Midline (vertical) c-section

[orangetickle]

My doctor mentioned today that if I have to have a c-section (would be an EMCS, and is unlikely, since DD was vaginal and no complications in this pregnancy thus far) he would cut down a scar I already have from previous abdominal surgery. It runs from just above my belly button to my bikini line. He says that way I'd only have the one scar, rather than two.

However I'd read that this type of c-section is riskier, with a longer healing time. I'm not fussed about having two scars - my current one is so ugly I'll never show my stomach in public again anyway, so an extra one makes no difference - so I'm considering putting on my birth plan a request for a 'normal' c-section cut should I need one.

Any advice?

I would ask if I was you. If the only reason is cosmetic then it seems slightly ridiculous to me if you're not bothered. Also I believe that having a midline incision means that you are much more likely to need a C-section next time should you choose to have more children.

I'm seeing him again next week anyway, so I'll bring it up - just rather took the wind out of my sails. He was trying to be nice I think: I desperately don't want more surgery, and if I have to have a big operation, I want the shortest recovery time possible...

The increased risk from a vertical scar is only if the cut in the uterus (womb) is vertical. It's called a "classical C section", and rarely used, and only if medically indicated.

The way the surgeon gets into the abdomen through the skin can be either through a vertical or a horizontal incision, and this does NOT affect the risk or healing time. (If anything, you might not heal quite so well after a horizontal skin incision if you've had a previous vertical one, as the blood supply to the apex of the T is slightly reduced. However in reality there is most likely very little difference between the two). So the orientation of the skin incision is, indeed, a cosmetic decision.

If other things being equal you'd prefer an 'inverted T' incision, ask for a horizontal (or pfanenstiel) incision. But if you're happy that the risks are equal, and it's just an alternative way through the skin, go with the opportunity to have your midline scar 'tidied up'.

I hope that is helpful.

That's really useful Pixel - thank you very much.

There's no reason I know why I'd need a vertical cut into my womb (other than emergency reasons obv): the abdominal surgery I previously had didn't touch my uterus, and, as I said, I previously delivered vaginally with no issues, so I assume I have a fairly normal uterus!

All else being equal, I'd go with the same cut (since who wants extra scars?!), but my desire to heal and be back to normal quickly outweighs any desire to avoid another scar if that makes sense.

Hi 1944

Thanks! Do you know what type of incision you had on your uterus? Did they cut that midline also?

A cousin of mine had a vertical incision c section years ago and told me that her belly actually looks like a bum from it, I guess it must be like the classic cs overhang but because its in the middle it has a bum appearance to it.... Seemingly it's incredibly unsightly!

Oh no! I currently have a very big scar, but at least my tummy is fairly flat around it (just the raised scar tissue)... Not sure I want a bum for a tummy, whether or not I'll ever wear a bikini again!!

Have got everything crossed that this one is prepared to come out vaginally like its sister, so hopefully this will be a non-issue....

Not scared - don't worry. I agree with you about it not mattering: my current scar brings back memories of a horrid time, but I see c-section scars as things to be proud of.

I agree that I need to decide based on medical priority and importance.