Labor with a scarred cervix

[smesler78]

I am currently pregnant (35 weeks) and this will be my 4th child. My 1st two children were completely natural and no trouble at all. My 3rd on the other hand was born 9 yrs after my 2nd child. In between that time I had a couple of procedure performed to to and get rid of abnormal cells on my cervix. First they tried cryo and then the Leep procedure. I did not realize until the delivery of my 3rd child that there would be scar tissue. So while in labor for my 3 rd child my doctor did what he call breaking open the scar tissue so I could dialate. After that I dialated normally and continued with a successful delivery! My question today is being I am pregnant again, will the scar tissue be an issue again with my 4th labor and delivery?

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[Beauchamp]

I had a pretty extensive LEEP a year and a half before the birth of my daughter. Unfortunately for me, my MW didn't know about breaking up the scar tissue (and didn't know my baby was posterior, but that's another story, lol) and my labor was AWFUL. Thankfully your doctor knew to break it up.

This time I have been told by numerous MWs that scar tissue should not be an issue, including a Farm midwife (the ultimate certification!) Since I dilated fully (which you did, too) it all should have been broken through. My doula said the same thing, so I feel pretty confident about it.

[kltroy]

Your cervix basically completely disappears, and has to remodel/rebuild after it fully dilates.  So I'm guessing that since you've been through that once after having the cryosurgery, it should dilate the second time without too much trouble.  Either way, I guess you'll find out soon!!

[*MamaJen*]

This is news to me. I had a LEEP about three years ago. I talked to the doctor pretty extensively and did a lot of research, and I was told that scarring should be minimal and it shouldn't be an issue. My understanding was that the older cone procedure could cause scarring and dilation problems, but the more current procedures were fine. But you guys are saying it did present a problem?

[smesler78]

To be honest I am really not sure about old and new procedures. I guess maybe I was assuming the leep and the cone biopsy were the same procedure which maybe they r, idk? Back in 2005 is when I had a Cone Biopsy done. Never did the Dr even tell me any aftermath that would occur. I actually found out by going to a clinic for an annual pap and the Dr at the clinic took one peek down there and I remember her reaction was scary. Apparently I didn't have a lot of my cervix left. She told me if I every had children in the future I may need a stitch to hold me closed from dialation. Which was just the opposite that happened being the scar tissue held me closed!  Never the less if you need a procedure it's because you have abnormal cells. Which can turn into cancer so take care of number 1 first!!

[Beauchamp]

Originally Posted by *MamaJen* 

This is news to me. I had a LEEP about three years ago. I talked to the doctor pretty extensively and did a lot of research, and I was told that scarring should be minimal and it shouldn't be an issue. My understanding was that the older cone procedure could cause scarring and dilation problems, but the more current procedures were fine. But you guys are saying it did present a problem?

YES. I had my LEEP in January 2008, birthed in June 2009. It was some serious pain. My MW arrived at my house after about 5 or 6 hours of active labor and pronounced that I was in transition because of my volume, how much pain I was in, etc. I was only 3 cm! She basically said each band of scar tissue can feel just like transition, and no one knows how many bands/areas each woman has. (She did NOT know about breaking it up, or if she did, she didn't offer it to me! lol) Internal checks were excruciating.

The LEEP basically "burns" the abnormal cells off with a hot wire (I am, clearly, not a doctor...) and the resulting scar/scab is what the scar tissue is. I'd imagine it hasn't changed much over the years. Although I can't comment on a cone, just the LEEP. I could be totally wrong. I am just relating my own experience. What I heard before my surgery was that a LEEP can cause you to dilate quickly/early (as in needing a stitch, as mentioned below, or that it can prevent dilation, and needs to be broken up, or that for some women it's no problem at all. (everyone is different!) My current MWs and doula say that they seen MANY times where the scar tissue has been manually broken up and the mama, who had been slooowly progressing or not preogressing, suddenly dilates very quickly and has no issues.

Originally Posted by smesler78 

To be honest I am really not sure about old and new procedures. I guess maybe I was assuming the leep and the cone biopsy were the same procedure which maybe they r, idk? Back in 2005 is when I had a Cone Biopsy done. Never did the Dr even tell me any aftermath that would occur. I actually found out by going to a clinic for an annual pap and the Dr at the clinic took one peek down there and I remember her reaction was scary. Apparently I didn't have a lot of my cervix left. She told me if I every had children in the future I may need a stitch to hold me closed from dialation. Which was just the opposite that happened being the scar tissue held me closed!  Never the less if you need a procedure it's because you have abnormal cells. Which can turn into cancer so take care of number 1 first!!

[*MamaJen*]

Thanks for sharing your experiences. I have learned so much over the years from this forum. I guess it sounds like it's not an issue for some women and is an issue for others, but it looks like the solution of breaking up the scar tissue is relatively simple? I'll definitely talk about it with my midwife if I do have another baby later on.

[*MamaJen*]

Here's a good blog post on it: http://enjoybirth.com/blog/2010/11/18/leep-cervix-procedures-cervical-scarring/

[Beauchamp]

Originally Posted by *MamaJen* 

Thanks for sharing your experiences. I have learned so much over the years from this forum. I guess it sounds like it's not an issue for some women and is an issue for others, but it looks like the solution of breaking up the scar tissue is relatively simple? I'll definitely talk about it with my midwife if I do have another baby later on.

From my own research and hearing stories, yes, it's relatively simple to break up the scar tissue, as in, it's done manually with some kind of lubricating/natural oil, and it takes only a few short minutes (often immediately yielding results and the mama dilates.) However, I have heard that it is *very* painful. As in, VERY.

Although, to be honest, it was beyond excruciating (for me) to labor WITHOUT breaking it up and waiting for my cervix to break it on its own. So, those few minutes of pain versus hours? No question!

This is something that is different for everyone, though. I hope for your next baby that you have no problems and it's not even an issue. That can happen, too, so don't let my singular experience scare you.