VBAC when you have cervical scar tissue HELP!

[BelleSauvage9]

Evening ladies.

Really hoping someone who has experienced this can advise!

Normal vaginal birth with Dd1

Had a lletz/leep procedure and cone biopsy between Dd1 and dd2

Dd2 was induced but cervix thinned but would not dilate. Had 5/6 pessaries over 4 days, waters broken manually, syntocin drip for 9 hours but never got passed 1cm dilation. Classed as failed induction and had an emcs which I found very traumatic. Recovery after wasn't too bad though. During labour it was me (not the hospital!) who realised it was likely due to the procedure I'd had previously and that all signs pointed to scar tissue on my cervix.

I've (unexpectedly) found myself pregnant with dc3 (19 weeks currently) and am looking at my birth options. Dd2 will be 15 months when I'm due. An elcs is an option, but consultant told me today that a vbac is also an option (I wasn't sure if they would allow due to scar tissue as added complication).

Had any one had the issue of scar tissue on their cervix and gone on to have a successful vbac??

I've read (multiple sources) that it's possible that massage during labour can allow the scar tissue to release. The consultant confirmed this to me today, but obviously they wouldn't be able to know whether this will be successful until it's done while I'm in labour.

I'd really like to have a vaginal birth but it's so hard to know whether it's likely to be successful so I have to consider my options carefully and am desperately seeking any stories from people who've experienced this and can give me information.

Really appreciate any replies x

Why not ask about having an attempt at vbac with the option to bail out much sooner than last time if things don’t progress as you hope? That way if the vbac’s successful then that’s great but if it’s clearly going like the last attempt the section would hopefully be less stressful.

Thanks @Greybeardy that's definitely a possibility and will discuss with the vbac clinic 👍 just hoping to come across someone who's experienced it and can give more info based on experience

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I am not quite at the birth stage yet (25wks today) but I am on DC2 and also had a lletz a year after DS, he was born via ELCS.

At my consultant appointment I did query the implications of my potentially weakened cervix due to the lletz, he explained that the concerns are usually around the cervix opening pre-term and requiring a placeholder stitch to stop that from happening, he said that many go on to have perfectly normal vaginal births after lletz. He was able to look up my records for my procedure and informed me that the cells they removed from me were very shallow and superficial, he stressed that he did not think they were going to be a concern at all, especially as I have had a good 3 years of healing since.

Perhaps you can ask your doctor the same thing, apparently obstetric consultants often work in colposcopy too. They should be able to read your records and advise you on the best course of action.

I am personally choosing to do another CS over a VBAC as I don't plan on having any more. In my experience they are very calm, the team are all very cheery and chilled and it just makes for a very pleasant experience, I was having a great chat with the anaesthesiologist during mine 😂

Thanks for your response @LunaBoBuna !

I did talk to the hcps during my second pregnancy about having had a lletz and they assured me they didn't expect it to be an issue! But it was obviously in my notes.

I've read they're generally more concerned about it causing issues earlier, but was still quite shocked that they didn't cotton on during my induction when my cervix was almost completely effaced but just not dilating. And I said to multiple midwives when they were doing my examinations and saying 'it's really weird', could it be because of the lletz and they didn't think it was 🙄 finally at the last one (new midwife) when I said could it be because of scar tissue she said 'oh yeah it could be that)!

Good luck with your cs 😊

Hello,

I had lletz procedure before all of my children in 2016, no one told me that I would have any issues with giving birth so naturally I never considered it!

both my first and second children were born successfully via natural vaginal delivery, easy births, full term 40weeks+.

Unfortunately I had 2 third degree tears with both births but not related to lletz as far as I know.

im currently pregnant with third due in 7 weeks and leaning towards c section due to previous bad luck with tears…

also, my first child was born 3 years after lletz and the lletz itself was quite a major under general anaesthetic, but again, both births were fine, and I had never heard of potential complications for birth following them until this post!

I know they always note previous surgery history but, that goes for any history of surgery.

hey @BelleSauvage9 it sure if you’re still on Mumsnet, but I’m currently trying to gather stories of vaginal birth with cervical scarring. Had a very thorough lletz 2 years ago (massive arterial haemorrhage 2 weeks later) and am finally in a healthy pregnancy after 4.5 years, 5 rounds ivf and two mcs. My cervix has been only 14mm since 16 weeks, but I’m very happy to have made it to 30 weeks so far. (They tried to place a cervical cerclage but there was no external cervix left). My cervix has remained pretty much unchanged and consultant says her biggest concern is it not being able to open in labour. I’d love to try labour, but equally do not want to end up in an emergency situation or add more medical trauma to my brain. How did yours go in the end? What would you recommend? It’s very unlikely I’ll achieve another pregnancy, but if I do my concerns are Damaging cervix further through laceration/manipulations, or ccection when already partially dilated. Or I’m gathering that 2 csections are bad?

Hi @Nosejugim still here :) firstly, huge congratulations on your pregnancy ❤️

My labour with dc3 didnt go as I wanted it to unfortunately. I’ll try to give as much information but I actually can’t remember everything anymore so I might miss things! I was diagnosed with gestational diabetes later in my pregnancy and consultants really pushed for an early delivery. I managed to push for induction 2 days after my due date and had 2 sweeps about 7 days and maybe 3 days before my due date. I remember that both sweeps were a bit of a challenge for them but can’t remember the exact explanation I was given as to why. I went in for a balloon induction (which I believe is supposed to push the cervix open) but my waters broke during insertion so they had to take it out again. I was then given 4 hours to make progress or I’d need a c section.

I don’t know why but I don’t think I asked for scar massage or anything, I think this might be because my consultant had basically told me they wouldn’t do that at an early appointment so I didn’t think I could ask? So I just tried to move around and hope things would progress but they didn’t, no dilation at all (and it was actually 8 hours to progress because someone else needed an emcs so got pushed back) so I ended up with emcs. Baby boy delivered and healthy :) he’s now a very mischievous almost 3 year old!

I was really disappointed not to be able to get my vbac, though on the up side, because I knew C-section was a likely outcome I felt more mentally prepared for that and it was not traumatic the second time around.

I think the biggest reason it was traumatic the first time was because I had no reason to expect that labour wouldn’t be straightforward so I really wasn’t mentally prepared for it, and I also felt that my care was substandard during dc2 labour and I found it hard to trust the hcps and feel safe (after they broke my waters there was meconium in them - I showed a midwife my pad who said it looked fine, then I showed a different midwife who confirmed it was indeed meconium, and then when they were giving me the spinal block the anaesthesiologist kept fucking it up so it took 8 tries to get it in and I was very scared etc).

Has your consultant talked about what would happen if your cervix doesn’t want to open? Like have they said any options for what might be the nexts steps in that situation?