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Cervical Scar Tissue ~ A Big Issue that No One Is Talking About.

Posted by on Nov. 17, 2010 at 2:07 PM
  • 9 Replies

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.

Tammy

"It is not the healthy who need a doctor but the sick."

 Join us in the Natural Birth Group!






by on Nov. 17, 2010 at 2:07 PM
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Replies (1-9):
RugersMommy06
by on Nov. 17, 2010 at 4:05 PM

Wow! I have a friend in mind that's due in February that I'm going to call and discuss this with. She's had some issues/surgeries in the past and I think she'd benefit from knowing about the scar tissue factor.

truealaskanmom
by on Nov. 17, 2010 at 6:29 PM

That was one of the first questions Dr. E asked me on my first visit because of my c-section.  Also the midwife checked for it because apparently if you have a c-section toward the end of labor the cut is on the top of the cervix causing the scar to be there rather than higher earlier in labor.  It is sooo important and why they don't check before the BS failure to progress is beyond me. 

truealaskanmom
by on Nov. 17, 2010 at 6:30 PM

Also Tammy would EPO be beneficial to insert vaginally if you have had cervical damage in the past?

DixieFlower
by on Nov. 17, 2010 at 7:40 PM

You know my doula had shared this with me since I had two LEEPS done several years ago. Then during my most recent birth the nurse was checking dilation and she asked me if I'd ever had a LEEP. I told her yes. She said she felt some scar tissue and was going to massage it for me. My doula was shocked as was I. This was my second birth and the scar tissue wasn't even mentioned during the first.

jenni_michelle
by on Nov. 17, 2010 at 9:42 PM

Wow! Thank you for this awesome post!! Wow, wow and wow! I had an abnormal pap smear and so I went and and had a colposcopy and they took some samples. Well a couple months later I got pregnant with my first. I was in labor for 12 hours and no change at all. Although things did change once I had pitocin and a epidural (after the 12hours). Do you think colposcopy's cause scar tissue? My second birth was around 5 hours long... much different than my first 22 hour birth!

Roadfamily6now
by on Nov. 17, 2010 at 11:05 PM


Quoting truealaskanmom:

Also Tammy would EPO be beneficial to insert vaginally if you have had cervical damage in the past?

Evening Primrose Oil can certainly help. It will SOFTEN up scar tissue making it easier to expand or "break up". If a women has cervical scar tissue, she still might need manual help breaking it up.

Tammy

"It is not the healthy who need a doctor but the sick."

 Join us in the Natural Birth Group!






Roadfamily6now
by on Nov. 17, 2010 at 11:07 PM


Quoting jenni_michelle:

Wow! Thank you for this awesome post!! Wow, wow and wow! I had an abnormal pap smear and so I went and and had a colposcopy and they took some samples. Well a couple months later I got pregnant with my first. I was in labor for 12 hours and no change at all. Although things did change once I had pitocin and a epidural (after the 12hours). Do you think colposcopy's cause scar tissue? My second birth was around 5 hours long... much different than my first 22 hour birth!

You're welcome! I did not write it but have heard a lot about this in the past few months. I find it amazing and so true in the majority of women that have cervical scar tissue.

It is also being told to Midwives and OB's currently so word IS getting out there and hopefully the more we all talk about it the more people will listen!  Spread The Word!


Tammy

"It is not the healthy who need a doctor but the sick."

 Join us in the Natural Birth Group!






aecampbell
by on Nov. 17, 2010 at 11:13 PM

Great post.

I am one who has had an abortion, more than one miscarriage, a few D & Cs. . . and am unable to stay pregnant PERIOD! Although, I did have my son. . . but that was VIA C-SECTION! Ahhhh What a bummer. . .

DixieFlower
by on Dec. 5, 2010 at 9:06 PM

BUMP!

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