Goodell’s sign refers to a softening of the cervix indicative of pregnancy appearing around six weeks into gestation. Over the course of the pregnancy, the cervix will soften considerably before it starts to thin, making it possible to dilate the uterine opening for delivery. A physician may be able to spot Goodell’s sign during a routine examination. It, along with other indicators, can be used to identify a pregnancy and determine the gestational age.
This phenomenon is named for an American gynecologist who worked in the 1900s. He contributed a large body of research to the obstetrical field, including the description of the cervical changes later named after him. In eras before reliable blood and urine testing provided definitive information about pregnancies, such signs were especially important for diagnostic purposes. Doctors couldn’t conclusively identify early pregnancy without indicators like Goodell's sign.
The cervix contains tough collagen fibers normally forming a firm barrier between the vagina and the uterus. In pregnancy, the collagen begins to break down in response to hormonal changes triggered by the pregnancy. Goodell’s sign takes the form of a noticeable softening of the cervix which begins to onset around six weeks. In women who are not pregnant, the structure should be tough to the touch, almost like cartilage. Over time, it becomes more pliant because of the decreased collagen bonds.
In the very late stages of pregnancy, women experience a process called cervical ripening to prepare for delivery. The cervix softens and thins, in a phase called effacement. Processes similar to those involved in the development of Goodell’s sign also contribute to cervical ripening. A mucus plug in the cervix acts to protect the uterus until the mother is ready to deliver. It is sometimes possible to hasten the cervical ripening process to encourage women to deliver earlier, as might be necessary if there are concerns about the pregnancy.
After labor and delivery, uterine and cervical changes start occurring almost immediately. The uterus clamps down to prevent blood loss, and over time returns to its original size. Thickening and hardening occur in the cervix to restore its firm composition. It may take several months for the woman’s body to fully recover. If she gets pregnant again, the same process recurs, with the uterus expanding and softening to accommodate the fetus. The cervix and the rest of the pelvis also prepare to hold the growing baby and realign to facilitate delivery.