Previous Cervical Procedure Causing Me Not to Dilate???

[ItzKel]

Ok, so my EDD is coming up this Thursday. This is baby #3, a planned homebirth, and with my previous 2 kiddos I went into labor naturally on their EDD's. I was sort of assuming I would actually go into labor earlier this time around since I am having a girl and statistically girls "bake" faster than boys. I remember with my 2nd DS, I had my cervix checked shortly before I went into labor and was at 4-5 cm dilated already - sweet!! A few weeks ago (at 36 weeks) my midwife wanted to check me to see where I was at and I was told I was at 1cm dilated. A week later (37+weeks) I had another cervical check due to an arrhythmia issue the baby had that brought me to L&D (I had posted about this previously). The OB there told me I was at 2cm dilated. Anyways, fast forward to yesterday, two weeks later, and at my MW appt I asked if she could check me just as an FYI since I'm a few days shy of my EDD. She checks me and says I am at 1 1/2 cm dilated - I remind her what the OB had said and she responded that these checks could be subjective in a way, that maybe the OB had smaller fingers or pushed both fingers in, or maybe even that my body closed up and stopped dilating because of the stress of that week for me re: the arrhythmia, etc. The baby is still high up and she also mentioned the lack of pressure from the baby's head not being engaged could be part of it, and encouraged me to keep walking and doing squats, etc. Overall she isn't concerned and logically I know cervical dilation is not a precursor to imminent labor or lack thereof; however, the fact my body was almost at 5 cm dilation with my last pg and yet I am barely 1 1/2 cm now is a bit frustrating.

This then leads me to think of another possibility, and that is that over a year ago I had a LEEP procedure done on my cervix to remove some pre-cancerous cells. At the time, I asked my OB if this could cause scar tissue build up on my cervix that would hinder dilation for any subsequent pg's I may have, for which she assured me that so many women have this procedure and go on to have children and she doesn't see issues as a result of the procedure. But now I am wondering if maybe this happens more often than OB's or midwives realize, and that "failure to progress" situations could be results of women who have had procedures done but no one has taken into account the possibility that built up scar tissue has hindered the cervix from properly dilating. I read an article today about this very issue and now am paranoid that it may be scar tissue that is keeping my cervix from dilating more than it has in the last few weeks.

Ok, so I admit this may be all just late pregnancy paranoia, but I did want to throw this out there to see if any of y'all have experienced scar tissue on your cervix and had this hinder your dilation when in labor?? I realize I am not even past my EDD right now, but from the way I feel, I could totally see going past my EDD because I just don't "feel" like labor is happening anytime soon...uggghhh, very frustrating thoughts that I wish I had an OFF button for, you know?

Thanks for any feedback, I appreciate it!

[Fyrestorm]

My understanding is that it can effect dilation..

http://www.birthresourcenetwork.org/...talking-about/

[ItzKel]

Yep, that is the article I read earlier... I will definitely have a chat with my midwife about this at my next appt. on Thursday. Knowing she doesn't typically do a lot of cervical checks during labor, I may need otherwise if we all are thinking I'm progressing when in fact I'm not. The last thing I want to go through is a long labor with little to no cervical dilation, only to find out later in labor that the scar tissue could have been broken up hours earlier, you know?

I am curious if others who have had homebirths have experienced a delay in cervical dilation due to scar tissue? If so, how was it managed? How painful is it to 'break up' the scar tissue?

[chandasz]

If it brings you some peace-- I had several LEEP procedures before my first pregnancy. Several. No issues....

[msmiranda]

Yes, this absolutely can happen. My best friend had her first baby a year ago; she had had a LEEP procedure several years prior, and when she went into labor (well, when her labor was induced after SROM), she got stuck at 1 cm for a long time. Her doctor examined her and had to break up some scar tissue to allow her to dilate further. As it happened, she was only about 36 weeks and had had preterm labor weeks earlier, so it was lucky that she had that scar tissue at the time because her baby would have been a true preemie rather than a late preemie if she hadn't. She'll probably need a cerclage next time. But anyway, the scar tissue from her procedure definitely prevented her from dilating.

ETA: I think I remember her telling me that breaking up the scar tissue was very painful ... she got an epidural later on but did not have it then.

[JudiAU]

I've read a few stories were slow dilation were traced to cervical procedures. If you mom and birth practioners were knowledgeable, they were sometimes able to work around it by either giving more time, or massage, even something more invasive that I can't remember. Other times it has led to stalled labors and "failure to progress" with no one making the connection.

I'd alert your midwife that it may be a possible issue.

[AZgirl2207]

A friend of mine was 'stuck' at 6 cm for 30 hours due to cervical scar tissue. MW tried to 'snap' the scar tissue manually. They ended up transferring, got the epidural, and she slept for two hours. The scar tissue 'snapped' and she was 9 cm after her nap. Epi was turned off and baby was born within two hours.

Of course, she had asked her OB (before her LEEP procedure) if it would have any impact on having children. She was told 'no, that never happens.' Well, hindsight is 20/20 and she figures the doc meant fertility not actually pushing out a baby.

BTW, my friend just had her 2nd baby--lovely FSBC birth with zero issues.

[smeep]

I would keep it in mind and discuss it with your midwife but don't worry too much over it because the worry alone could negatively affect your labour. I'm just going to reiterate that being dialated, effaced or whether or not baby has dropped DOES NOT determine when you will go into labour, the length of labour, or how well it will go. Every woman is different and every pregnancy is different.

On the note of doctors who say that it doesn't affect the ability to have children...a lot of doctors are so used to cesareans that they seem to think cesarean is a normal way to give birth and so many of them are unnecessary already, so they may not really have the ability to see if there's a correlation between more complicated labours/births after a LEEP procedure than without a LEEP procedure. KWIM? They just figure if baby comes out and is "fine" then cesarean vs. vaginal is irrelevant and doesn't matter...it's an unfortunate thing that it's become such a common way of thinking for many HCPs.

That's also not to say that LEEP can mean a cesarean is necessary, it could also be that it means mum may need significantly more time, and we all know how common it is for HCPs to have time limits for everything...FTP is generally just a matter of Failure To Wait, and could be higher for women who, for whatever reason, need longer than average, but otherwise may have gone on to have a long but very successful vaginal birth.