Cervical cancer during pregnancy: Effects, treatment, and more

Finding out you’re pregnant usually comes with a flood of emotionsexcitement, nerves, maybe a sudden urge to organize every closet in your home. Being told you may have cervical cancer on top of that? That’s a plot twist nobody asked for.

The good news is that cervical cancer during pregnancy is rare, and when it does happen, it’s often found at an early stage. Modern medicine has come a long way, and in many cases, it’s possible to protect both your health and your baby’s health with a carefully tailored treatment plan.

This in-depth guide explains how cervical cancer can affect pregnancy, how it’s diagnosed, what treatment options are available, and what to expect for your fertility and your baby. It’s meant for information only and is not a substitute for personalized medical adviceyour own care team should always have the final word.

How common is cervical cancer during pregnancy?

Cervical cancer is one of the more common cancers diagnosed during pregnancy, but it is still considered uncommon overall. Research estimates roughly 1 to 12 cases per 10,000 pregnancies, or around 1.4–4.6 cases per 100,000 pregnancies in some studies. In other words, most pregnancies will never involve this complication, but it’s not so rare that doctors haven’t seen and studied it.

Cervical cancer usually develops from long-term infection with high-risk types of human papillomavirus (HPV). Many people have HPV at some point, but only a small portion develop cancer. Screening with Pap tests and HPV tests is designed to catch abnormal changes long before they become cancersometimes even during early prenatal visits.

Why does cervical cancer develop, and does pregnancy cause it?

Pregnancy itself does not cause cervical cancer. Instead, cervical cancer is typically the result of:

• Persistent infection with high-risk HPV types
• Not being up to date on cervical cancer screening
• Smoking, which weakens local immune defenses in the cervix
• A weakened immune system (for example, from certain medications or illnesses)
• Having multiple full-term pregnancies and early age at first full-term pregnancy, which may be linked to hormonal and immune changes

Pregnancy can, however, make it easier for doctors to find cervical changes. Many people have their first Pap or HPV test in years when they come in for prenatal care. So sometimes it feels like the pregnancy “caused” the cancer, when in reality it just helped uncover something that was already there.

How is cervical cancer diagnosed during pregnancy?

The path to diagnosis in pregnancy often starts the same way it does in anyone elsewith an abnormal screening result or concerning symptoms such as:

• Vaginal bleeding between periods, after sex, or after a pelvic exam
• Unusual vaginal discharge (watery, bloody, or with a strong odor)
• Pelvic pain or pain during sex

The tricky part? Some of these symptoms can also show up in a perfectly normal pregnancy. That’s why it’s so important not to dismiss any new or unusual bleeding and to let your provider know what’s happening.

Tests used to evaluate the cervix in pregnancy

If your provider is concerned about the cervix during pregnancy, they may recommend:

• Repeat Pap and HPV testing: If an earlier test was abnormal or unclear.
• Colposcopy: A close-up exam of the cervix using a special microscope and gentle solutions that highlight abnormal cells.
• Biopsy: A small sample of tissue taken from suspicious areas. Biopsies can usually be performed safely during pregnancy, though they may cause a small amount of bleeding.
• MRI (magnetic resonance imaging): If invasive cancer is suspected, MRI without contrast is typically used to stage the disease because it does not expose the fetus to ionizing radiation.

Your care team will carefully balance getting enough information to stage the cancer accurately while minimizing risk to the baby. That’s why these decisions are made by a multidisciplinary team that usually includes a gynecologic oncologist, a maternal–fetal medicine specialist, and sometimes a neonatologist.

Does pregnancy change how cervical cancer behaves?

A major concern for many patients is whether the pregnancy will make the cancer grow faster. Current research suggests that pregnancy does not significantly worsen the outlook for most people with cervical cancer when the disease is treated appropriately.

What pregnancy does change is the context:

• Your body is already under extra physical and emotional stress.
• Some standard treatments can harm the fetus, especially in the first trimester.
• Decisions need to account for both cancer control and fetal development.

So while the biology of the cancer is similar, the treatment strategy is often very different from what might be recommended if you were not pregnant.

Key factors that guide treatment decisions

There is no one “standard” plan that works for every case of cervical cancer during pregnancy. Treatment is individualized based on factors like:

• Stage of the cancer: How deeply it has grown into cervical tissue and whether it has spread to lymph nodes or beyond the pelvis.
• Gestational age: First, second, or third trimester (and how close you are to fetal viability or term).
• Type of cervical cancer: Squamous cell, adenocarcinoma, or more aggressive types like small cell carcinoma.
• Size of the tumor: Small microscopic lesions versus larger, visible tumors.
• Your wishes: Your priorities about continuing the pregnancy, future fertility, and the balance of risks.

It’s completely normal to feel overwhelmed by these decisions. A good team will take time to explain options clearly and revisit them as your pregnancy progresses.

Treatment options for cervical cancer during pregnancy

1. Preinvasive disease (CIN, carcinoma in situ)

Sometimes, a pregnant patient is found to have high-grade cervical dysplasia (CIN 2 or 3) or carcinoma in situ rather than invasive cancer. In these cases, the abnormal cells are confined to the surface layer and haven’t invaded deeper tissue.

The usual approach during pregnancy is watchful waiting:

• Regular colposcopy and Pap testing to monitor for progression.
• Deferring definitive treatment (like excisional procedures) until after delivery, unless signs suggest invasion.

This approach works because preinvasive lesions typically progress slowly. The priority is to avoid procedures that might increase the risk of bleeding or pregnancy loss unless there is strong evidence of invasive cancer.

2. Early-stage invasive cervical cancer

For early-stage disease (for example, very small stage IA or some stage IB tumors), there may be more than one acceptable path:

• Conization: A cone-shaped portion of the cervix containing the tumor is removed. This can both treat very early cancers and help confirm the stage. It’s often done in the second trimester when miscarriage risk is lower than in the first trimester.
• Radical trachelectomy: Surgery that removes the cervix and nearby tissue while preserving the uterus. In some centers, this can be performed during pregnancy in highly selected patients, usually in the second trimester.
• Delayed treatment: If the tumor is small, slow-growing, and appears confined to the cervix with no lymph node involvement, some patients may safely delay definitive treatment until after delivery. This might involve early delivery by cesarean section once the baby is viable, followed immediately by surgery such as a radical hysterectomy.

To decide whether it’s safe to delay treatment, doctors often evaluate the pelvic lymph nodes, sometimes through laparoscopic surgery up to about 20 weeks of pregnancy. If lymph nodes are positive, a more aggressive approach is usually recommended.

3. More advanced cervical cancer or aggressive tumor types

For larger tumors or disease that has spread beyond the cervix (Stages II–IV), delaying treatment is usually not recommended. The standard treatment for advanced cervical cancer typically involves:

• External beam radiation therapy to the pelvis
• Chemotherapy (often cisplatin-based) given weekly
• Internal radiation (brachytherapy) to the cervix

These treatments are not compatible with continuing a pregnancy because they can be highly toxic to the fetus and can damage the uterus and ovaries. If the cancer is diagnosed early in pregnancy, patients may face decisions about ending the pregnancy so that treatment can begin quickly.

In some situationsparticularly in the second or third trimesterdoctors may use neoadjuvant chemotherapy (chemotherapy given before definitive treatment) after the first trimester to control tumor growth until the baby can be delivered safely. This is a complex decision that requires careful discussion of potential risks, including preterm birth and low birth weight.

4. Mode and timing of delivery

When cervical cancer is present during pregnancy, the timing and method of delivery are often planned with oncology in mind:

• Cesarean section (C-section) is generally preferred if there is a visible cervical tumor, to reduce the risk of tumor bleeding or spread associated with vaginal birth.
• Delivery may be planned slightly earlier than full term (often 34–37 weeks) to allow timely cancer treatment while still giving the baby a strong chance for healthy outcomes.
• In some cases, a hysterectomy may be performed immediately after C-section if it is part of the treatment plan.

These decisions depend heavily on the stage and behavior of the cancer, the baby’s gestational age, and your own wishes after detailed counseling.

How does treatment affect the baby?

Naturally, one of the first questions is, “What does this mean for my baby?”

Key points to know:

• Diagnostic tests like Pap tests, HPV tests, and colposcopy are generally considered safe in pregnancy.
• Most biopsies are low risk, though they can cause spotting or light bleeding.
• Chemotherapy is usually avoided in the first trimester (when organs are forming) because of the higher risk of birth defects and pregnancy loss.
• Chemotherapy in the second and third trimesters may be used when needed. Many babies are born healthy, but there can be increased risk of preterm birth, low birth weight, or temporary effects on the baby’s blood counts.
• Radiation to the pelvis is not compatible with continuing the pregnancy, because it can severely damage the fetus.

The neonatology team (specialists in newborn care) will often be involved early so they can advise on the safest timing of delivery and what kind of support your baby may need after birth.

Will I be able to get pregnant again after treatment?

Future fertility depends largely on the treatment you receive:

• Fertility-sparing treatments, such as conization or trachelectomy, can allow some people to carry future pregnancies, although the risk of preterm birth may be higher.
• Hysterectomy (removal of the uterus) means you will no longer be able to carry a pregnancy, but if your ovaries are preserved, egg retrieval and gestational surrogacy may still be possible.
• Radiation to the pelvis can damage both the uterus and ovaries. In some cases, ovaries may be surgically moved (ovarian transposition) before radiation to preserve hormonal function, and egg or embryo freezing may be considered before treatment.

Ideally, fertility preservation is discussed before treatment beginseven in the whirlwind of a new cancer diagnosis. If this conversation doesn’t happen automatically, it’s absolutely okay to bring it up yourself.

Coping emotionally with cervical cancer during pregnancy

It’s hard to overstate how emotionally intense this situation can be. You’re managing:

• Concern for your baby
• Fear about your own health and future
• Rapid-fire medical decisions with incomplete certainty

A few strategies that many people find helpful:

• Build a trusted team. Ask to be treated in a center that routinely manages cancer in pregnancy and includes gynecologic oncologists and high-risk obstetricians.
• Bring a support person to appointments. Another set of ears can help you remember details and ask questions you might forget.
• Ask for information in plain language. It’s your right to understand what’s happening without feeling like you need a medical degree.
• Seek emotional support. Counseling, online communities, or local support groups for people with cancer or high-risk pregnancies can make you feel less alone.

You don’t have to put on a brave face every day. It’s okay to be scared and hopeful at the same time.

Frequently asked questions

Can my baby “catch” cervical cancer?

Cervical cancer itself does not spread to the fetus in the usual sense. There are extremely rare reports of cancer cells being found in the placenta or fetus, but this is not the norm. The main risks to the baby come from the treatments (like chemotherapy or preterm delivery), not from the cancer cells themselves.

Should I continue my pregnancy?

This is one of the most personal decisions a person can face. For some early-stage cancers, it may be safe to delay treatment until later in pregnancy or after delivery. For more advanced disease, your team may recommend starting treatment quicklyeven if that means ending the pregnancy or delivering early. Your values, beliefs, and family situation matter here every bit as much as the medical facts.

What questions should I ask my doctor?

You might start with:

• What stage is my cancer, and how certain are we about that?
• What are my treatment options at this point in pregnancy?
• What are the risks to me if we delay treatment?
• What are the risks to my baby if we treat now?
• Will this treatment affect my ability to get pregnant in the future?
• Can I get a second opinion from a center that specializes in cancer during pregnancy?

Real-life experiences and lessons learned

While every story is unique, hearing how others navigated cervical cancer during pregnancy can make the path feel less lonely. The following are composite examples based on typical scenarios seen in clinics, not actual individual patients.

Case 1: Early-stage cancer and a full-term birth

Imagine someone who is 16 weeks pregnant when an abnormal Pap test leads to colposcopy and a biopsy. The results show a very early stage IA cancer, confined to a small area on the surface of the cervix. MRI reveals no spread, and pelvic lymph nodes appear normal. After a long discussion with her gynecologic oncologist and maternal–fetal medicine specialist, she chooses a cone biopsy in the second trimester to remove the cancer and confirm the stage.

The procedure goes smoothly. She has a few days of spotting and is advised to rest and avoid heavy lifting for a short period. Follow-up testing shows clear margins and no deeper invasion. Her team monitors her closely throughout the pregnancy, watching for any signs of preterm labor because removing part of the cervix can slightly increase that risk. At 37 weeks, she has a planned cesarean birth of a healthy baby. A few weeks later, she returns for follow-up exams. She feels both grateful and shakenbut also empowered by knowing that careful staging and conservative surgery helped her keep both her baby and her uterus.

Case 2: Balancing advanced cancer and fetal viability

In another scenario, someone at 22 weeks of pregnancy presents with recurrent bleeding after sex and pelvic pain. A large cervical tumor is visible on exam, and staging shows a Stage IIB tumor extending beyond the cervix but still within the pelvis. Her team explains that standard treatment involves radiation and chemotherapy, which can’t be given while continuing the pregnancy.

After counseling and a second opinion, she chooses neoadjuvant chemotherapy starting in the second trimester to control the tumor while her baby grows. The infusion days are exhausting; she battles nausea and fatigue, on top of normal pregnancy symptoms. She also has extra fetal monitoring to watch the baby’s growth. At 34 weeks, the oncologists and obstetricians agree it’s safer to deliver. A planned C-section brings a small but vigorous newborn into the world, who spends a short time in the neonatal unit for monitoring. Within days, she begins a full course of chemoradiation.

The treatment is physically and emotionally draining. She grieves the loss of a “typical” third trimester and the difficulties of caring for a newborn while going through cancer therapy. But she later describes feeling proud of how she and her team navigated conflicting prioritiesgiving her baby a strong start while still taking her cancer seriously.

Case 3: When treatment means saying goodbye to future pregnancies

A third composite story involves someone diagnosed with an aggressive cervical cancer in the first trimester. The tumor is large, and lymph node involvement is suspected. The team explains that the safest course for her survival is to end the pregnancy and proceed quickly with radical surgery and radiation. She is devastated; becoming pregnant had taken years and was deeply hoped for.

With the help of a counselor and support group, she moves through anger, grief, and eventually acceptance. She chooses to explore fertility preservation options before radiation, freezing embryos with the hope of using a gestational carrier in the future. Years later, she remains cancer-free and is parenting a child carried by a surrogate. She often tells others that the story didn’t unfold the way she imaginedbut that having honest information and support early on helped her feel that, even in heartbreak, she made the most informed decisions possible.

These experiences highlight a few common themes: the importance of expert care, clear communication, emotional support, and giving yourself permission to feel everything you’re feeling. There is no “right” way to respond to a diagnosis of cervical cancer during pregnancythere is only the way that aligns best with your health needs, your values, and your life.

Conclusion

Cervical cancer during pregnancy is rare but complex. The good news is that with modern imaging, careful staging, and a multidisciplinary team, many patients can safely navigate both cancer treatment and pregnancy. For some, that means conservative surgery and close monitoring until delivery. For others, it means chemotherapy during the second or third trimester, or even very difficult decisions about ending a pregnancy to prioritize life-saving treatment.

Whatever path you face, you deserve clear information, compassionate care, and a voice in every decision. If you’ve just received this diagnosis, know that you are not alone, and that there are specialists, support groups, and survivors who have walked this road before you and come out the other side.

sapo:
Cervical cancer during pregnancy is a diagnosis no one expects, but it doesn’t automatically mean you have to choose between your health and your baby’s. This in-depth guide explains how cervical cancer is found and staged during pregnancy, what treatment options look like in each trimester, and how decisions change with early-stage versus advanced disease. You’ll learn about fertility-sparing surgery, when chemotherapy can be used while pregnant, why radiation usually requires ending or completing a pregnancy, and how delivery is planned. We also walk through real-world experiences, emotional coping tips, and what questions to ask your care team so you can move from fear and confusion toward informed, confident choices.