Double cervix and vaginal birth - Mothering Forums

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Old 10-04-2005, 01:47 PM - Thread Starter
 
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I have a client(due in April) who has a double cervix. This is her 2nd pregnancy. Her first was taken by c-section because of the double cervix. She was told that because she has a double cervix that she HAS to have c-sections. I did a very quick & short google search and apparently this isn't true. Her first was conceived through IUI, 2nd was naturally conceived after I gave her TCOYF and she realized the "specialists" had no idea what they were doing with her first. So she's open to realizing that what they say is often not true, especially if she's seeing the 1 obgyn here who I'm pretty sure she is. So does anyone have any info or know where I can get info on a vaginal birth with a double cervix, anything on a VBAC in this situation too?

Thanks
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Old 10-04-2005, 10:22 PM
 
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i would think that as long as there is one uterus connected to one of those cervixes, then there should be no problem vaginally birthing a baby through it. after all, that one uterus will dilate that one cervix, right?
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Old 10-04-2005, 11:58 PM
 
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I remember seeing pictures in spiritual midwifery. Maybe there is someinfo in there. I dont have my copy handy.
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Old 10-05-2005, 12:06 AM
 
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I don't have data handy, but my understanding is that this type of unusual anatomy can indeed present problems for vaginal deliveries--I've heard (anecdotally) of the "wrong" cervix dilating, for instance. If she's interested, I would encourage her to find some VBAC friendly doctors and speak to them about her particular case. I would not be suggest that this condition may not be problematic--it may be.

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Old 10-05-2005, 12:18 AM
 
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yeah, well, if there were two uteri and two cervixes, then I can see how the "wrong" one can dilate. however, if both cervixes are normally functioning, then why would one be "wrong" and one "right"? either way, the baby will pass through one of them, right?

I guess it's going to be hard to get good answers about this stuff, but a review of the literature from the past 40 years should offer some help. DES (diethystilbesterol, a drug given to women decades ago that caused major malformations in reproductive organs) caused many issues like these and I'm sure that surgeons were less quick to operate then.

I guess I would want to know what the risks are of not having a surgical birth. What risks would come from vaginally birthing a baby with one uterus and two cervixes? Could a trial of labor be done? Does your client know any of this? Does she want a vaginal birth?

I would just think it is hard enough to find VBAC supportive docs, not to mention one willing to VBAC with any reproductive anomoly (not that it makes her risk any higher than any other VBAC, but you know how western medicine thinks...).
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Old 10-05-2005, 12:20 AM
 
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I used to be in contact with someone who had a double cervix. She gave birth twice, both times vaginally. Duringone birth, both cervixes dilated (both didn't dilae completely, however), the other birth only one cervix dilated. I don't know how "smoothly" the births went,and I haven't talked to her in years, so I can't ask either. Similary, I know someone who had a double uterus who delivered vaginally, though she had a really long labor because the wrong uterus and cervix were trying to birth for a while. It can be done. I haven't read alot about it, though what little I have has been mixed. I'm sure it's not hard to find info pointing to the negatives, justmight have to look a litte harder to find positive info. I second the idea of her finding VBAC friendly docs. Ihope everything works out for her!!

Namaste, Tara
mama to Doodle (7), Butterfly (2), and Rythm (due at home 1/06)
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Old 10-05-2005, 03:01 AM
 
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i dont understand how a cervix can dilate more than a few centimeters without a head/bow behind it? how owuld the wrong cervix dilate? i can see it effacing, maybe, and dilating a little from the hormones, but beyond that i am lost. . .

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Old 10-05-2005, 11:45 AM
 
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Ya got me, I just repeat what I'm told I imagin it didn't dilate very far. 'sides, people dilate all the time with a baby whose head is too high up to push on it still.

Namaste, Tara
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Old 10-05-2005, 12:04 PM
 
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well we are midwives right , so basically I believe women can give birth and in this situation it is the pregnancy and labor that will inform you.

yes there could be some problems- having two cervixes is a divisional error does she have a septum in the uterus, a partial septum or full septum , heart shaped fundus , rudimentary horn
get her c-section records( probably the full records from the hospital, not the doctor summary) they may have more details
different configurations could have different problems that you may need to be alert for- a partial septum can make for unusual positioning ie variations of transverse- there also seems to be a higher percentage of breech babies with 2 cervixes and an early problem to watch for would be a tubal pregnancy
A midwife I use to work with had a client with a rudimentary horn and when palpated the fundus had a heart shape to it- the placenta attached in the rudimentary horn area- and it limited the placenta size the placenta was just a bit bigger than a deck of cards, baby did not labor well

so the rest is probably about how labor goes-- I am still trying to imagine 2 cervixes fully dilated - it would seem that one would have to push the other out of the way other wise you would have a bigger 20 cm hole with a lump of tissue between dividing it - probably a well applied head or bottom would decide which cervix dilates more-- or maybe you would have to push a side lip out of the way ; )
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Old 10-06-2005, 12:56 AM - Thread Starter
 
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Thanks. If she is with the OBGYN here I may be able to convince her to go with the other OBGYN here(dh & dw team) who practically lives for not doing c-sections and preserving a woman's perineum. If she's with the high risk dr's in the city, I'm not sure but I could push more because I'll never have a birth with them.lol

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I would not be suggest that this condition may not be problematic--it may be.
don't worry, I had no intention of doing this. I was going to gather info, before bringing up a possibility of a vaginal birth.

I was going to ask them(there's 3 sisters and 1 brother) if their mother took DES while pg with them because all 3 sisters have uterine issues but one of the sisters told me that she thinks it's hereditary because their aunts & grandmother had similar issues.

Sister A(the client) only has 2 cervixes, no septum or anything like that. From what I've read a woman with 2 cervixes does have a higher rate of breech babies IF there is a septum.

Sister B(also a possible client, they're due 2 weeks apart) does/did have a septum. It's confusing, 1 dr told her she had one based on an US then she had a ectopic that burst while she was in the hospital and she lost alot of blood and just about died. Something happened with her anesthesia too. She would have died had she not been in the hospital. While they were doing the surgery for the ectopic they decided to remove the septum and when they went in there wasn't one.

Sister C(AFAIK is not pg, had her baby in Feb), I can't remember what her uterine/cervix/vaginal issue is but she had to have IVF to get pg. Then when she was in the hospital in labour consented to an epidural that worked too high and they had to do a crash c-section and revive her at the same time, then she was on life support for 5 hours.

Since Sister C had the epidural thing happen, none of the sisters want to go that route ever.

All 3 of them have issues and they keep telling their younger brother he's going to birth his own baby.lol Their mom had no problems getting pg or vaginally birthing all 4 of them.
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Old 10-06-2005, 02:15 AM
 
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A doula friend of mine in VA had a client in May with a double uterus and cervix. I told her about the Farm experiences, and we looked up other sites on the Web, and she and client worked together, and the lady had a long labor(most of it at home) and birthed a fine baby after a few hrs in the hospital. So yes, it is possible, and the doc they worked with was very agreeable with them. (He is a rare bird in that state). So that is how that went. FWIW, she had a section with a previous birth, in the other uterus, and wanted to avoid that situation again.
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Old 10-06-2005, 02:46 AM
 
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I've cared for a woman with a double cervix as a L&D nurse and we were just warned to be on the look-out that we didn't get fooled by the other cervix (which in this case did not dilate or dilate much) when doing vag. exams. She delivered vaginally. I know there have been moms deliver vaginally with bicornate uteruses with a cervix on each side too, but I didn't care for any of them.
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