Cervical scarring and dilation?

[Sanguine]

Hi all,
Nine years ago, I had laser vaporization for CIN after a pap smear revealed moderately scary precancerous cells. I had a great surgeon, and have had no more abnormal paps (woohoo).

I'm now a little overdue (edd was 9/3) with my first baby, and a month or so ago my midwife and I were reviewing my history--she groaned when we got to the laser surgery part. She said that surgeries (laser, leep, cone, you name it) can leave scarring on the cervix that make it difficult to dilate. Then she did my first internal exam and found I was already effacing, so I got all optimistic and figured I was in the clear. However, here we are, several weeks of increasingly convincing (and frustrating) false labor episodes later, and I'm about 80% effaced but dilated .5 cm (which sounds like OB-speak for 'nothing doing but we don't want her getting too discouraged)... no change for the last 2-3 weeks.

At my last appt. on Wed. I asked what happens if there is scarring--how do we know, what do we do. My MW said we'd know because I'd be in active labor but just not dilating, and what we would do is pitocin. Ugh! She's very experienced and a great MW... definitely not drug-happy... but I was pretty bummed to think that pitocin might be on the horizon.

I have a call in to her to see what she thinks about evening primrose oil as an alternative... and in the meantime I have some very goofy visualizations going on (involving teams of tiny burly female gnomes hauling on ropes to get my cervix to dilate). I'm hoping this won't actually be a problem for me, but I'm curious to see if anyone else is thinking about this/has dealt with it already. Any thoughts, experiences, pep talks?

Thanks!

[maciascl]

I think EPO helps with effacement rather than dialation, but I am not sure. Your mw could tell you better of course.

I love your female gnomes visual I was going to suggest visualizing your cervix opening, but I guess you are already doing that. I also have been repeating some positive affirmations to myslef & trying not to let any negative thoughts in. I just keep the visual of my 'perfect' birth running through my mind. (It is actually several diffrent positive birth scenes, because there are so many variables, but they remain positive.)

Good luck!

[huggerwocky]

A woman I know had the same probglem. Her cervix was manually stretched during the labour, it did NOT open by itself. They did not try Pitocin.

[gulatigirl]

I can't say I've got any reassurance or advice for you, but wanted to post that I'm worried about this too. I had laser for CIN in 2000 and 2001. I remember reading at the time that there could be some risks associated with getting pregnant and birthing but didn't realize it had to do with dialating. I have noticed an impact on my cervical fluid over the years - it is more white, lotiony and less of the clear eggwhite etc.

I'm going to ask my midwife about it on Tuesday if baby doesn't come by then. I've had lots of contractions off and on but no ongoing labour action. Haven't had any internal exams so not sure how much if any I am effaced and dialating. I had hoped a fair bit but who knows.

So i just wanted to wish you the best and let you know I'll be thinking of you as I head toward these possible scarring complications as well. I'd be really bummed too because we're planning natural home birth and I'm really excited about bringing our first into the world this way.

Let us know if you hear about evening primrose oil!

[VBMama]

Hi - I'm not sure what CIN is, but wanted to tell you that I had cryosurgery(?) to freeze precancerous cells off my cervix about 4 years before ds1 was born. My dilation/labor was slow (36 hours) but I got to 9 cm before I was given pitocin to move things along (ds's heart rate was suffering from the long labor as he had the cord wrapped around his neck, and he was posterior). With ds2 my whole labor was quick & pretty easy. I don't know how the effects of the cryo- treatment on the cervix compare with laser treatment, though.

Sending you good labor vibes!

[Sanguine]

hi--sorry about the jargon! CIN is Cervical intraepithelial neoplasia-- that's 'doctor' for precancerous cells in/on your cervix.

I just talked to my midwife... she wants me to wait til tomorrow (one whole week past edd) before I start with the evening primrose oil... then to put on a glove, pop a couple of capsules of the oil, and gently rub it on the ol' cervix once a day. I just did a little more looking around and found a post on another site
http://forums.obgyn.net/pregnancy-bi...9911/0225.html
which talks about evening primrose oil being especially helpful for people who have had scarring from surgery for funky cells! It does mention being careful not to go poking around internally if your water has broken (mine hasn't)--and I think it's a good idea to talk to your midwife/ob about it first... but it sounds like it could help. My neighbor (2 sons, both overdue) said she dilated after using it for a while& really thought it helped... no surgery/scarring for her, just a stubborn cervix.

Thanks, everybody, & good luck to all of us! I've been having contractions today, but they aren't getting worse yet.. so I'm not getting excited about it. He'll show up when he shows up, I guess!