Labor & Cervical Scar Tissue

I've been to more than a few births. 

I've worked with women from a variety of backgrounds and previous birth experiences.


I've been at labors that have lasted 30 minutes (yes...that's total) and labors that have lasted multiple days. I've been at the births of multiples, at inductions, at birth centers and hospitals. I've worked with dozens of different doctors. 

There are moments when I think I've seen it all.

And then the next labor opens my eyes to something new.

One of my recent "something new" came from a doctor who shared a great deal of information about cervical scarring. He explained it in a way that blew my mind and made me come home to do more research on the topic.

Pregnant people! You need to know this.

If you've had any type of cervical biopsy, an IUD, a D&C... any sort of procedure that involves placing something on or through your cervix, this is information you need to be familiar with.

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We all have scars somewhere on our body.

When our skin is cut, the healing causes a tougher spot to form as the skin comes back together. The same thing happens to the inside of our bodies. When a procedure is done that causes a 'cut' on the cervix, scar tissue forms as it heals. Many women have scar tissue on their cervix. And if women knew the truth about cervical scar tissue, their birth experiences could improve dramatically.


But does cervical scar tissue actually affect labor?

A typical/average labor follows an expected progression. In the typical scenario, a woman is often slightly dilated before labor begins. As contractions get going, there is a linear dilation expected. With each check, medical staff expect to find the cervix steadily making progress toward complete dilation. We know that the first 6ish centimeters tend to take the most time, and then 'transition' hits and the average dilation becomes one centimeter per hour. This scenario is considered "normal." It's what medical staff is expecting to happen in a labor that is progressing well.

Cervical scar tissue can throw a wrench in "normal."

If scar tissue is present, there is a strong possibility that the cervix will not dilate in the typical linear manner. That strong tissue may hold steady and make it seem as if labor has stalled. Contractions may feel like transition-type contractions. A woman may appear to be in very active labor. But dilation may still be at a lower (and, let's just admit it, disappointing) number. If this continues for an extended period of time, other interventions may be used. And a cesarean birth may be recommended.

BUT... If/when that scar tissue breaks up on its own or with the assistance of other methods, dilation can (and often will) make a rapid jump from 'not much' to 'how did that happen?!' 

It is possible to have a vaginal birth with cervical scar tissue.

What can I do about scar tissue in labor?

First off, if you think there is ANY possibility of scar tissue on your cervix, start that conversation with your doctor early and do your research. There is some evidence that shows that massage of the cervix during labor may be very beneficial in breaking up the scar tissue and assisting in making dilation happen. There also appears to be possible benefit in using Evening Primrose oil in late pregnancy to begin preparing your cervix. It's definitely something to ask your medical provider about.


The most important thing?

Know going into labor that things may appear to be happening quite slowly in the beginning. You may feel like you're having 'active labor' contractions, yet cervical exams show little progress. Let your care providers know about your cervical scarring and ask them for help with it. 

When we can go into our experience informed, we may have the opportunity to make better decisions.

Andrea WillemsPNW Doulas