Cervical scar tissue
Last Friday I saw my midwives, Mary and Nedra. We finished the whole urine, weight, blood pressure, fundal height, heart tones routine in about fifteen minutes, and I asked a couple of questions about vitamin K and ultrasounds, and then we just got chatting. Quite a bit of time passed, and their next client didn’t show up, so we just kept on chatting. I could have stayed all day, I think. It was so great to have extra time with them.
I don’t remember how we got on the subject, but Mary started talking about the cervixes of women who have had a LEEP procedure. I didn’t know what LEEP was, so she explained that it’s when they go in and cut away abnormal cells from the cervix. Then bells and whistles started going off in my head because I remembered reading several months ago about how having procedures done on your cervix can create scar tissue that often proves troublesome during childbirth. My midwives said they’re seeing more and more women with cervical scar tissue.
When I first learned about cervical scar tissue’s impact on labor, I thought: women need to know this! I did share a link on facebook and in the sidebar of my blog, but then I let it slip to the back of my mind. After the chat with my midwives on Friday, I felt driven, again, to spread the word. With more and more women approaching childbirth with scarred cervixes, this information is more important than ever. In fact, I have a hunch that cervical scar tissue is likely contributing greatly to the rising cesarean rate.
Why does cervical scar tissue matter?
When a cervix has scar tissue, dilation can occur slowly, sporadically, or not at all. Let me illustrate with an excerpt from the post that first introduced me to this important subject, “Cervical Scar Tissue – A Big Issue That No One Is Talking About,” from the San Diego Birth Network’s blog. The author of the post, doula Dawn Thompson, describes how her sister had spent over a week contracting off and on when her water broke:
She has mild labor, 7 minutes apart for 16 hours. Nothing is changing. I suggest we head in. Something is just not right. We get to the hospital and a different midwife she has never met comes to check her. 100% effaced but only a finger tip dilated. What?! Are you kidding me?! Then the words that changed my life. “Have you even had any procedures done to your cervix?” My sister says “yes, I had cryo surgery done a couple of years ago to remove pre cancer cells”. Midwife “ok well that makes sense, you have scar tissue on your cervix, and I can feel it.” Huh? Scar tissue on the cervix? Why had I never heard of this? . . . The midwife proceeds to explain to my sister that she is going to try and massage the cervix and break the scar up. With some discomfort for my sister, she went from a finger tip dilated to 3 cms in a matter of minutes. An hour later she was 4 cms and an hour after that my nephew was born. Once the scar tissue had completely released, she flew to 10 cms.
Dawn later drilled the midwife with questions. The midwife told her “that HPV is so very common and more and more women are having these standard procedures done, but are never informed that it most likely will leave scar tissue. Although less common, this includes women who have ever had a D & C after a miscarriage or abortion.”
Mary, my midwife, explained that the scar tissue from D&C’s is usually minimal. It’s the LEEP procedure which typically creates the most troublesome scar tissue. When one of my midwives’ clients has cervical scar tissue, they explain to them ahead of time that they will need to have more frequent cervical checks throughout labor so that they can massage the scar tissue. If the cervix is left alone, these women can end up laboring “for days” with little to no progress. They also explained that once the scar tissue has been broken-up, subsequent births are usually much quicker and smoother. Unfortunately, doctors aren’t usually around while their patients labor, so massaging the scar tissue rarely happens. Instead those women far too often get stamped with “failure to progress” after a long, exhausting labor, and sent to the operating room. Many spend the rest of their lives believing they’re incapable of giving birth vaginally.
Thanks to those spreading the word like Dawn Thompson, some women are being spared that outcome. She says:
Since this very important day 3 1/2 years ago [her sister's birth], I know I have prevented c-sections. Several times in the hospital I have asked the doctor to please, when he is checking mama to feel for scar tissue. Almost every time the doctor has said “oh yeah, I feel some sort of knot here” or some other variation of that statement. This then leads to a question of; can you try and rub it out?
Why Doctors aren’t talking about this is beyond me. I honestly think they don’t know that it is an issue. I don’t believe it is something they are being taught in medical school. We all need to start talking about it because unless women are being asked the question, they just don’t know. (Source)
Some women are talking about cervical scar tissue. You can read multiple discussions at the Mothering.com forum. In one of the threads, a women talks about discussing her cervical scar tissue with a nurse practitioner. She had been concerned that her excessive cervical scar tissue might prevent her from conceiving again. The nurse said that “it’s usually more of an issue during a pregnancy (when it can cause pre-dilation and may require cerclage) or during labor. . . . She said most OBs then recommend C-section.” So cervical scar tissue can cause early dilation too? And look at the possible risks associated with cerclage and other treatments for “incompetent cervix”:
- Premature rupture of membranes (1-9%)
- Chorioamnionitis (Infection of the amniotic sac, 1-7%) (This risk increases as the pregnancy progresses and is at 30% for a cervix that is dilated more than 3 cms.)
- Preterm Labor
- Cervical laceration or amputation (This can be at the procedure or at the delivery, from scar tissue that forms on the cervix.)
- Bladder Injury (rare)
- Maternal hemorrhage
- Cervical dystocia [failure to progress]
- Uterine rupture
(Source)
As I talked with my midwives last Friday and our discussion of cervical scar tissue came to a close, I said:
“So, if you want to have better births, protect your cervix?”
They both said, “Yes!” You better believe I’ll be talking about cervixes and the implications of HPV, abnormal cervical cells, LEEP, cervical scar tissue, and impaired dilation with my girls long before they have a chance to put their cervixes in any danger.
Has cervical scar tissue impacted your births or the births of your clients? Please share your stories in a comment. And please spread the word. Women need to know.
UPDATE: Be sure to check out my follow-up post about cervical scar tissue from cesarean births: “Cervical scar tissue and cesareans.”
Related posts:
Yes, it can, scar tissue can make conception more difficult and you’re more likely to need a c-section.
It can also (in severe cases) interfere with menstruation and can lead to endometriosis, cramping, pain, odour and may need a procedure/surgery to re-open the cervix. (and sometimes more than once) There is a tragic post over at Blogcritics and Unnecessary pap tests from a young women left with a seriously damaged cervix after an unnecessary procedure following false positive pap tests in her 20′s. Women under 30 produce the most false positives and it’s 1 in 3 for those under 25. Her life, health and body has been destroyed – her posts were terribly sad and it’s all completely unnecessary, if she were Dutch, Finnish or English she would have been protected from this sort of harm – they don’t screen women under 30 or 25 (UK) for good reason – it doesn’t help, but causes lots of worry and harm. Anyway…
Doctors should not do pap tests during pregnancy – it’s an elective cancer screening test that has nothing to do with pre-natal care or anything else. It was once required for the Pill – that was simply using coercion to increase coverage – when you use an unreliable test to screen for a rare cancer you need at least 80% of women screening at least every 5 years. So, the margins are tight and that’s why we get more pressure to screen for a rare cancer, than a more common cancer like bowel cancer. The most pressure is reserved for the rarest cancer, that’s why rare cancers are not normally the subject of population screening, especially with an inaccurate test.
Agreeing to a pap test within 6 months to a year after delivery can also mean a false positive due to trauma to the cervix and hormonal changes.
I find it disgraceful that doctors will test at these times knowing the risks – that can mean being worried sick your entire pregnancy or being stressed and having unnecessary biopsies or treatment during the challenging transition to motherhood.
It’s only by women talking to each other, and warning each other, that we can make the best decisions for our bodies – our doctors don’t seem to be doing that for us.
Dear Buscando la luz,
I belong to a group of Bulgarian women, united by our desire to make natural birth possible for other women in Bulgaria. To this end we have created a website called Rodilnitza (http://www.rodilnitza.com/) – it offers information in Bulgarian about the options women have in birth as well natural approaches to pregnancy and parenting in general. We would like to translate and publish this article created by you and would like to ask for your permission. We do not charge money for use of our website and we do not receive any remuneration for our work – it’s completely non-commercial and run by volunteers.
If you grant us permission, the your name will be kept in the translation and a link back to the article as it appears on your website will be provided.
Thank you in advance for your valuable contribution to this cause.
Kind Regards,
Violeta Dineva-Ivanova
Yes, I had a similiar experience several years ago. After 2 days of labor and the typical labor exhaustion, we transported only to have the doctor say, “The cervix is scarred. All we need to do is massage it and break that scar up.” He did and she dilated quickly to 10 cm and had a baby. Of course, by that time, she needed his pitocin on top of it all, which we could have avoided had I done some massage earlier, but I didn’t know. Since then, I have seen a scarred cervix on occassion. They don’t seem to open on their own, no matter what. They must be massaged open. However, recently, I have fallen under severe attack by other midwives in my area for doing vaginal exams or any kind of cervical “fiddling” they call it. Some would rather sit with a woman for several hours or days with no progress, and then when the labor wears out, they take her in for pitocin. What is worse? How are long hard labors with no progress good for mother or baby? How is pitocin better for either? Yes, this word does need to get out. Thank you
PS I have also heard that the birth control pill can change the texture of the cervix and cause it to be extra rigid.
Thank you so much for sharing your input, Liz! I had never heard that about birth control pills! Now I’m totally intrigued.
When I was 20 years old my pap came back with severely abnormal cells. I had to have a LEEP procedure. It took me a year to get pregnant with my first son. I was never told that having this surgery could cause issues with getting pregnant and labor (i would have still done it, but it would have been nice to know). I went into labor with my son on a Monday and stayed in labor with him until Wednesday, they had me on potocin and everything. I was MISERABLE, they wouldnt give me an epidural until I reached 4cm, which took me 28 hours! I was so exhausted that I was passing out in between contractions.
CONT…After having my son my cycles became much more painful ( I had always been told they would be less painful) I couldnt get any doctors to check me out. After 18 months we decided we wanted another child. After trying for 18 months I felt like something was still wrong. I had to switch doctors 4 times to get one to finally run tests on me. I always got the “your young, your cycles are regular, and you already have one child” excuse. Well this wonderful doctor finally agreed to run some tests. I went in for a sonogram and they found a mass in my uterus that was 3cm. At first I was told that it was probably a miscarriage that never finished the process. After having to have a DNS it was determined that I had had an infection in my uterus for 2 years now due to my extremely long labor! Due to this infection my uterus could not stay polyp free and my tubes became blocked. We then had to resort to Invitro. Luckily the first try worked and we were blessed with two more little boys. At this point I was so terrified of labor that I refused anything but a c-section. How sad is it when you would rather be cut open because you know it will be a million times easier than what you had to go through in labor. Im not blaming any of this on the LEEP procedure, I truly needed it, but I wish my doctor had been more knowledgeable in how this surgery would make my labor an absolute nightmare, and been a little kinder to me. I was so exhausted from the labor that I didnt even get to enjoy the birth of my first child. I was to scared to even hold him because I was so shaky :(
CONT. after having him my monthly cycles became very painful and I kept telling the drs that I thought something was wrong. No one would check me out because they kept saying I was young and fine. when our son was a year and a half we decided to start trying again. After 18 months of no success I started going to drs asking for help. No one would run tests. They would just say that I was “young, healthy and fine.” After switching drs 4 times I finally found one willing to run tests. they started with a sonogram and saw that there was a 3cm mass in my uterus. I had to have a DNC where they found out that I had had an infection in my uterus the entire time! 2 years!all from my extremely long labor. Due to this my uterus had a horrible time staying polyp free and my tubes became blocked. We then had to resort to invitro. Lucky for us it worked the first time and we were blessed with two more wonderful little boys. I was so terrified of labor though that I refused to do anything but a c-section. How sad is it when you would rather be cut open because it seems like a much easier option, and I have to tell you after what I experienced in labor, it was easier. I wish that my dr at the time had known the complications of a leep procedure and how that it would make my labor an actual nightmare. They refused to give me an epidural until I reached 4cm which took me 28 hours!!! All of this, having to have many tests, procedure, and surgeries all lead back to that horrible labor. Having to pay a ton of money and go to extreme circumstances to be able to have more children, all go back to that labor.
I went to a health clinic today to receive a IUD, during the procedure the nurse advise e that because of my scar tissues she wasn’t able to finish the procedure.I’m only 36 and my only child is 20 I’ not really sure what it means and what I should do. But I don’t want and more children
Tammy, I just had the same experience yesterday. The fact that I had this scar tissue was news to me; and now this additional information regarding the pill is also disturbing.
I had already had 3 fairly fast, easy and uncomplicated births (one being a vaginal twin birth) when I had my LEEP procedure done due to pre-cancerous cells being found and testing positive for HPV. All my labors and births were no longer than 18 hours from beginning to end. Eight years after my 3rd birth, I became pregnant again, quite easily. At almost 40 weeks and 2 days of contractions I had NO progress…none!!! 12 hours of cervidil (sp?), IV fluids…nothing. My Dr. suggested an epidural (probably thinking that a C-section was possible). Right before I recieved the epidural my water broke but I was not dialated at all…I felt the pop and felt DD drop. My Dr. checked me again…my cervix was completely closed…not even a dimple. But after I had the epidural within 10 minutes she was born. I dialated completly and delivered in 10 minutes! I bercame pregnant again 6 months later so I figured with this delivery it would be faster and easier. It was practically identical to the previous birth…this one quite a bit more painful and this time I actually dialated to 3 cm on my own…before the dreaded epidural…then I dialted within 15 minutes. I know that you relax more (supposedly) but I am due again in 2 1/2 months (last one!!!) and I really don’t want any intervention or medication but unfortunately I don’t trust my cervix anymore. I knew it could make labor and birth a little harder and longer but nothing ever prepared me for my last 2 births.
Unfortunately I don’t have an answer for you, but would love to hear if anyone else does. I talked recently to a friend who does the exact same thing with epidurals… she has a lot of kids, and it’s always the same thing. She can labor a long time or a little, but never dilates (or hardly at all) until she gets the epidural, and then goes to complete in sometimes minutes. If anyone has answers, please share!!
I had a friend who also had a hard time dilating without an epidural. I don’t know what to tell you. It sounds like maybe your cervix is opening up a little more on its own with each birth. SO maybe this time it will ease open more easily? Maybe I’ll post a question on my fb page wall to see if anyone else has some ideas. https://www.facebook.com/BirthFaith GOod luck, Virginia!
Busca- do you know if scarring would be a problem only on the first birth following a procedure, or is it all subsequent births? If you had LEEP, say, when you’re 20, and then have the scar tissue broken up while in labor at 24, would you likely have similar problems dilating with a 2nd (or 3rd, etc) baby? Or once it’s broken up, does it stay like that?
My midwives said it’s usually not a problem in subsequent births after it has been broken up. But I can say from personal experience.
I had 2 LEEPs done in between my first and second baby, expecting a short L&D as my first was less than 5 hours I was afraid I was not going to be able to deliver vaginally after 13 hours of HARD labor and no significant progress. I am not sure if the Vag checks got me enough of a massage or it was the shot of Morphine I got that caused my cervix to go from 3 – 10 in less than 20 minutes but she came fast once things started moving. #3 was only about 4 hours of labor and #4 was 2 hours. So once the scar tissue was streached for me things went well for the subsequent births.
Funny thing is I asked my Doctor about it, while I was pregnant with 2, and she assured me that it would not impact my L & D.
Like Busca, I can’t say from personal experience, but it will likely depend on a number of factors including but no limited to the length of time between pregnancies, how your body typically responds to scar tissue, the extent of the scar tissue, if any recurring infection(s) have been present postpartum, and generally your overall health. I don’t know if there are diets, herbs or other supplements that are generally healthful in relation to scar tissue but I suspect if you research you will likely find that there are things you can be proactive about doing to aid yourself, in this matter.
It’s a great question. I would venture on average that scar tissues on the cervix are less of a problem in subsequent births just as it is typically easier for a cervix to dilate in subsequent pregnancies. Blessings towards you in hopes that it isn’t ever a problem again.
I have had an extensive LLETZ procedure done on my cervix late last year. I have now found out I am pg again which is very surprising as I have barely finished bleeding from the LLETZ (I had excessive bleeding and needed packing in theatre due to the blood loss).
I have also had many biopsies (not cone biopsies though) including one before children in about 2004 – I struggled to dilate with my first child but had an easy 2nd labour (baby born at home with MWs) and had planned to have my 3rd at home but after 3 weeks of pro-dromal/latent labour baby had got very distressed and passed lots of meconium so when my waters went they were green! That baby was born in hospital but again a quick and easy birth.
This baby I worried about birthing as I have about 6 biopsies and then the LLETZ (pre-op consent went over the risks of pre-term labour but didn’t mention problems if you got to full term). Is there anything I can do to help the scar tissue when the time comes?
I can’t take evening primrose oil due to a contra-indication with a pre-existing condition so I don’t know what else there is!
Any advice?
The only other solution I’m aware of is to have your care provider massage the cervix to break up the scarred tissue. Wish I could be more helpful, V!
Thank you so much for posting this!! I was told I have HPV and then underwent a colposcopy just 2 months before getting pregnant with my son. I was induced at 38-5 (by my midwife for a big baby but that’s a whole nother story!) I was very slow to progress and ended up with a c-section after just 10 hours. I always thought it was simply that my body and baby were not ready yet and now I beleive cervical scar tissue may have played a role too! I am hoping to one day have an HBAC, before now I never would have know to ask about any scaring!!
Thank you again!
I believe this is what cause issues with my cervix during my 4th birth. I had an IUD prior to #4 that ended up with the strings going up into hiding in my uterus. So when it came time to remove it the OB had to try and fish the strings out with some jabby metal tools. It took quite a bit of fishing to get the strings, and besides being extremely painful, I believe it also caused scar tissue in my cervix. So with #4 I went into labor at 38 wks (about when I’d had my 2nd and 3rd), and cx were 5 min or less apart for a long time, intense and was having bloody show. So I called my midwives, they came to my home, checked me and said I was 5cm and 100% effaced so we all expected a baby before long. Well things just kept puttering along, and finally 4-5 hours later I had the other midwife check my cervix and she said it was about 6 cm then said “wait a minute, actually it’s funnelling and the inside area is only 4 cm. I was not happy to hear this. Eventually I sent everyone home and then spent the next 2 wks having contractions and my cervix was slowly changing a tiny bit, but still funneling. Finally the day B was born after being up all night with really hard cx 10 min apart all night I decided I was going to try and stretch my own cervix (I had already been checking it at that point which I think helped me not go insane since at least I got what they were saying about the funnelling), and I was pretty aggressive at massaging/stretching that inner area of cervix. After that I went to the birth center (I had decided to go there rather than birth at home at that point), and cx were still just puttering along. Midwife got there after I’d been laboring for about an hour and checked me. I was 8 cm and the cervix was pretty much all just mush with how soft it was. She suggested I push through a cx to see what happened. I went and sat on the toilet, pushed and babies head moved right down and was bulging on the perinium. He was born 10 minutes later. His birth day was fantastic, but seriously those 2 weeks leading up to it were pure torture! I thought I would lose my mind. I was so happy after the fact when I found info about scarring and could finally feel like I understood what had been the hold up with his birth. I’m expecting #5 in June and I’m hoping that the scar tissue won’t be an issue, but at least now I know what to do if it is!
I am so glad to have found this! I am pregnant with my 4th baby, 39 weeks. I went to my dr today, he had planned on sweeping my membranes if my cervix was favorable. While doing the procedure, which was getting quite painful, he asked if I had ever had any cryo surgery done. I told him I had not. After a few very painful mins of trying to sweep, he gave up. He told me my cervix was dilated to a 2, almost 3, but just past the tip it was hard and closed. He admitted he had never encountered anything like it. I was at a loss, all my other pregnancies I was much more dilated at this week. After I left the clinic, I got to thinking, I had a D & C after a miscarriage 3 years prior. I wondered if that could cause scar tissue on my cervix. I have spend the afternoon looking for information, and this seems to fit exactly what I am experiencing. What advice would you give me, concerning labor? I am now worried that I won’t dilate properly and I do not want to have a c-section. I have been taking EPR for the last 2 weeks, orally and vaginally. It wouldn’t seem that has helped the scar tissue to break up.
I’m glad the post was helpful to you, Tabby! I don’t know what to tell you except that you will want to ask the doctors and nurses who are caring for you in labor if they would be willing to try to massage the cervix to break up the scarring. Good luck and let me know how everything turns out!
Thank you for educating women about this! I had the same thing happen. I’d had cryotherapy 8 years before my baby was born. After 12 hours of labor & hardly dilated, a 2nd shift nurse asked about prior procedures. My doctor then returned and broke up the scar tissue. Unfortunately, it was hardly painless for me. But it was worth it. A couple of hours later, my baby was born. I have heard that the scar tissue can re-appear, so I’ll know this next time around.
Yes, I had cryo therapy done when I was 21 and when I was 31 I labored for 36 hours and ended up c-section. My second child I had natural waterbirth vBac that only took 5 1/2 hours but ended up post partem hemoraging BADLY with a shredded cervix. I ended up needing a blood transfusion. My midwife suspected that my cervix did not dilate completely due to scar tissue. Since I most likely pushed through an undilated cervix it shredded it! When the midwife and emergency Dr were searching for the reson I was bleeding out everywhere I was torn REALLY REALLY bad and ended up having major reconstruction repair surgery 1.5 years later with a 12 week recovery. I will now have to have c-section in the future. All do to HPV given to me from my cheating exhusband!
A few days before my first child was born, I went to the Labor & Delivery at our hospital because I was certain my water had broken, though I seemed only to be leaking at night when laying down. They did a cervix check and asked me if I had every had surgery on my cervix because I had what felt to them to be scar tissue on my cervix. I’ve never had an abnormal pap, although I’ve also only every had about 5 or so and I am 30 years old. I had an emergency c-section with my first after 36 hours of regular 2-3 minute contractions (baby never engaged and I never dilated). With our second child, I found a new OB who was open to a VBAC, but still ended up with a c-section due to not dilating (this time baby was head down and fully engaged). Not only did I not dilate, but the doctor said I didn’t even fully efface, that part of my cervix was 100% effaced and part never got past 50%. But never was scar tissue mentioned again by either OB. I’ve been having issues now with my cycle since having my son and a few people have mentioned that endometriosis can cause cervical scarring. My sister has endo, my mother has PCOS and my younger sister is showing signs of PCOS as well, so I know my chances are high that I may have such an issue. Do you know anything more about the connection between endometriosis and cervical scarring?
Wow, Elizabeth. I had no idea endometriosis could cause cervical scarring. I don’t know anything more about it, but I’d love for you to come back and share here whatever you do learn. I may even have to do some digging and maybe a blogpost about it. Good luck with your journey.
I had a LEEP done 16 years ago right after having my 2nd child. When she was 13 months old, I conceivedmy first son. I started dilating an bleeding at 6 months, and he was born healthy at 35 weeks and 4 days. Wheh he wad 12, I conceived my 2nd son. I started contracting at 18 weeks, which led to dilating and meds to stop all of it that worked wonderfully. My midwife stripped my membranes at 38 weeks and broke a and of scar tissue-I went from 3 to 5 cm in her hand! He was born 7 hours later after numerous bands of scar tissue. When I conceived my 5th child, I was worried about the scar tissue returning-it was horribly painful. Didn’t have those problemsbut my cervix was about half the length it should have been and had started to dilate @ 27 weeks and I had to go on bed rest and insert vaginal progesterone suppositories twice a day. We made it to 39 weeks and 1 day and had no painful scar tissue.
I had the LEEP procedure done at age 19 to remove cells, and. D&C a couple years later to remove polyps in my uterus. Ar age 35 I became pregnant with my first child. At 40 weeks, the dr did an exam – I was neither dilated or effaced. At 41+5, I started leaking brown water….the doc said he thought it was old blood, but couldn’t explaun it. I was only very slightly effaced but not dilated. He said he could feel a scar on my cervix. I was admitted to hospital and hooked up to oxytocin. After 20 hours and a failed epidural (which they had to redo), I had only gotten to 5cm and they suggested a section, which I accepted. The doc recommended future sections, but now I wonder if I should seek out a midwife who is able to do the massage….I’m so glad I found this site cuz I was given such little info by the doc.
I am a Breastfeeding Peer Counselor and am a CLC certified lactation Consultant.. I am pregnant with my 3rd child and my co-peer clc’s are always looking for reasons why moms who have csections have such difficult times and experiences with breastfeeding. I am one of thosethat when I was 16-17 had the LEEP Done and to this day all that rings out to me is the nurse trlling me to be still “that if I dont have the procedure I’ll never havr babies.. Well now there will be 3, but I am sonpraying that with my new found knowledge of cervixal scarring and the use of EPR that maybd I can talk my dr into massage and possibly trying to have a VBAC.. I so really really desire to give birth naturally.. and to be able to go back and give my old OBs this information.
Thank you for this article–I found it through a Facebook friend and it relieves fears I’ve had for some time. I have never been pregnant, but three years ago I found out that I had slightly abnormal cervical cells and read just about everything about the possible procedures I might have to get, like LEEP, etc. I knew that if I did have to get these procedures they could cause problems with future pregnancy, and that was part of the general terror and anxiety I had about the whole thing. I’ve had multiple colposcopies over the last few years but no actual procedures to remove cells, which had cleared at my last exam (but still kind of pessimistically afraid they will return). Anyway, I am very reassured to know that at least in many cases, it sounds like with proper care, a woman can get a LEEP and still be able to have a regular birth. Since I’ve had biopsies, it’s also really helpful to know that if I do get pregnant, I should find a OB/doula who knows about massaging cervical scar tissue.
Because on the whole this is really awesome info, I feel bad for complaining about anything, but, okay, when I found out about the irregular cells I was really swamped with guilt that’s been very hard to disperse–e.g., “it’s my fault/will be my fault if I have future problems with pregnancy,” etc. Like at one point I was literally sobbing on the floor thinking I’d destroyed the lives of my future children–which was clearly ridiculous; as I said, I was somewhat ill-informed about the whole thing and have a tendency to be self-critical and melodramatic. But anyway, using “protect your cervix” as the key phrase, while very important, also makes me a little uncomfortable, because so many women do get HPV and do have to get these procedures, and it seems like it’s pretty easy to jump to the conclusion that they should have “protected their cervixes better,” which puts the fault on them? But maybe that’s not at all what you intended; I apologize for nitpicking a really great and important piece of writing here because of my own neuroses. No one else seems to have mentioned this so I am probably being hyper-sensitive, it’s just something that really severely impacted my psychology for the last few years.
I had a LEEP procedure when I was 17. I don’t think it was unnecessary because I had an active case of HPV, but it did cause scar tissue, so when I was pregnant at 18 it took two days of five minute contraction to dilate to 4 cm. Fortunately my hospital kept sending me home thinking that I was overreacting because of my age and not really in Labor. It was horrible. When I finally was allowed to stay at the hospital I still progressed slowly, but I was able to deliver vaginally without to much intervention (thank GOD I have a uterus of steel that can push a baby out without helping) Even though it is supposed to be easier with each birth that has not been my story. Early Labor (0-4cm) is always excruciating because of were the scar tissue is located once I get past that point it goes really fast. Besides working with an amazing midwife, with my last two births there are two things that I did (with my midwifes permission and guidance) that helped tremendously. Throughout my pregnancy I take Evening Primrose Oil (recommended dosage on the bottle) and starting at 36 weeks I double the dosage, and start breaking open more capsules to directly apply the EPO to my cervix. Once I go into early labor I drink a bunch of Gatorade (to stay hydrated) and I take a couple of benedril. Then I am able to sleep through the most tedious part of it. I hope this helps someone else. I’m still angry that they did not tell me of the possible repercussions, and I am so great full that there is more awareness of this problem
Although scar tissue didn’t affect any of my pregnancies, it certainly affected my body, in a horrible way, and forced me to make a decision I never wanted to make. During my last pregnancy after an abnormal Pap smear, I was diagnosed with Cervical Dysplasia (Precancerous cervical cells) following a colposcopy. It was caterogized as CIN2. Periodic colposcopies were done throughout my pregnancy and my doctor said as long as category did not change, I would be okay to deliver. She said treatment of the dysplasia would be arranged after delivery. At 8 weeks postpartum a LEEP was performed. Heavy cauterization of deeper tissues was required, leaving my cervix basically “cored”. The scar tissue lead to stenosis (narrowing) of the cervical canal and after awhile complete occlusion. (We didn’t know this until later.) You see, during this time I was breast feeding and did not have a menstrual cycle. I continued nursing until my daughter was 27 months old. My doctor did voice concern about my prolonged nursing as she was concerned about the amount of estrogen I was producing to keep my cervix supple. (You produce very low levels of estrogen while nursing.) Nonetheless, I didn’t want to stop nursing until we were both ready. When I stopped nursing and began to ovulate once again, I waited for my period, and nothing happened. I shouldn’t say “nothing”, just no menstrual flow. I got excruciating cramps that felt like labor and lasted about 1-2 weeks. After enduring this for a couple of months, I decided to see my doctor and find out what was going on. That is when she discovered the occlusion (by way of vaginal ultrasound). She wanted me to have a hysterectomy, but I flatly refused. So instead I had surgery to open my cervix. This seemed to do the trick – that is, for about 6 months. Month by month my flow decreased and the pain increased, it got so severe, I was literally eating Tramadol like vitamins. Again, full occlusion. Again, my doctor highly recommended that I have a hysterectomy, but I did not want to go that route! Subsequently, it got so bad that one month I ended up in the hospital having an emergency D&C (on my wedding anniversary!) My doctor had to put in a balloon catheter to drain my uterus. In the end, I finally gave in and had the hysterectomy the month following the D&C. I was 43 at the time and even though my child bearing years should have been over, having the hysterectomy was one of the saddest days of my life. I really wish I had known about scar tissue and ways the occlusion could have been prevented, if at all.
Thank you for this article I wish it was up ten years ago. At
Age 21 I had 4 leeps and several biopsies. No one ever told me anything about fertility issues or birthing problems. I was total caught off Gaurd when the doc brought it up to me at my 16 week appt. I am sure everything will work out but I am so mad
This was not disclosed to me ten years ago
I consider myself fortunate because I had a leep done when I was 20, have had no problem with getting pregnant, and had two normal vaginal deliveries (at ages 22 and 24). Although I think it is very important for women to be educated about their bodies, I just want to put it out there that just because you had a leep, does not mean you will have difficulties. (-:
I have been looking for info on line, i have an appointment next week with my OB here in Spain, but in the meantime does anyone know – Would every IUD cause scar tissue or only if there are ccomplications?
I am so pleased to read this thread and discover that people are talking about this. I had a LEEP procedure after two normal pregnancies and deliveries but subsequently have had excruciating cramps when getting my period. It literally felt like labour and the first time it happened I ended up in the emergency room. My obgyn told me nothing about the – albeit rare – potential side effects. She has also refused to make the connection between the painful periods and the Leep procedure though it seemed like a pretty amazing coincidence to me. I now have fluid in my uterus which I fully expect to be menstrual blood which is unable to escape due to cervical scarring and possibly cervical stenosis resulting from the LEEP. Other than surgical dilation does anoyne know if the kind of cervical massage performed on pregnant woman could help this issue in a non-pregnant woman? Anyone got any comments ‘cos my obgyn has NO clue!
I had a leep done in 2006 and was not told about the possibility of having difficulties dilating during the birth process. Fast forward to 2012 after 34 hours of labor I had to have a cesarean because I was not dilating due to the scar tissue on my cervix. I wish I would have know about cervical massage prior to my sons birth because I would have insisted on it to try to facilitate dilation.
My question now is does anyone have any experience with a vbac when cervical scaring was an issue during a previous birth?
I’ve just looked at this and thought that perhaps my first birth which was very long and hard could ahve been due to cervical cells being removed from my cervix a couple of years before. I didn’t dilate for hours and I was helped by the midwife pening up the cervix with her hands at the end to dilate fully. My baby had a really pointed head and I dreades giving birht the second time as it was so horrible. I never thought it could be due to this scarring. My subsequent births were much quicker(2nd better than last). This is something women should take into consideration but then what else can you do if you have lesions on your cervix? You can hardly leave them there.