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Cervical Scar Tissue, A Cause for Unnecessary C-Sections

By, Dawn Thompson

My nephew just had his 6th birthday a few weeks ago. Who knew his birth would mean so much to my career as a birth professional. This was the day I first heard the words, Cervical Scar Tissue. How is it that I had been a doula for four years and had never heard this before? Those words changed my life. I sat down just days later and wrote a blog post. Cervical Scar Tissue – A Big Issue That No One Is Talking About. In the past 6 years that article has circled the globe and has been read more than 50,000 times and significantly more if you consider how many other people have gone on to write and quote my story. People are now indeed “Talking” about it. The emails and comments I have received have been staggering. Most of them women having an Oprah Aha! Moment. Many of them feeling a sense of relief, to have an answer to “why” it happened to them. I have even had women find the blog during early labor, looking for a reason why their labor wasn’t progressing after days and days of surges.

At the time of writing that blog of sorts, I didn’t know much. Since that time I have dedicated most of my doula career to learning more about cervical scar tissue and specifically helping families that experienced a c-section with their first birth. I started working very closely with a local ObGyn whom was very aware of cervical scar tissue. We started referring each other all of our VBAC (vaginal birth after c-section) clients. I kept track of their previous birth experience, what kinds of procedures they might have had and then what happened in their subsequent birth. The results were very clear. Out of 21 mothers, 3 of them had c-sections because of breech presentation and 18 of them were listed as “Failure to Progress” during their first birth. 17 out of the 21 had an obvious long, prodromal labor pattern. They also “seemed” to be having transition like labor but were only 4-6cm dilated when arriving at the hospital. In all 17 the doctor observed obvious scar tissue during their subsequent births. The majority of these women also went on to deliver anywhere from just a few minutes after the scar tissue was resolved by the doctor to 2 hours after. In all cases the labor progressed quickly.

The most interesting part of this observation is that not all of these women had had the typical cervical procedures associated with scar tissue like LEEP, Cone or Cryo. The scar tissue also presented differently in some of these women. The women who had the procedures previously mentioned had tight rubber band type scarring on the interior of the cervix. Others though had more granular type scarring. I have since heard it described as feeling like a piece of uncooked rice on the outer part of the cervix. That lends to the question, do other procedures cause scarring?

After interviewing several Midwives and ObGyn’s, I believe the answer is yes. I found that the other women in our small group all had had procedures like a D&C or an IUD placed. For both of these procedures, in many cases, there is a cervical stabilizer (Tenaculum) used. This instrument pierces the cervix while it is being manually dilated. This seems to be what causes the granular type scarring. Not all women seem to be affected by this type of scarring or maybe some of them don’t get much scarring naturally anyway. I have heard a few people share the theory that if a mother gets significant stretch marks, than she has a higher likelihood of scarring. Some people naturally produce more Keloids. Keloids are the excess growth of scar tissue at the site of a healed injury. This would make sense why some people would be affected and others would not.

Signs of CST

•           Prodromal labor

•           Release of waters after much Prodromal labor

•           Dilation Stall

•           High Effacement/Low Dilation

•           Mom describes surges, but gets checked with no dilation

•           Mom appears to be in transition but has early labor dilation

•           Overwhelming urge to push, but low dilation

Since this small group 4 years ago, I have gone on to help many more women and experience their joy and relief when their scar tissue was recognized and resolved. All of them climbing that amazing mountain, to reach the top with a roar, holding their beautiful new gift. Thankfully many of them first time moms that might have otherwise been recovering from an unnecessary c-section.

For more information about Cervical Scar Tissue Dawn offers a live online class. To check for date and time of the next class you can visit Dawn’s personal site, www.douladawn.com

Dawn Thompson is the president and founder of Improving Birth.org. She has been in the birth industry since 2003, supporting hundreds of families as a Labor & Postpartum Doula, with a background in public relations and marketing. Because of her own personal struggle through 3 unnecessary c-sections and finally a triumphant vaginal birth, her passion and desire to empower people through education has become her mission.


10 Comments

  1. Donna Hayes RN, CD, CLEC

    Nice Job Dawn!   I'm so inspired by you.    Love D

  2. Wow, IUD insertion.  That is something I have never asked my doula clients about.  But SO important to know!!!  Especially because I had an IUD.  

  3. Such great info!  I was in labor for 2 wks with my last baby, and my cervix was funnelling and dilating on the outside, but then less on the inside.  I completely believe this was due to scar tissue from an IUD removal prior to getting pg.  My strings had curled up inside the uterus and the dr had to "fish" them out with  a pokey metal instrument.  I think this caused scar tissue on the inner part of the cervix but not the outer which caused the funnelling (I was a 7 on the outside and 5 on the inside 4 days prior to his birth).  I finally massaged and stretched my cervix myself the morning my son was born because I was desperate for something to change and he was born a few hours later.  Thought this story might give you some insight on other strange cervical phenomenon!!

  4. Danielle

    Thank you so much for this article. I had a baby 4 years ago. After being in labour for 6 days, having my waters broken and being induced I only got to be 7cm dilated and stayed that way for hours until the situation started to get dangerous for myself and my baby and I was rushed off for a c-section which didn’t go very well and I ended up being able to feel the whole thing. The doctors couldn’t explain to me why I couldn’t have a baby naturally then just said sometimes it happens. My husband & I have wanted another baby for a while now but I have been to frightened after what happened last time. I decided to do some research on the reasons why people have problems during labour and I came across the article you wrote and suddenly it all came rushing back to me, during one of my many internal checks I had the doctor asked me had I ever had any type of surgery done, at the time I didn’t realise that the procedure I had done was what they were talking about but after reading everything I realised it was. I now have some hope that this is what caused my problems and that I may be able to have a natural birth. Thank you.

  5. I’ve had a LEEP and an IUD. I can feel scar tissue in two different places on my cevix. So that begs the question… What Do I Do About It?

    • *Cervix*

    • Gigi, as mentioned in the article, some midwives recommend evening primerose oil or Borage oil vaginally after 36 weeks. Then having a provider that is familiar with cervical scarring and that is willing to come during labor to break it up manually, is crucial. I would imagine if you can feel it yourself, then you could also help rub it out. I would suggest you have a consult with a midwife about it.

  6. I had my cervix cauterized when I was younger after an abnormal pap smear. First labour stalled for a very long time, but then all of a sudden was fully. I strongly believe this hold up was at least partially related to scare tissue.
    Subsequent births were 3 and 2 hrs respectably.

  7. Oh my goodness! I just came across this after googling “cervical scar tissue and labour.” When I gave birth to my son I had a 3B cervical tear due to his head being asynclitic and coming down fast. I am 25 weeks pregnant with my second child and it only just occurred to me to find out if the scar tissue from that could be a problem. Thank you for your posts, I have something I need to discuss with my midwife.

  8. Abigail Perez Muraira

    This may sound a little moronic, but how did you massage your cervix? I’m in the same predicament with CST and low dilation and high effacement.

    We are emotionally drained and hoping for a TOLAC/VBAC, currently at 40w3d. My midwife stretched my cervix from a 1 to a 2.5/3 and swept my membranes she said I am now about 80% effaced from 50/60%. During the stretching she asked me if I had any surgery on my cervix and said I had CST so she broke it up for me.

    This was done a Thursday we are now 3 days post and have an appointment on Monday. So far I have felt stronger surges than the week before.

    I’m extremely nervous since we scheduled a csection for this coming Friday.

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