Cervical Scar Tissue: Recognizing a Hidden Cause of Unnecessary C-Sections and How to Advocate for Yourself
Dawn Thompson is a seasoned birth professional with over 20 years of experience in the field. As the founder of Birthify, she is a passionate advocate for maternal health and has dedicated her career to improving birth outcomes through education, awareness, and support. Dawn is widely recognized for her pioneering work on cervical scar tissue, having written the first article on the subject in 2009, which sparked global awareness and discussion. Her commitment to empowering women and challenging the status quo continues to inspire both her clients and the broader birth community.
In 2006, as a dedicated birth professional, I first encountered a term that would change the course of my career and impact countless lives: cervical scar tissue. At the time, it was an issue that no one was talking about—a hidden cause behind many so-called "failure to progress" diagnoses that often led to unnecessary C-sections.
After years of reflecting on this and seeing its implications in my work, I wrote an article in 2009 titled Cervical Scar Tissue – A Big Issue That No One Is Talking About. This became the first article on the internet to address this critical topic. The response was overwhelming. The article went viral, resonating with women and birth professionals worldwide, and has since been read by countless people. It inspired many birth professionals to write about cervical scar tissue, and it began to be taught in doula and midwifery programs across the country. Unfortunately, to my knowledge, it still hasn't reached medical training programs, where the majority of providers assisting in pregnancies in the U.S. are educated. This means the issue remains significant if no one asks the right questions or considers this possibility.
Understanding Cervical Scar Tissue
Cervical scar tissue, or cervical stenosis, can develop after procedures like LEEP, Cone, Cryo, D&C, or even IUD placement. These procedures often involve the use of a cervical stabilizer (Tenaculum), which can pierce the cervix and lead to scarring. This scarring can impede the cervix’s ability to dilate appropriately during labor, resulting in a stalled labor often diagnosed as "failure to progress." Without recognizing the presence of scar tissue, many healthcare providers may recommend interventions, including unnecessary C-sections.
Recognizing the Signs of Cervical Scar Tissue
If you’re pregnant or planning a pregnancy, being aware of the signs of cervical scar tissue is crucial. Here are some key indicators:
Prodromal Labor: You experience labor-like contractions over days or weeks, but they don’t lead to active labor.
Dilation Stall: Despite strong contractions, your cervix dilates slowly or not at all.
High Effacement, Low Dilation: Your cervix becomes very thin (high effacement), but the dilation remains minimal.
Urge to Push with Low Dilation: You feel an overwhelming urge to push, but your cervix hasn’t dilated enough.
How to Advocate for Yourself
Understanding cervical scar tissue is just the first step. Here’s how you can advocate for yourself if you suspect cervical scar tissue might impact your birth:
Educate Yourself and Your Partner: Knowledge is power. Ensure you and your partner understand cervical scar tissue, its causes, and its implications.
Know Your Rights: You have the right to ask for time and avoid rushed decisions during labor. If labor stalls, inquire whether scar tissue could be a factor before agreeing to interventions like a C-section.
Talk to Your Healthcare Provider: Discuss your concerns with your healthcare provider early in your pregnancy. Share your medical history, especially any procedures that could have caused cervical scarring. Ask if they are familiar with cervical scar tissue and how they would manage it during labor.
Consider a Second Opinion: If your provider seems unaware or dismissive of cervical scar tissue, consider seeking a second opinion, preferably from a midwife or ObGyn experienced in VBACs or natural birth.
Prepare for Labor: If you’re at risk, discuss possible interventions with your provider, such as manual massage of the cervix to break up scar tissue during labor.
Hire a Doula: A doula experienced in VBACs and cervical scar tissue can provide invaluable support and advocacy during labor.
Moving Forward
As we continue to raise awareness, it’s crucial for women to be informed and prepared to advocate for themselves. By understanding the signs of cervical scar tissue and how to address it, you can help avoid unnecessary interventions and experience the birth you deserve—one that is informed, supported, and free from preventable complications.
Your voice matters in this conversation, and by speaking up, you can help bring about the change needed to ensure that cervical scar tissue is recognized and treated appropriately in all births. Together, we can ensure that every woman has the opportunity to have a safe and empowering birth experience.
Dawn Thompson
Birthify
Virtual Doula Support, Full Spectrum Doula, Speaker, Writer, Advocate
Find her on social media @birthify_
https://birthify.net
