Methods to break open scar tissue on cervix - What have you seen?

[Carrissa]

Hi all midwives, doulas and childbirth educators,

I'm new to these boards and am currently pregnant with Baby #3. I had a c-section in 1991, a successful VBAC in 2004 and now due 12/2/06.

I have had 2 LEEP procedures on my cervix prior to having Baby #2. When I went into labor w/her, I was not dilated at all. After more than 24 hours of labor, I was still not dilated. Finally in hour #30 or so, the OB tells me she has finally realized what the problem is - scar tissue on my cervix. The interns had not figured it out and they had been the only ones to examine me thus far and were pretty reluctant to do so as my water had broken very early on day #1 and they were worried about infection by examining me too much. My doula that I had never mentioned to me that this might be caused by the scar tissue and it never dawned on me at the time (perhaps because I was in serious pain!!).

The OB proceeded to tell me that she needed to open the scar tissue and that in order to do that she would need to give me an epidural as it would be too painful otherwise. I reluctantly agreed. I had been really looking forward to delivering naturally and believed that I could still do it. About 1/2 hour after the epidural was administered and coincidentally right before she was putting the instrument in to break open the scar tissue, I felt a tremendous ripping sensation inside me. Instinctively I believed that the tissue had ripped on its own. The OB nevertheless put the instrument in, did whatever she was doing (I couldn't feel it) and I IMMEDIATELY dilated from 0 cm. to 4 cm. I was then pushing the baby out in 1 hour literally. 12 minutes of pushing and we were done.

This time around I want to be assured that this isn't going to happen again. I have talked to my OB (still the same office, but that OB during the last delivery was the one on call) and she has expressed to me that typically the scar tissue does not grow back together and I should be OK and not have to do a repeat. I am finding it very hard to believe that. I guess I find it akin to tissue that has been cut and needs to repair itself. So first, I'm wondering if any of you have experience with this and whether you have had a repeat client who has had this problem more than once.

I'm also wondering if there is another method of breaking open the scar tissue without giving the woman an epidural. After it all happened, I thought perhaps I should have asked why they just couldn't numb up my cervix like they had when I originally had the LEEP. I would like to know what my options are so I am more prepared this time. I am not a fan of the epidural!!

My new doula has expressed that her doula group recently had a discussion about this and she was going to find out their opinions as not everyone had had their clients get an epidural. I'm guessing this is becoming more and more common. I would appreciate your knowledge and expertise on the subject. Thanks!

Carrissa

[DLsGroovyMoM]

mkh

[sevenkids]

I've seen this many times, it's pretty common for scar tissue from cervical procedures to slow dilation even with good, strong contractions. The tissue feels sort of crinkly, like cellophane. I don't know what your doctors did that was so painful (and why one felt she needed some sort of instrument!), but I have had great success simply rubbing the scar tissue very gently and breaking it up. It dissolves and the cervix softens and opens right up. It doesn't feel great, but it's tolerable, and I always ask the ladies if they will allow me to do it, and explain the changes as they happen. It's amazing to feel the cervix soften and open, and both mama and midwife are very happy with the changes. It's almost like the cervix breathes a sigh of relief and just releases.
I have never seen it repeat itself, either. Once the scar tissue is broken up, it doesn't seem to grow back, IME, and the next labour progresses without difficulty or the need to break up scar tissue again.

[BirthFree]

My previous MWs used clary sage essential oil dilluted a bit in regular olive oil.

[Charmie981]

Yes, I was going to suggest the clary sage oil. I've also heard that lobelia tincture taken orally helps with "cervical dystocia." I don't know what she was doing with an instrument in there either. The only method I've ever heard of is what sevenkids just described, either with or without clary sage oil as a lubricant.

[JeDeeLenae]

I'm actually not a healthcare professional, but wanted to add my story.

My first son was born after a very tedious labor. No clue why I didn't dialate before being induced and even after induction had very slow progress until I got an epidural 8 hours into it. This time around, my MW actually said it was possibly the scar tissue that caused the problem. (The doctor with ds never even mentioned this.) On the brighter side of things, my 2nd delivery went quite well with no scar tissue problems. I was actually 3 cm dialated at 38-39 weeks. Hopefully you have a similar experience.

[logan&jordansmommy]

I also had some scar tissue last time. My dr said he broke some of it and I didn't feel it but I didn't get past 2 cm so I had a c/s. So either I had more scar tissue or I just wasn't ready anyway (I was induced, long story). But I was told by other mw's that if you have the scar tissue but get it broken up and you do dilate to 10, that you won't have it happen again the next time (not saying it can't happen, just what I have been told).
I did have a naturopathic dr tell me that a dr can give you an epidural and "tear the cervix open." She kept saying that and scared me so I never contacted her again
It sounds like to me you are going to have a great chance of no scar tissue this time!!

[Jane]

I've seen a midwife break up scar tissue in labor. She did a vaginal exam, said she felt a ring of scar and manually broke it by opening her fingers in the cervix, causing a dilation from 1 to 5 cm immediately. She just told the woman that it would be painful, and to take a deep breath and it was over in a few seconds.
I've also been at second or third births where the mom was afraid that would happen again, but it hasn't happened. That's not anything more than anecdotes, but I thought I would share.
I think if it were me, I'd make sure everyone was informed in advance, but not expect it to happen again. After all, the natural collegens in the cervix are broken (enzymatically) during pre-labor and early labor, and when the collegen reconnects, it's not scar tissue-like.

[nickers]

wow i am so glad i found this topic.
I am currently 7weeks pg with baby #2
DS was delivered by c/s after a 15hour labour and my cervix had not began dilating (Not even 1cm) The reasoning behind this is because about 5yrs ago i had abnormal cells quarterised off after a pap smear results.CIN3. This is quiet a common procedure am i am quiet sure many women go on to have natural births afterwards so i was quiet upset that i couldnt.

DS was born at 33weeks so toward the end a quick decision was needed to be made as his heart rate started dropping.

My OB from DS has told me 100% this time thinks i should have a c/s. I am moving interstate so will be seeing a different OB this time so would like to discuss things further with him but this is the first i have heard of being able to break op the scar tissue.

do you know if you can have an internal examination through the pregnancy would determine whether breaking the scar tissue could be successful during labour? Ive always longed for a natural birth and if there is any way possible to do so i would like ti give it a go.
My other risk is i have a 1 in 6 chance of having another prem but that shouldn't hinder whether i have c/s or natural.

[BirthTender]

scar tissue on cervix

I massage it open with some natural oil

[BirthTender]

cervical scars/dystocia

OH, be careful with the lobelia tincture. It is noted with a bacl X not a red X in the herbal pharmacopeia books.
It is also an old-fashioned remedy for asthma/COPD/other chronic lung problems and this is doucmented via scientific research. My Dad, who is almsot 70 remembers the mountain doctors giving lobelia to chidlren with asthma, but the lobelia was rolled up in wrapping like for a tobacco cigarette.
The reason that it might work for cervical dystocia, is because it is a relaxant (that's why is also works on the bronchial passageways). I use strong passion flower tinctures (that I make myself) for dystocias, including cervical ones.

[crysmomofthree]

Omgoodness I can't believe this. I have a very abnormal pap smear during my pregnancy (marked amounts of squamous cells) and it was recomended that I go have a colposcopy and a leep procedure and possibly a cone biopsy. They considered these things safe to do WHILE I am pregnant! (30 weeks now)

I was told repeatedly that the leep procedure would not cause scarring maybe the cone biopsy but not the leep. And that there was no danger to be birth experience such a short while away.

I turned down the procedures and have them scheduled for 8 weeks after my due date. What a bunch of lyers I new it sounded fishy I think I need to go do more research