Uterine Ligaments

In this article and the following video demonstration, I’ll teach you about uterine ligaments and their role in uterine health and position, and the origins of the Wandering Womb. I’ll also cover uterine ligament anatomy, including the round ligaments, the broad ligament, the utero-sacral ligaments, the cardinal ligaments, the suspensory ligaments of the ovaries, the proper ovarian ligaments, and the pubocervical ligament.

When you complete both the Free The Belly Abdominal Scars & Restrictions course& the Womb Care course, you will be eligible for 14 CEUs approved by NCBTMB for home-study self-care continuing education credits! These courses are combined for the 14 CEUs.

The Wandering Womb

“The belief in the ‘wandering womb’ was found in ancient Greece. One description of the theory of a ‘wandering womb’ comes from Aretaeus, a physician from Cappadocia, who was a contemporary of Galen in the 2nd century AD. He wrote that the uterus could move out of place and float within the body.”…. “Edward Jorden, author of The Suffocation of the Mother, used hysteria as an explanation for mysterious medical occurrences in young women. He supposed that the hysteria caused by the “wandering” of the womb around the body was the source of witchcraft, and often presided in witchcraft-related trials as an expert on the subject. The Suffocation of the Mother connected the phenomenon of hysteria with actions like singing, laughing, crying, and choking.” Source 

Luckily, we now know that there is no way that the womb will wander through the body and cause suffocation because ligaments well support it. These are specialized ligaments that often provide pathways for blood vessels and allow some movement, because the uterus needs to move as it grows with a fetus, or as the bladder and rectum fill. The uterus also moves during intercourse, menstruation, and ovulation!

Below you will find an overview of the uterine ligaments and their attachment points:

Round ligaments are thin fibro-muscular cords that run from the lateral aspect of the fundus of the uterus and travel anterolaterally through the inguinal ring and canal and connect to the superficial perineal fascia at the labia majora. The round ligaments pass through the two layers of the broad ligament. The round ligaments lengthen from 4-5 inches to up to 18 inches or so during pregnancy! The round ligaments help maintain the anteverted position of the uterus.

Broad ligament: connects the uterus to the lateral walls of the pelvis.  The broad ligament is an extension of the peritoneum and envelops the uterus in its folds, so it appears as two flat, wide ligaments extending outward laterally.  From the picture below, you can see how the position of the rib cage and motility /mobility of the digestive organs can affect the ligaments of the organs below via the peritoneum.  Everything is connected!

Utero-sacral ligaments: The name implies that the uterosacral ligaments attach the uterus directly to the sacrum, but that is the case only 7% of the time.  This study shows, “the origin of the uterosacral ligament from the genital tract extends from the cervix to the upper vagina. The insertion on the pelvic sidewall occurs to the sacrospinous ligament (see image below) and the coccygeus muscle in 82% of all cases, but in only 7% do the uterosacral ligaments insert on the sacrum, and 11% the piriformis muscle, the sciatic foramen, or the ischial spine. This suggests that the uterosacral ligaments exhibit greater anatomic variability than their name implies, and this might be an important insight for the understanding of the pelvic organ support mechanism.”  This ligament prevents the cervix from moving forward toward the bladder and from prolapsing. Given the attachment points, it makes sense that the position of the femurs, sacrum, and pelvis plays a supportive role. Can you see the importance of the squat and posterior push-off (using the glutes while walking) for optimal sacral positioning? The gluteal muscles are the main force keeping the sacrum from moving anteriorly.  Remember the puppeteer image… sacrum=puppeteer handle thingy,  uterosacral ligaments=strings, and the uterus=puppet

Cardinal ligament:  It is known as the main supporting ligament of the uterus, upper vagina, and cervix.  It attaches in a circular pattern around the cervix and moves laterally to the obturator fascia along the pelvic sidewalls.  Inferiorly, it is continuous with the fascia on the upper surface of the levator muscles! The obturator internis attaches to the medial aspect of the greater trochanter (see image above), so this tells me (I’m guessing, I haven’t seen any studies on this) that a neutral femur would help support the cardinal ligament.  It also makes me wonder if an “incompetent cervix”  has to do with a disruption of flow through the ligament to the cervix due to poor alignment or a tight pelvic floor.

Suspensory Ligament of the Ovaries: connects the ovaries to the lateral sidewall of the lesser pelvis and to the lumbar fascia. These ligaments are extensions of the broad ligaments. The suspensory ligaments of the ovaries are pathways for blood vessels that go to and from the ovaries. These ligaments allow for the ovaries to move like a door on hinges.

The proper ovarian ligament, also called the utero-ovarian ligament, is a fibrous ligament connecting the ovary to the lateral side of the uterus.

The Pubocervical Ligament is a ligament connecting the cervix to the pubic symphysis. It is thought to provide a supportive role to the uterus.

In the Womb Care course, I’ll teach you abdominal uterine massage and pelvic alignment techniques for uterine positioning and more. 

Author: Barbara Horsley has more than 26 years of experience as a licensed massage therapist. She specializes in abdominal massage and Visceral Manipulation™ and is an NCBTMB-approved educator. In addition to being certified in abdominal massage, she also studied biomechanics and restorative exercise. She is also a Certified Women’s Herbal Educator and a graduate of the IWHI Perimenopause & Menopause Certificate Program.