Previous LLETZ procedure - requesting ELCS?

[Sunflower2023123]

Hi,

I have previously had LLETZ procedure to remove abnormal cells. I have had an additional internal scan at 20 weeks to assess length of cervix (this was fine and met their required length guidelines). Do you think I would still be able to request an ELCS? I have been reading up on others experiences and I am petrified that I may not be able to dilate fully if scar tissue prevents this and ultimately I wind up needing an emergency c section... I would far rather a planned section so I can go in prepared. Keen to hear anyone else's stories who has had procedure and requested ELCS please.

Thank you x

You should be able to. I had a home birth after my consultant signed it off after 3 LLETZ procedures. It didn't end great as I had a massive cervical tear from scar tissue and a PPH. So if I had anymore (although that ship has 100% sailed as menopause and vasectomy) I would absolutely have an ELCS.

I do know others after 1 LLETZ that have been fine though and my consultant didn't think I would have any issues, and he was fully on board with a home birth.

Thank you so much for your reply. Cervical tear and PPH sound horrendous! I'm just not sure if they will agree to an ELCS with it being my first baby and only having had one previous letz procedure 😐. Did you find the consultant assessed your cervix again later in pregnancy? As so far it's only been the 20 week internal scan for myself...

I had a stonking LLETZ (it’s been commented on by anyone that’s been in there since) and no one batted an eyelid about my birth. I was booked for the stand alone midwife centre until I had some other unrelated issues. Didn’t have any cervical tears or anything (sounds awful, I’m so sorry to the PP).
Essentially what I’m saying is I don’t think it’s a given you’ll have a problem with a vaginal birth. But you have the right to insist on an ELCS (as does any woman) although you’d probably have to fight for it a bit and be very strong against persuasion.

I’ve had a LLETZ and knife cone so I had a pre- emptive stitch put in at 16 weeks and then ELCS at 39 weeks on the logic I needed a stitch in case the cervix dilated preterm and I needed an ELCS in case it didn’t at term.

My best advice is to be clear to your consultant that this is what you want. Discuss it at every appointment. Be adamant! It is not their body and they will not suffer if you do not dilate. Do not be fobbed off, just be calm and clear these are your wishes. They will probably arrange for you to speak to a birth options midwife but that’s fine, jump through their hoops. Do what you need to do to get the best for you and your baby. Good luck with everything and as always, congratulations x

Hi op, I am currently 34 weeks pregnant and booked in for a c section at 39 weeks.
I too had a previous lletz procedure. I was scared to labour myself due to worries about scar tissue too. I spoke about it with midwife who basically said I didn’t need to worry and I would “probably” be fine to labour as normal.
I too had a scan of my cervix at 20 weeks and it was found to be in normal parameters.
I was very worried though so spoke to my consultant who was lovely and said she would support whatever I wanted to do. I was adamant that I wanted a c section so she booked me in there and then, I got no push back from the consultant.
This happened at my consultant appt at 30 weeks.
Hope this helps to reassure you, I know how worried I was.

Hi everyone thank you so much for your responses and apologies for the delay in replying. This has made me feel a bit more relaxed in regards to requesting it, I have a consultant appointment in 3 weeks and will be requesting it then with my guard up for any push back haha!

I had a vaginal birth after a LLETZ. Was absolutely fine. It had never occurred to me that it might cause problems with labour to be honest!

You are well within your rights to request an ELCS, even without any relevant obstetric or Gynae history. Just speak to your midwife. You may get some resistant but it’s your right to choice. However, if you do want to consider a vaginal birth, the midwife should be able to reassure you about that too.

I've had two vaginal births following lletz, and in both I dilated very quickly with no problems, I think it depends on how much you had removed

Hi thanks for your message, do you mind Mr asking how much you had removed during the LLETZ? I'm just trying to gauge whether larger amounts equal trouble dilating. Extra scar tissue etc. Thank you x

Thank you, I fully agree every woman should have the choice to choose for themselves, however I feel the midwife is very closed off when it comes to discussion, same goes for advocating for breastfeeding versus bottle, I feel a lot.of.discuasioms are shut down quickly and your simply told "natural birth and breastfeed, goodbye". I'm hoping the consultant has a more independent conversation with me at my appointment.

@Sunflower2023123 I had approx 1-2cm removed, I had problems with my cervix in my first pregnancy in that it shortened at 24 weeks and had to have progesterone and later on bed rest, but that was it, my lletz was nine months prior to falling pregnant

I take it you had an additional scan at 24 weeks for them to diagnose the issue? Or were there signs to look out for? Sorry for all the questions!

I’m really sorry to hear that you’ve been made to feel that way by your midwife. Her job is to advocate for you and a student midwife (due to qualify next year), it makes me said that there are midwives out there that practice in this way. Are you under a consultant at all?

@Sunflower2023123 don't be sorry, ask away, I saw a consultant at 21 weeks for a scan of my cervix, had had some bleeding with intercourse and because of this the consultant had me back at 23 weeks where he picked up it had shorterned by 1cm and I also had a small leak from my hind waters at 24 weeks, all was fine though and I carried to 40+5, was kept under the consultant until 36 weeks.

My second pregnancy last year was absolutely fine, I was monitored, but not problems with my cervix other than it being soft

Im the opposite way round, I’m pregnant and about to have my second csection but need cells removed after. I’m just really glad this is my second baby and I could potentially stop now but I would have probably liked three. I had my first csection for no medical reason, just anxiety (although that technically is a medical reason). I found the same with the midwives. I was extremely set in how I would give birth as I just physically couldn’t have considered the alternative as an option out of the sheer fear of it. They didn’t seem to take me seriously and kept delaying on letting me speak to a consultant and saying I’d change my mind. Re breastfeeding one even said ‘you don’t realise how much you’ll love your baby until you meet them, you will want to breastfeed’ 😳 As if no one that formula feeds loves their child! When I spoke to the consultant it was a different story and they agreed to it in the first appointment. The only thing she did try to do (which I suppose she has to do anyway) was scare me off it with the risks. Luckily I’d already looked into all the risks myself and knew how rare a lot of them were but it was as if they were trying to exaggerate them to put me off. They also are the risk of ALL sections and not elective ones so that includes emergencies when it’s been life or death going into it and the section has literally been saving the woman’s life! I’d say do your own research and go in with a decision already made so they can’t try to scare you out of anything but on the whole they were much more open to it than the midwives

I had 2 x LLETZ and a broken cervix which led to an EMCS. 2nd DC was an planned CS.

My period blood never came out properly after my first LLETZ though which we should have realised was a bad sign.