This will give insight. I’ll turn it over to Heidi…

You may be wondering at this point, just what is this girl doing forcing perinatal information down our throats? Truly the sole purpose of my blog is to Right the Perinatal Wrongs, that I have read in several fiction books over the past few years. Authors, even fictional writers, need to acknowledge that they have a responsibility to their readers to give them accurate information especially when writing medical scenes.
Your reader may actually have the condition mentioned in your story, or know someone that does. Your readers may be in the medical field, professionals or paraprofessionals that take great pride in their work and tremendous offense to your presentation of their skills-or lack their of.
Think about it, just like a professional writer would know the difference between a comma and a semicolon, wouldn’t an Infertility Specialist be just as distinct when diagnosing the bicornuate and septate uterus? Of course they would.
It’s okay if you personally don’t know, but if you have a character in your story that is supposed to know….that is not okay, unless of course it’s weaved somewhere into your plot, otherwise it makes your character look ignorant, and in turn that reflects upon the author.

The editor will not necessarily pick up on your mistakes either. They may know as little about obstetrics as you do. It is your job to do your homework to ensure you have the right diagnose and treatment for your characters. So I’m getting down off my soap box now and here we go….

You got a what? Bicornuate Uterus? Are you sure about that?

Authors love to fill their stories with drama, and what brings more tears and heartbreak then a beloved couple struggling with multiple miscarriages…and their diagnosis, is a misdiagnosis via the author…. a bicornuate uterus.

A bicornuate uterus is an acquired birth defect where the top of the uterus forms like the top of a heart (valentine heart) thus making the uterus two distinct chambers. The two major risk factors for a bicornuate uterus are cervical insufficiency and preterm labor. Bicornuate uterus is not a factor in recurrent miscarriages. The patient is closely monitored for preterm cervical dilation. The physician may recommend a cervical cerclage (stitch) in order to prevent preterm dilation. In most cases physicians do not treat this condition. This condition can be corrected laproscopically.

Septate uteri is often misdiagnosed as bicornuate uterus. Septate uteri is round shaped one chambered uterus, that contains a band of tissue called a septum running down the middle. The septum has very little blood supply and cannot support implantation. Women with this condition have an extremely high recurrent miscarriage rate. The treatment for this condition is hysteroscopic surgery (surgical removal of the septum).
Diagnostic determination of these conditions is trifold. Proper diagnosis requires ultrasound, OBGYN evaluation and hysterosalpingraphy levels(HSG).
So, please be careful with your diagnosis, especially when your character is a specialist in their field of study. A professional infertility specialist would make the distinction between these two conditions and the treatment regime to implement. 


Adelheideh Creston lives in New York. She is former military and married military as well. Her grandmother was a WAVE and inspired her to become a nurse. Heidi spent some time as a certified nursing assistant, then an LPN, working in geriatrics, med surge, psych, telemetry and orthopedics. She’s been an RN several years with a specialty in labor and delivery and neonatology. Her experience has primarily been with military medicine, but she has also worked in the civilian sector.

Heidi is an avid reader. She loves Christian fiction mysteries and suspense. Though, don’t recommend the gory graphic stuff to her… please. She enjoys writing her own stories and is yet unpublished. 

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