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Fibroids and c-sections

(12 Posts)
Starryeyes1984 Sun 01-Mar-20 18:31:13

Hello, does anyone have any experience of birth options with fibroids. I have one that is quite low down and orange size. The baby's head has got past it so in theory nothing stopping a vaginal delivery but I'm a bit stressed out as the doctors have talked about higher chances of bleeding because of the fibroids and higher chance of needing an unplanned c-section anyway so may just want to have an elective one as the bleeding will be even worse if I've tried to deliver vaginally and then needed to c-section. I genuinely don't know what route to go down. Can anyone with fibroids low down in their uterus share their birth experiences?

OP’s posts: |
Midlifebaby Mon 02-Mar-20 00:19:16

I’ve done as much research as I can on this one as I have a large fibroid blocking my cervix- Medical advice is an elective cs and I’ll get the date set approx 8-10 weeks before the due date (ie I’ll know in advance, not a cs that early!!!). My main worry is the bleeding, and my uterus contracting like it needs to in order to shrink back down in size which I understand can be a complication of fibroids. I’m interested to read the experience of other women who have had a planned or unplanned cs, or managed a natural birth with a low lying fibroid, and also how your recovery went.

Bearlyawake Mon 02-Mar-20 14:16:16

I'm not sure how helpful this is but...my DS didn't engage and I ended up having waters broken / induced on drip due to unstable lie. Had successful vaginal birth.

Afterwards, long story but a large mass was accidentally found in my pelvis and it turned out to be a 12cm fibroid. Can't be sure, but likely the reason he didn't engage. But I guess he managed to get past it in the end, and had a successful delivery. Like I say, not sure how helpful this is because didn't know about the fibroid beforehand and only speculation thay it caused the unstsble lie. But basically, it all turned out OK. Though I'm now waiting to have the fibroid removed.

idlevice Mon 02-Mar-20 22:27:14

I had one of my fibroids low down & was initially told I'd need a vertical incision C-section, horror of horrors...However, nearer full term it was found the growth of the uterus had pulled the fibroid up, which is common apparently as the lower section really really grows & stretches during later stages of pregnancy. My consultant thought it best to try labour at least, with blood ready in case needed.

DC1 was back to back, which I hadn't appreciated before can mean a tougher labour, but I was able to deliver naturally with no pain relief despite having augmentation (not my choice though & not recommended). Maybe DC1 was in this position due to the fibroid - who could say?

I had heard fibroids can cause contractions to be less efficient due to disrupting the muscle action of the uterus but again who can say whether that would definitely be the case in any given situation. In my case, the augmentation ramped up the contractions anyway. I do think though, that if the baby had been not back to back, the better positioning would have stimulated better contractions & they would have been more effective.

I ended up with a retained placenta & massive bleed, mainly due to uterine atony/uterus being overly worn out after labour. This can happen without fibroids obviously & is more associated with induction/augmentation, I believe.

For DC2 I was advised specifically not to have a C-section due to bleeding risk, as even though the medics can be prepared for blood loss they are not getting any extra help from the body's own reflex reactions to help with blood loss - as it was explained to me. Due to previous birth they wanted close monitoring of me so I was induced but with epidural beforehand, even though epidural can increase the chance of intervention, & I did deliver naturally, 9pounds! Still lost blood & needed transfusions afterwards but not as dramatic as first birth.

With DC2 I was able to be up & about within the day but with DC1 I was effectively recovering from a surgery (removal of placenta), so was bed bound for the first 24hrs & barely able to do much the first week after, which I would imagine must be similar to C-section recovery, plus there would also be the surgical wound to deal with. So in that respect I was glad I didn't have a C-section.

If I had not been guaranteed an epidural with my induction I would have pushed for a section though due to avoidance of pain! But it's rare not to have the option of an epidural with the use of synthetic hormones, as it's generally regarded as akin to torture! so don't let that be a worry.

In respect to getting the baby out, I had done no preparation for labour as I'd believed I'd be having a section & I was not fit or anything, had not exercised when pregnant or beforehand for about 10yrs probably. I don't really know how I did it! I think I was fully expecting to be taken for a section at any time, especially as I had waters break & false starts over 72hrs preceding (which I would put down to non-ideal position of the baby).

One big tip: make sure you are not low in your iron levels at all, both circulating & stored (haemoglobin & ferritin), because if you do have bleeding it is more detrimental if your levels are compromised to begin with. This was not mentioned to me with DC1, even though I had bleeding whilst pregnant. With DC2, due to cock ups, I was severely anaemic just before birth but despite that & then blood loss, I was heaps better after the birth, as no surgical intervention & associated recovery.

Hope something in that epic tome may be of help!

Midlifebaby Wed 04-Mar-20 14:59:31

@idlevice thanks so much for your reply to @Starryeyes1984 question. I had a 30w apt today, and consultant still wants to take a wait and see approach and discussed that the fibroid could get “flattened” out of the way making a vaginal birth possible. She then did an impromptu scan as couldn’t find the heartbeat (I wasn’t concerned though as the baby had been moving throughout the appointment!) she found Baby head down, back to back and noted the fibroid. I guess I’d better book a birthing class or two lol!

Starryeyes1984 Wed 04-Mar-20 15:23:23

Thanks for your feedback ladies. I'm as confused as ever! Part of me feels I should try to labour naturally but the other side is so worried that I'll end up needing a frantic emergency c-section that is almost rather just have the elective one so at least the doctors are better prepared as fibroid surgeries can cause loads of bleeding and it's so low down. We're having a scan next week (35) so we'll see what the doctor says after that.

OP’s posts: |
Midlifebaby Wed 04-Mar-20 20:16:16

Good luck @Starryeyes1984 - please do come back and share an update as I’m just a few weeks behind you in a similar position!

BluntAndToThePoint80 Wed 04-Mar-20 20:23:25

I had a massive fibroid but it was up the top.

No issues with two natural births with no pain relief other than gas and air. One was back to back. The other over 10lbs.

No complications after - got the extra injection to help the uterus contract and reduce blood loss and it did. I did lose a fair bit of blood and needed iron tablets after my second, but no transfusions or anything.

I was told it depended on the location - if they can get passed then it should be ok.

Starryeyes1984 Wed 04-Mar-20 21:19:16

@BluntAndToThePoint80 that's what I was told too and the head is past the fibroid now which is great. But then the consultant said you're more likely to bleed so we'd put you on an IV just in case and you're more likely to end up having an unplanned csection hence my worry. It is definitely all about location and mine is at the front and low down so it's awkward apparently but it could all be absolutely fine. I actually think the consultant spoke too quickly and gave way too much information at the last appointment. I will be better prepared this time!

OP’s posts: |
BluntAndToThePoint80 Wed 04-Mar-20 21:39:41

@Starryeyes1984

With my first I was actually induced at 36 weeks due to PROM. I was continually monitored but no IV or anything. All went fine.

My second was induced at 39 weeks as she was massive and I could take it anymore ! No monitor or IV needed either.

I really didn’t want a section as I hated the idea of a spinal, needles in my back etc... also being awake for surgery. Sorry - not trying to put you off, it just freaked me out. I would have had a section if medically necessary but it wasn’t for me as my fibroid was way up the top. However I know loads of folk for whom a v birth was not their choice for one reason or another and I think there’s something to be said for an elective over an emergency section if that’s likely.

Write a list of questions for your next appointment and see what they say. Also do a bit of your own research as I found very often different doctors gave different personal views (in my experience how to handle my second giant baby rather than the fibroid issue).

I’m sure you’ll be fine !

idlevice Wed 04-Mar-20 23:17:04

A PP reminded me: during labour they couldn't monitor DC1's heartbeart properly as obstructed by the fibroid. They tried the internal one linked to the baby scalp & I had to stay on my back even though I wanted to be on all fours. In hindsight I should've just done what I wanted. There were incidences of them thinking baby's heart-rate had dropped but they'd got mine instead.

It's impossible to predict what will happen unless you opt for the elective CS. There are too many variables otherwise, even down to who's attending you. I actually felt quite pleased with myself to have given birth vaginally as without the fibroids I would have been a water-birth, hypnobirthing type & was surprised I had it in me to get through it! (Not that I think a section is a walk in the park or not a proper birth etc etc)

Flyfisherlady Fri 06-Mar-20 03:09:32

Hello, I’m In the same boat. I have a 16 cm pendunculated fibroid at the top of my uterus, which is actually rather sore as baby pushes it. I also have one low down and obstructive. I’m quite resigned to go for an ELCS. I feel the whole thing is more controlled. I just can’t think of anything worse than going through all the effort of labour than having to have an emergency section because of a fibroid I knew about. I’m seeing the consultant tomorrow and I’ll update on what she says.

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