I have seen many a cervix refuse to completely open big enough (10 cm) so that a mama can start pushing.  There are many, many, many reasons this can happen.  One of the reasons is because of cervical scarring.

I once was hired to be a doula for a beautiful woman who was very happy to be having her first baby.  She and her husband were so loving and worked well together.  They seemed very much in love, happy and excited about their new baby.  I got a call in the evening to come on over to her house so I could labor with her and help her decide when to go to the hospital.  Her contractions were coming regularly, noticeably intense and she was managing beautifully.  She was SO ready for this.

After much debate, we decided to go to the hospital so she could see how dilated she was.  The receptionist at the front desk said that “triage will see her in a few minutes to see if she is in labor.”  I was slightly offended the receptionist would say that to her and replied, “Oh, she’s in labor.”

I waited for an eternity in the waiting area, got fed up, and marched myself back to triage to see how she was doing.  To my amazement, she told me she was only dilated to one cm.  I was flabbergasted, confused, empathetic, and discouraged.  If I felt all that, imagine what that mama felt!!

We went back home, continued to labor and when she could take it no longer we went to the hospital again in the middle of the night.  She had no further cervical change, but they admitted her so that they could help her sleep.

Long story short, mama labored and labored and labored, was exhausted, hardly progressed, tried many interventions to see if that would do anything and eventually her Next Best Thing was a cesarean birth.

I (and obviously the mama) walked away from that experience in a fog.  How could this happen?  Are our bodies really lemons?  What happened back there?

As I processed this birth I remembered something the mama told me and her doctor during her birth.  She told me that she had cervical scarring from a procedure that was done to her cervix when she was a teenager.  I didn’t know what this meant, or what this meant for her labor at the time, but now I am well aware.

You see, sometimes scarring on a cervix can prevent the cervix from dilating/opening during labor.  Nobody tells women this when they get D&C;’s, D&E;’s, biopsies, incisions, surgeries, etc. that this procedure might impact any future childbirths they have.  My client had no idea.

One thing I read somewhere on the internet is that sometimes if the cervix is not dilating during labor due to cervical scarring that a gentle massage of the scar tissue can help it to dilate.

I think there are a few morals to this story.

  1. If something like this happens to you or has already happened, your body is not a lemon and is honestly doing the best it can with what has already happened.
  2. Talk to your care provider about cervical scarring before any procedures are done to your cervix.  If it’s something you can avoid and is not medically necessary, avoid it.
  3. If you are in labor and you think you aren’t dilating because of cervical scarring, have your nurse, midwife or doctor gently, gently massage the cervix and see if they can help you melt open.
Have you ever heard of this issue? 
Love,
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4 Responses to Cervical Scarring and “Failure to Progress”

  1. R. Lewis says:

    I'm sure you read the same article I did, but this is an especially important issue for those trying for VBAC who *think* they haven't had any cervical scarring – it's possible your cervix was manually dilated after your surgery and that can be a reason for scarring/not dilating during your next labor.

  2. R. Lewis – Thanks for that tip. So why would someone need to have their cervix dilated after a cesarean?

  3. Tanashia says:

    Lindsey,
    Unfortunately, this is somewhat common. If the scaring is severe enough it can be felt during the exam. It makes the cervix feel like a tight band. Sometimes providers attempt to break the "band" to facilitate dilation. It is very uncomfortable.

    Curious about the manual dilation after a cesarean too?!?!?

What do you think?