Cervical Scar Tissue – A Big Issue That No One Is Talking About.
In my first year of being a birth doula, I had this client. She desperately wanted a VBAC (vaginal birth after c-section). She told me how in her first birth that she was in labor for hours. Waters broken, Pitocin, epidural, tubes and wires coming from every direction. During her extremely long ordeal the only change to her cervix was the effacement (the thinning of the cervix). Her cervix never opened at all. I assumed at the time that this was because her baby was just not ready to come out. This time could and would be different. She would wait for labor to start. We would stay at home and labor where she was comfortable. When the day came, that is exactly what she did. Her labor seemed to be moving right along. When we got to the hospital I expected they would tell her that she was 4-5 cms. Instead what we got was, 100% effaced but only a finger tip dilated. I think I may have even gasped out loud. I immediately started beating myself up in my head. How could I have read her labor so wrong? 6 more hours would pass with her, her husband and I working hard. Moving from the birth ball to the shower and I swear every inch of that hospital room in between. After 6 hours, still a finger tip dilated. Obviously there is something wrong with her cervix, but what. No one seemed to know. Not the two different nurses that we had the pleasure of getting to know or the doctor who we saw just once when he was coming to explain that she would be having yet another c-section. This is one of those moments in my career that I really wish I knew then what I know now.
I have never stopped thinking of her. There has always been this part of me that wanted to call her and say “I know what it is now, can you have another baby so we can fix it?” I just know this would not make her feel any better. Instead, I keep her close to me whenever I ask the question now during each and every prenatal visit, “Have you ever had any procedures done to your cervix?” Every single birth professional that is assisting clients should be asking this question.
Look, I’m not a scientist, researcher, doctor and anything else that would know how to study this stuff. What I am is a doula that has had the pleasure of attending over 100 births. I know that the client I mentioned above was not the only one who had a c-section because of scar tissue during my earlier days. I can look back and think of all the clients that seemed to be in transition (7-10 cms) but when checked were still only 4cm. Stuck there for hours and hours. Then wondering for days after their c-section if there was something I could have done differently to help.
A New Day!
The day that changed my life as a doula forever, my very own sister was having a baby. She was having her second baby. I told her how great it would be and it would be so much faster than her first. When she started having surges just a few days before her due date, we were excited. I went to her home (3 hrs away) and stayed the whole weekend. She had surges off and on all weekend but nothing really steady. I went home after three days and decided that maybe my being there was freaking her out. For the next week, she had surges every day. I kept telling her it was going to be great. All this work would get her cervix open slowly and gently. Then she visited her midwife. She was just a finger tip dilated. I chalk this up to my sister being a big drama queen. All the surges have been Braxton Hicks! The next weekend comes and I find myself making the drive because this time her water broke. Now we know this baby is coming. She has mild labor, 7 minutes apart for 16 hours. Nothing is changing. I suggest we head in. Something is just not right. We get to the hospital and a different midwife she has never met comes to check her. 100% effaced but only a finger tip dilated. What?! Are you kidding me?! Then the words that changed my life. “Have you even had any procedures done to your cervix?” My sister says “yes, I had cryo surgery done a couple of years ago to remove pre cancer cells”. Midwife “ok well that makes sense, you have scar tissue on your cervix, and I can feel it.” Huh? Scar tissue on the cervix? Why had I never heard of this? My client from before comes rushing back to my head. Of course! The midwife proceeds to explain to my sister that she is going to try and massage the cervix and break the scar up. With some discomfort for my sister, she went from a finger tip dilated to 3 cms in a matter of minutes. An hour later she was 4 cms and an hour after that my nephew was born. Once the scar tissue had completely released, she flew to 10 cms.
As you can imagine, I asked that Midwife a ton of questions. I wanted to know all I could about this scar tissue stuff. Besides “massaging”, what can you do before hand? She shared her knowledge with me. Told me that HPV is so very common and more and more women are having these standard procedures done, but are never informed that it most likely will leave scar tissue. Although less common, this includes women who have ever had a D & C after a miscarriage or abortion.
Once I was armed with the knowledge, my successful VBAC rate shot up as did my vaginal birth rate in general. I would ask the question and if the answer was yes, I would tell them what I knew. I would suggest that they mention it to their doctor so that if anything came up during labor, would he or she be willing to massage the cervix. Also I learned from that Midwife that evening primrose oil taken orally and vaginally would help break up the scar tissue before labor. (Orally taken the entire pregnancy and vaginally each night only after 36 weeks).
Since this very important day 3 1/2 years ago, I know I have prevented c-sections. Several times in the hospital I have asked the doctor to please, when he is checking mama to feel for scar tissue. Almost every time the doctor has said “oh yeah, I feel some sort of knot here” or some other variation of that statement. This then leads to a question of; can you try and rub it out?
Why Doctors aren’t talking about this is beyond me. I honestly think they don’t know that it is an issue. I don’t believe it is something they are being taught in medical school. We all need to start talking about it because unless women are being asked the question, they just don’t know.
Written by: Doula Dawn Thompson
56 comments
THIS HAS BEEN SO HELPFUL. LUCKILY MY DOCTOR DID ASK IF I HAD EVER HAD ANY SURGERIES. BUT THIS INFO REGARDING THE PRIMROSE OIL HAS BEEN MOST HELPFUL BECAUSE I WAS HAVING CONTRACTIONS 2-3 MINUTES APART FOR HOURS BUT I GOT SENT HOME, THE NURSE SAIS IT WAS FALSE LABOR BECAUSE MY CERVIX HAD NOT CHANGED BUT THAT I WAS AT LEAST 80% THINNED OUT. IT HAS BEEN VERY PAINFUL DEALING WITH THE SCAR TISSUE AND KNOWING THAT THERE ARE WAYS TO HELP VAGINAL DELIVERIES ALONG IS VERY RELIEVING THANK YOU!
OMG…I am sooo glad to read this. I was only dialated to 1 1/2 after 24hrs of hard labor. My water had broke, I was on Poticin, and I was given something vaginally to soften my cervix which was left in for 12hrs. My doctor notices scarr tissuse and decided to place the epidural and attempting to stretch my cervix open. After 36 hrs. of labor the doc said I had to have a c-section. I desperately want to have 5 children and have been worried that would not be possible. My son is now 13months and we are going to start trying for our second baby in June. I am going to take this article to my doctors office before we start trying again and see if she knows anything else I can try as well. I have been basically praying that if I do have to have all c-ections that I would be blessed with multiple birth since they say you can only have 3 c-sections. I am an only child and have my heart set on a big family…if you have any other advice that would help me I would really appreciate it. (both w/ the scarr tissue and with conceiving multiples w/o in-vitro)
Shannon,
I’m glad this has given you an answer that may be an issue you can deal with. The other thing I suggest though, is that it could also be the position of your baby that can also cause prodromal labor. Visit http://www.spinningbabies.com. This site is mostly about breech babies, but also talks about how to get your baby is the best position for birth. You sould be super diligent over the next couple of days in doing the exercises they suggest. It really can make a difference in your birth. Otherwise ask your doc about working your cervix a little and see if he/or she can break the scar tissue. Just know that this is not the most comfortable thing in the world to have done, but way better than the recovery from a c-section. Good Luck!
Kaycee,
I’m sorry that you had such a difficult birth but I hope it helps you know that your body is not broken and is very capable of giving birth vaginally. During your next pregnancy so much research about taking Evening Primerose Oil orally for your entire pregnancy. Most midwives suggest that and then vaginally from 36 weeks on. I would also like to mention that there is no rule about how c-sections you can have. There are plenty of women who have had more than three. Ultimately the risk slightly increases for complications but if you visit the http://www.ICAN-online.com you will find tons of studies and information about VBAC. I’m sorry but I don’t have any tips on how to get multipules. Good Luck!
I’ve had a client with scar tissue on her cervix. Her midwife found it and was able to help it break apart a little. My client who hadn’t dilated in over 24hrs moved from 2 to 3cms right away and continued to progress. I’m sure it made a difference in her labor! I’m glad the word is getting out!
Great information!!!
I had a VBAC 2 months ago, and I think that I also may have cervical scarring from my C-section (never had any other procedures done that would cause it). My OB said she felt scarring, and massaged it for me during labor. It makes me think that could be why I was stuck at 5 cm for over 24 hours?
I’m so thankful my doctor didn’t try to pressure me into another C-section. She DID train with midwives though!
I routinely ask about cervical procedures with all my birth clients. I too spoke to midwives about the Evening Primrose Oil. They recommend it to most of their clients, and have for many decades. I am finding some resistence when my client then takes that information to their OB. The OB’s in general don’t recommend it, because it has not gone through the FDA for approval. Any ideas how I can alleviate any fears based on the OB opinion. My clients that have used it, were very successful in \softening\, \thinning\ and \opening their cervix prior to labor. I also think this helps to prepare them in the event of an induction, to increase the odds for a vaginal birth. Any thoughts on research that I can pass on?
Great info, Doula Dawn. Ever since you shared that info with me, I’ve been telling my HypnoBirthing clients to be aware of this important issue. I’m going to post this to my FB page & to my blog! Thanks!
I had a cerclage placed my last pregnancy because of having two previous preemies. The cerclage is what caused my scar tissue. I felt the urge to push very strongly towards the end but my OB said there is no choice but a C-Sect because I hadn’t made any changes for hours. I was so dissapointed. Is there anything that can be done in future pregnancies to avoid having another C-Sect due to my scar tissue, but not cause premature labor? I am not intending on getting another cerclage. (I was assuming the scar tissue would hold everything in place and I would have to have subsuquent C-Sect’s.) I have a two month old now and we want to have two more. Thanks for your insight and this article.
Angi,
I’m so sorry that your birth was not everything you wanted it to be. I know from personal experiance how devastating that can be. I can’t give you medical advice of course, but what I can tell you is that midwives suggest Evening primerose oil orally during your entire pregnancy and vaginally after 36 weeks. It does soften your cervix and that is why you only do it vaginally after 36 weeks. The idea is that it breaks up the scar tissue. For further advise, I would contact one of your local midwives. You can always schedule an office visit with one even if you choose to have an OB for your care. Some midwives will even do co-care, which you would pay out of pocket. The cost is probably more resonable than you think. A midwife would also be willing to massage your cervix to help break the scar tissue.
The best thing I can tell you is to be sure to get as much information as you can about VBAC. Make sure that you are also with a care provider that is known to support VBAC, not just one that says they do. There is a great website for VBAC info called ICAN-online.com.
Good Luck and I hope nothing more for you than having your best birth next time around!
As a birth doula for the past nine years, I too have run into this situation of “no dilation/hard labor” with many clients. Dawn shared her “aha” moment with me years ago about cervical scarring and it is now a significant part of my consultation to FIND OUT if she’s had any procedures done to her cervix so that I can help her appropriately. So many women have had something done to their cervix, so it is a significant portion of women who are affected by this sort of thing. Many women actually forget if they have had something done because it was a “mild procedure”. I just attended a successful VBAC birth yesterday and cervical scar tissue was a part of it. Most of the women I help with a VBAC have this issue. It makes me wonder just how many women who have had a c-section for “F.T.P.” (Failure To Progress) in fact just had cervical scar tissue that was slowing/stalling their labor. It also makes my heart ache for every woman who has had cervical scar tissue, labored very hard at home only to get to the hospital to hear “You’re not even dilated yet. These contractions aren’t strong enough to dilate your cervix. Come back when you are in real labor.” Ugh!
Thank you so much for sharing all of this information. I am currently in tears as I just experienced such a similar situation with a client, my first client actually. I am a new doula being certified through DONA and I was attending my first birth, a friend from highschool who wanted nothing more than a natural birth. I arrived home from this birth less than 24 hours ago. Mom had done all her research on natural birth, asked me many questions and I had given her many resources. She was birthing at a hospital in New Port beach CA with a very high C-section rate and with a very conservative doctor. However, with her partner and myself by her side as well as a wealth of information we felt confident we could give her the birth she desired. Our plan was to labor as long as she was comfortable at home and arrive at the hospital when she was pretty far into labor.
Mom ended up 41.5 weeks into pregnancy and was getting very anxious. At every appt. her doc would say your cervix is closed shut and very posterior. I tried to help mom not get discouraged and gave her some resources to find some things to get labor going. She decided to start taking Evening Primrose capsules and took them for two days before labor begun. The night that labor started Mom and I went and had a nice dinner and walked around the mall she was feeling a few light contractions. We then sat down and talked for a while and she filled out some papers that I would need for this birth to be part of my certification. While we were talking she said that she was scared that she would not go into labor naturally and would have to be “cut”. She then told me of a procedure she had on her cervix called Cryotherapy about 7 years ago. One doc had told her that it could cause problems in labor, but others including her current OB said it would not be a problem. I said we should go home and look it up on the computer to see what we could find. She called me a little later and we discussed that neither of us had found anything that said it should cause any type of problem.
That night around midnight I got a call from Mom that her water was slowly leaking and she was having mild contractions, I joined her at home and we did some laundry ate some food and went on short walks. Contractions progressed and started happening consistently about every five minutes lasting around one minute; she was handling them beautifully swaying or squatting. She was feeling some back labor and needed counter pressure but all and all was doing great. Mom decided it was time to go to the hospital and called her partner we arrived at the hospital around 6 am. When a nurse came in to check her I honestly thought she would be at least 3cm. As soon as the nurse started her check she said “have you ever had any procedures done on your cervix?” These nurses were so amazing, so respectful of Moms birth plan. Mom expained the procedure she had and the nurses said she had scar tissue on her cervix not allowing it to open. They went and got a nurse who had this her self and who new how to loosen the scar tissue. The nurse loosened the scar tissue, which was painful for Mom but she was so strong and then stated you are 3cm. The entire room lit up with excitement and Mom now had a very positive outlook. Moms family got a call from Dad that she was 3 cm and before I new it they were all there. Now labor really slowed down and contractions almost went away completely. I talked to Mom about the interuption and gave her the idea that maybe Dad and her needed some time to themselves; the nurse also suggested nipple stimulation. For the next four hours Mom continued leaking fluid having contractions and back labor. We walked and tried many positions to get baby to move down and rotate. When she was checked again she was still 3cm. The nursed said she had a bulging fore-bag of water and it might help to rupture it; Mom decided that was the right thing to do. After the bag was ruptured baby moved down and Mom’s back labor was relieved, contractions were now very easy for her to integrate. Family came back in and labor once again slowed. Two hours went by and Mom was checked again still 3 cm. The nurses recomended starting a small amount a pitocin, but Mom was not ready we again started walking got rid of the family and let Mom and partner be alone. 2 more hours and still no change. At this point Mom decided pitocin was a good idea. Nurses started on the lowest dose and turned up the pitocin every 30 minutes. Ofcourse now contractions were very strong, and it took all of our attention to get Mom through each one. Mom and I had now been awake for over 24 hours and I was very worried about her getting exhausted. She handle pitocin contractions without medication for 2 more hours and still no change. The nurse came in and took me aside and said she thought an epidural or some pain meds might let Mom relax enough to dialate or at least get some sleep. I talked with Mom and we all agreed it would be a good idea. After the epidural the nurses cranked the pitocin up and everyone rested. Baby was handling contractions pretty well and we were hoping Mom was dialating. We all rested for about 1 hr and Mo was checked still no change. At this point Mom lost it, and with good reason, she was sobbiong and shaking and it took a lot to calm her down. We did not know what else to try and baby was starting to not look as well on the monitor. Mom was however still not ready to talk about C-section. About another 30 minutes went by of severe shaking and exhaustion all the sudden Mom said ” lets do the surgery.” I had a nurse come in and we all talked about options and what a C-section would mean for Mom and baby. Mom decided it was the right thing to do and at any moment doc would have made that decision for her. One hour later Mom was holding her beautiful 9lb 8 oz baby boy in her arms. He came out with the cord around his neck a few times and quite the noggin. The doc told her it was his size that did not allow him to be born naturally, but I do not know if that was so true. Mom was 5ft 8 in tall and not on the small side, and after reading the above posts I really feel it was the scar tissue on her cervix that did not allow her to dialate. I do not think the nurses were able to get it all, not because of a lack of trying.
I am very grateful and it helped me so much to share this experience here, so thank you. Also although it was a very dificult first birth experience as a doula, being awake for 48 hours and not knowing why what I learned was not helping Mom. It is comforting to know that Mom got to make all of her own decisions in her own time along the way. The hospital staff nurses and doctor really surprised me and in the end I got to use so much of what I have learned and Mom got her healthy beautiful baby b oy. I will always ask every mother if they have had any procedure done on there cervix and explain to them the complications it can possibly cause. I really hope that more research is done on this in the near future and will do anything I can to make this happen. Thanks again for giving me this outlet to share this story it helped more than you know.
Oh my goodness, I am soooo happy to have come across your site. I had a wonderful pregnancy with my 1st child with no complications but the delivery was quite the opposite. I live in a small town near eastern ontario and when I arrived at the hospital 10 hours after being induced with cervadil and contractions every 3 minutes apart, an older nurse told me my cervix was completely closed and that she had never seen this in her 30 years of work. She wanted to send me home after removing the cervadil saying that the contractions should stop once it is removed. I strongly objected since I was having very painful contractions and knew I was not in any shape to be anywhere else than in the hospital . They sent my husband home telling him to go to sleep and that they would keep me under observations. Once the cervadil wore off, the doctor told me that my real labor had kicked in(\real\ I told her, these contractions have been real for 12 hrs now). Since she was a new doctor, she consulted someone with more experience over the phone(I could hear everything, the office was right beside my room) and I was the one who ended up telling her that I had had a liquid nitrogen treatment when I was 17 to remove pre-cancerous cells. While all this was happening, my son’s heartrate had begun dipping and after a 1/2 hour they dragged me to an emergency c-section with my husband making it back in the nick of time. It was a very overwhelming experience. Of course I am grateful that my son is healthy and everything turned out alright but I am bitter that no one had explained to me at 17 that I would have scar tissue on my cervix and that it may cause problems during delivery(maybe they did not know this 15 years ago). Your article has given me new hope of possibly realizing a natural childbirth for our 2nd child and I will take the advice of the evening primrose oil. I was wondering since I know that trying to massage the cervix is very uncomfortable, is there any advice you could give me that I could relay to my doctor to minimize the pain. Is there some sort of numbing cream, injection, or possibly attempting it during an epidural if that were the case that could help. Also, is there anything my husband can do after the 36 weeks to help, I know he would be more gentle than the doctors. Thank you so very much, I now have renewed hope that there may be another way than being cut open…again. Julie
P.S- Just a side note, many friends of mine who have also ended up in a c-section have had problems with breastfeeding after, the problem being the lack of milk supply. I also had to revert to pumping and formula because of the same problem and am curious to see if there is a connection between the 2. We are all women over 30 years of age.
so interesting!! thank you.
I wanted to see if you have any knowledge on women having scarring following long pushing with no actual vaginal delivery that ends in a c-section.
my best friend, who I was a doula for last
may progressed to completion… but after pushing for 3 hours with baby not coming down, wound up with a c-section. I wonder if you have any experience with mamas in this boat who for subsequent births have scarring due to the pushing but with no vag delivery.
mama experiences pain during intercourse 8 months later… has been checked by doc and things look normal… but I wonder. and am thinking about her next birth and desire for vbac wondering if this might be a factor to consider.
thoughts?
thanks.
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That was BRILLIANT!!! I have Doula-ed for 17 babies and have 3 more on my schedule and plan on asking all 3 moms about cervical procedures and will be including it on my prenatal massage therapy intake forms as well. I can’t believe I’ve never come across this topic in any of the books and research I’ve done! You have proven that as doulas, we can learn as much from each other as from our books, sometimes more!!! Thanks so much!
[...] — learn about cervical scar tissue Posted on February 19, 2010 by Kathy This was an interesting post, and I thought I’d pass it along. If you’ve ever had a procedure done on your cervix [...]
[...] http://www.birthresourcenetwork.org/blog/cervical-scar-tissue-a-big-issue-that-no-one-is-talking-abo... Leave a Comment [...]
Thank you so much for sharing this information. It may be why I was on pitocin and not doing anything too. I had a lot of biopsies, but refused the LEEP (thank goodness, now that they’ve realized most dysplasia goes away on its own). I took supplements at alotek.com
Hi, I’m wondering if biopsies can cause scar tissue? You know, you have an abnormal pap, and then they take a small part to biopsy. I had that done twice, wondering if it could cause problems like you’ve described you think?
We use Borage Oil instead of EPO, because Borage has about twice the amount of GLA (gamma linolenic aid. We don’t start cervical checks until 39+ weeks; if the cervix is unripe, we recommend 3-5 capsules per day by mouth and 3-5 in vaginal at night (capsule melts and oil is released). In 5 years, we have only had one client go to 42 weeks and need to be induced at the hospital simply for post-dates (we’ve had inductions for other reasons, including moms choosing induction prior to 42 weeks). Another product that I think helps to prevent post-dates is Dr Christopher’s Pretnatal Formula. 6 herbs that all help the uterus get ready for labor. We recommend that all first-timers take it, starting at 34 weeks. All our clients also take a safe fish oil supplement throughout their pregnancy, such as Nature’s Way Fisol.
I can’t do VBACs, but if I were counseling an intended VBAC, I would recommend all three products.
Baby Love Birth Center
Cape Coral, FL
Amy, yes for sure. I believe its less, but the potencial is still there. Better to treat is as such, than find out while in labor that it’s an issue.
Wow, that is a fascinating post!
Dawn, I couldn’t be more excited. You deserve the credit- for DISCOVERING something profound. Maybe we could make a “seminar” so you could share this information with Nurses, and any OB’s who would be interested enough to listen.
My client yesterday never progressed past 6cms- and her cervix was swelling. I had heard about this from you and discovered, shockingly, when she was at 6cms for 12 hours, that she had had 2 D&C’s- a factor HER NURSE said, when I mentioned (at 8 hours at 6cms) could potentially CREATE a problem of scar tissue. When a C-section was presented as the last hope, I encouraged my client to request cervical massage, in light of the D&C’s, but she was meek and hesitant, and the nurse shook her head sadly, as if this was not going to help, and my client aquiesced, without even talking with the OB about it.
Sadly but very very impressed by your knowledge and discovery,
Kayti
I had steady contractions (every 7-10 minutes) for three 12-24 hour periods the week before my water broke. When it did and I had not dialated, I was put on pitocin. I was on the drip for two days, having contractions but never dialating, before an unwanted c-section. I never had any surgery before though and have only had a D&C since. Is there another reason I could have had cervical scarring, or could there have been another cause for my “failure to progress”?
This is amazing to read – I had a difficult labour and was convinced into having a CS at 5 cms. Would a difficult coil insertion cause cervical scarring? I had a coil fitted at 18 and suffered cervical shock from the procedure. Obviously this wouldn’t be as severe scarring as the treatments other women have mentioned but I guess it’s worth asking your opinion! Thanks!
There is also a connection between this kind of hard labor and slow dilation with women who have been on Birth Control pills– midwives see this a lot and also use EPR or Borage to help break up the tissue caused by the BC use.
I’m nearly breathless with the validation I am feeling right now!!! I had cervical cryosurgery a few years after my oldest was born. But it never came up again (besides being in my medical record) when I next got pregnant 16 years later. That labor got started with Cervadil (yikes) and I labored heavily via the Bradley Method for about 9 hours and was still only 1 cm dilated with no drugs. My contractions started double-peaking very painfully and we decided on an epidural since the situation was puzzling. (They just thought I couldn’t “relax” since it had been 18 years since my last birth.) On my way to delivery for the epi, I had a violent contraction and felt something go “pop” inside. Turns out it was my cervix, and I dilated from 1 to 7 in a matter of minutes! (Yowch.)
I was the one who put two and two together after the fact to realize what had happened. When I had my last daughter two years later, I had a smooth, 8 hour textbook Bradley labor with a fast delivery. (She was born about 3 minutes after getting to the hospital.)
Great information. Thanks
I swear by evening primrose oil and red raspberry leaf tea 
Take care.
Dawn, Thanks for getting the word out. Midwives I have worked with for the ten years or so have been aware of cervical scarring and usually recommend EPO or Black Currant Seed Oil to prep the cervix to all mamas, previous surgeries or not. The majority of folks in hospitals who don’t follow the midwifery model of care seem not to be aware of the risks or possible outcomes of any procedure that alters the cervix (abortions, cryosugery, LEEPs, etc.) It’s great that more people and mamas are getting this information.
I am in tears reading this post…I went through the same thing with my son’s birth. I wanted a natural birth so badly and after 13 hours of labor, 7 hours of intense, close contractions without dilation…I gave up, got the epidural, and later my midwife asked if I had ever has a procedure on my cervix because she felt scar tissue. I had. She massaged my cervix. In 1 hour I went from a 1+ to a 10 with my son descending. He was born 2 hours later.
I have always felt like a failure that I gave up and got the epidural. I really felt like no matter what i did during labor, I was contracting against a brick wall. And I was..well, sort of.
Thank you for acknowledging this can affect dilation. Thank you for educating others on the topic. Now all I worry about it whether or not I will have this problem again. Do you have any insight on this?
Thank you,
Bridget
Hello, I am so pleased that this information is being discussed. I am a new doula and learned about scarred cervixs in the book \the Labor progress handbook\ by Penny Simkin and Ruth Ancheta. I personally had cryosurgery, 2 DNCs,and a C-sect. Lets say I had some scar tissue! My midwife brought it to my attention at a prenatal visit but I didn’t put it together then. My vbac birth was successul but it took a very very long time to dilate, due to that scarring. My twin sisters births were the same as she has also had cryosurgery. Thanks for sharing!
What about massaging the cervix prenatally with herbal oils (like the evening primrose)? Has anyone tried this?
[...] http://www.birthresourcenetwork.org/blog/cervical-scar-tissue-a-big-issue-that-no-one-is-talking-abo... [...]
The Doula Guide To Birth, my book published in 2009 by Bantam Books, discusses the issue of cervical scars on pages 132-133. I list seven cervical procedures that can potentially lead to scarring: D&C after miscarriage, abortion, insertion of IUD, cryosurgery/other treatments for abnormal Paps, biopsies, and removal of polyps. I also report on other, commonly misunderstood, factors in seemingly “stalled” labor: history of taking birth control pills, length of cerix, normal deceleration phase in the Friedman Curve, buildup of lactic acid in labor, and more. For those seeking scientific references on these topics, my book is available in many libraries and on my web site.
[...] this article written by a San Diego Birth Doula to hear her story: Cervical Scar Tissue- A Big Issue that no one is Talking About. Care Providers, Managing Labor, Unmedicated Childbirth, VBAC & Cesarean [...]
This makes me think of a woman that I once knew who had two c-sections both because her cervix never dilated past 1 1/2 cms. I’m glad to learn about this.
I have a question:
Can this sort of cervical scarring occur from placement of an IUD as well?
Jenne,
From what I understand, yes. It can happen for some women after any procedure that occures to the cervix. Anything basically that causes the cervix to be tampered with. I think part of the issue we are dealing with is that most often women are not asking or being told what exactly is happening when they are having something done. The word non-invasive can be very deceiving. My stance is, if you have a proceedure done and it causes bleeding, there is a possiblity that scar tissue can develop.
I could have written this exact story myself. It happened with a backup doula client I went to and we spent 18 fruitless hours of back to back contractions and doing every trick a doula knows. Once we gave up and went to the bc the midwife on call finally realized there was a LEEP in her history and she went from 1 to 7 to birth in less than three hours after breaking up the scar tissue. I ask this question of EVERY mother I work with now as well.
Wow! This post really hits home. I had a cone biopsy and colposcopy in January 2009 then a cryo in february 2009. I felt like the doctor rushed me into making the decision to have it and that he didn’t explain fully the effects. I found out that I was pregnant in June 2009 and at my 38th week OB appointment, I was not dilated at all. At 39 weeks, I still wasn’t dilated and the doctor asked if I had a cryo. I told him yes. He said that was why I hadn’t dilated. He told me he would induce me the Monday of my 40th week. They put me on medicine to make me have contractions. I was told that the baby’s heart rate kept dropping and they performed a c-section the next morning. I was scared and upset at the same time. I had so many problems physically and emotionally following the cryo and biopsy. I wish I had known that it would cause problems with labor.
thank you so much for this information.
i was in the hospital last week and again this week after having 12 hours of labor both times only to be sent home for “lack of progress” for not moving beyond 3cm.
i actually thought about it after leaving this week…. hey, what if my cervix is scarred from that procedure?!?!?!?
i have my 40 week check day after tomorrow and have already called my docs office explaining that i would like them to massage my cervix. they seemed very receptive to the idea… let’s hope.
I am most likely going to need my cervix massaged, because of scarring. Who can I get to do such a thing correctly?
Hi: I’m a women’s health nurse practitioner student in my last semester of school and I am aware of the problem of cervical scarring and the potential impact on labor and vaginal birth. My professors and preceptors are as well- leading me to believe that most OB/GYN docs should have an idea of it, too. In fact, one of my nurse practitioner preceptors had this problem herself during labor, and her OB was astute enough to realize the problem and break up the scar tissue with his fingers.
Often during a woman’s annual gynecologic exam, the scarring to the cervix is apparent because it is palpable during the pelvic exam and/or the Pap sample is difficult to collect (difficulty inserting the cytobrush into the cervical canal or, in more severe cases, unable to insert the brush at all). Providers often use the term cervical stenosis and may note it on a woman’s medical record as a reminder to themselves as to why the Pap report may come back later with a result of inadequate sample. However, they frequently may not communicate this information to the client, especially if she is not pregnant at the time. In any case, cervical procedures after abnormal Pap results are so common that providers should be aware of this issue. The other, related issue is that sometimes cervical procedures take away so much of the cervix that it can cause incompetent cervix later during a pregnancy. However, I have not heard of IUDs being a cause of cervical scarring, because parts of the cervix are not being cut away or biopsied during an IUD insertion.
I could go on an on about this, but suffice it to say that the problem of cervical scarring is one reason why I am so glad that the cervical cancer screening guidelines from ACOG recently changed. Before, too many teenagers and young women entering their childbearing years were undergoing too many Pap tests and invasive procedures to their cervix as a result of abnormal Paps. Now, we know that younger women’s immune systems are adept at clearing HPV infection on their own (extremely common, found in 70-80% of the population), and beginning Paps too soon results in unnecessary procedures and possible harm. The new guidelines recommend Paps beginning at age 21 regardless of age of first sex, and then every 2 years if there are no abnormalities. At age 30, if a woman has had 3 normal Paps in a row, she can go to Paps every 3 years.
Thanks for your post and keep doing the good work of caring for women in labor and birth. Your suggestions about primrose oil sound very effective.
It would be interesting to see some statistics on how many women’s labors are impeded by cervical scarring.
I was glad to come across this article – this too happened to me. After the birth of my second daughter I had an abnormal pap test which resulted in a colposcopy and a LEEP procedure. I was always told that having this would not effect pregnancy or the chances of conceiving. I did end up conceiving a third time, had a perfectly normal pregnancy, but when the time came, I was not dilating at all. Baby had dropped into position, my cervix was effaced, everything was ready but no dilation. My doctor was fantastic and felt right away that I had some scar tissue. He said the chances of me dilating on my own were slim so I was booked in for an induction. I never dilated past 1-2 cm. He gave me an epidural, manually stretched me to about 4 and within the hour I delivered my baby girl. I think it’s very important people are aware of this and I am thankful that my doctor was on the ball and I was able to avoid a C-section. I now make sure to tell everyone I know who has had the same procedure and is planning on having babies to be aware that this can happen.
I had cryotherapy (TWICE) not for irregular cells but for abrasions on my cervix. It was done by some free clinic b/c back then I didn’t have insurance. I didn’t have any HPV just what the doctor described as some cervical abrasions that would not heal properly. Anyway, fast forward 4 years and my husband and I had planned a natural water birth at at a natural birth center located within a hospital. I had a midwife, doula and birth plan. I was ready! Then my water broke and I didn’t go into labor for 12 hours, just light pre-labor contractions 10-15 min apart. When I showed up to the hospital the checked me and I was not even a fingertip dilated. They started induction with an enema which worked like a charm. All the sudden I was having STRONG contractions ever 2 minutes. For 6 hours I labored very hard in what I can only describe as transition like contractions. After 6 hours NO dilation. The looked at me and said, “you are not in labor”. I’d been in what felt like transition for 6 hours and here the were telling me that I wasn’t “in labor”. The midwife tried to pry my cervix open but she never tried to massage the cervix. Then I was transferred to the L & D wing and put on every intervention known to man. After 4 more hours I had some small dilation and another doctor tried to pry my cervix. He got it to about 4 cm. Then the pitocin was causing terrible distress to my son at which point he had a bowel movement. When I was finally wheeled of for the c/s I was only 5 cm dilated and my water had broken 36 hours prior and I’d been in the hospital for 19.5 hours. I never understood what had happened but I assumed my body just wasn’t ready. I was so out of it by the birth of my son that I couldn’t even see when he was born. I didn’t regain my vision until the next day. My doula had to hold my baby to my breast to help him nurse. All I could see was shadows and even then I couldn’t hold my eyes open long. Now I’m planning baby no. 2. We are planning a homebirth with a professional midwife. Thank you so much for this article b/c I would never have thought to take the Primrose Oil prior to this. I’m going to send this to my new midwife and make sure she knows about the cryotherapy.
Cheers,
Jen
So glad to read this! I had a cryosurgery 11 years ago and had heard something about this, but when I asked my OB (for first birth) she acted like it wasn’t really something to be concerned about. Luckily for me it didn’t pose a problem, but people should know this. Knowledge is power.
[...] original article: http://www.birthresourcenetwork.org/blog/cervical-scar-tissue-a-big-issue-that-no-one-is-talking-abo... [...]
[...] about cervical scar tissue and non dilating cervix I came across this article and thought it may help a few people. It talks about the correlation of cervical scar [...]
This makes so much sense now to me. I had to have a c-section for my firstborn four years ago after 11 hours of hard labor I wasn’t progressing past 8 cm and it ended in a c-section. I had another c-section the year after. I am happy with both c-sections, but it’s always been a mistery as to why I wasn’t able to progress more, and reading this I think that I may have had cervical scar tissue from cryosurgery done to me years before to remove pre-cancerous tissue from my cervix. I am going to ask at my next checkup to check for that. Wow! It all makes sense now … Thank you for posting this!
[...] — Tasiyagnunpa @ 2:45 am I thought this was an important enough piece of info about how scar tissue on the cervix can impact dilation, since the number of women having surgical procedures continues to increase with preventative and [...]
Hello,
my frist c-section was a induction I went into labour with very fast hypercontractions…they tried to dialate me overa periuod of 3 days and nothing never more than the fingertip. They were supprised about that after all I had quite some contrations…they noticed scar tissue and I had a c-section.
With my 2nd I tried for a VBAC I had prodomal labor over 4 weeks contractions started and lasted a while but nothing they told me to have a c-section at 41 weeks since after all my cervix is 80 % effaced but a fingretip not even all the way…no induction possible. I did EPO by the way
Well now I am pregnant again and I hope I can have it vaginal at least this one time…what can I do? I mean before labor start what if it never really starts on its own because I never dialate more than this fingretip?? What if something has to be done to my cervix beforehand?? I would try anything, I plan on staying at home with this one till I am further dialated so I might have to work on it myself?? What could I do, I may sound crazy but would a smal vibrator work that massages around the cervix at maybe 38 weeks?? I wonder cause I never really good at finding it myself
Thank you so much for any help
Claudia
Hi,
When I had my son in 2002, I never dialated past a fingertip. On my due date, my midwife did something she called the rotor router, where she manually scratched at the membrane & said labor would be anyday. After being a week & a half overdue I had an ultrasound and told that my contractions weren’t Braxton-Hicks but real labor. When they checked me I still wasn’t dialated. They gave me something vaginally overnight and the next morning I was only dialated 4cm. As labor progressed my cervix started to close back up. I had to have a c-section due to having an “incompotent cervix”. The odd thing is that I never had any procedure done to my cervix until after my son was born. Was there something wrong with my cervix before hand that I didn’t know about?
Thanks for sharing, this has been very informative for me.
Jules
It’s good to see someone talking about this. I was in labor for 36 hours with my first baby; the last 12 hours contractions closer than 5 min apart, the last 3 hours 1-2 min apart. Never dialted past 1. Was sent home twice during the ordeal “until they got stronger”. It was so painful, and couldn’t get pain meds because daughter was not reactive enough on the monitor. Finally begged for this to stop; so they considered this an elective c-section. Anyway, we knew going in that I had cryo and scar tissue – but no one offered to intervene with my cervix, just with surgery. Really saddens me now – I had a second baby via c-section (risk of rupture scared me too much and was having #2 only 18 months later). Now pregnant with 3rd and will have to have 3rd c-section. I wish every day I could have had a vaginal delivery!
[...] a sliver of more information for your tool kit as you keep unpacking and working through this. Cervical Scar Tissue – A Big Issue That No One Is Talking About. | Birth Resource Network Me (34) & H (35) Our darling son 19/3/2008 Planning a 18/11/2010 Reply With Quote [...]
OMG…..thank your for realizing this…..
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