Q: How does previous cervical surgery (such as LEEP) for dysplasia affect
the ability of the cervix to dilate during uninduced labor? One CNM
estimated that about 60% of her clients who have had LEEPs have cervical
scarring that temporarily prevents the progress of dilatation for up to
My experience seems to be either/or: short labor, long labor.
I would recommend that any pregnant woman with cervical scarring take
evening primrose oil during the last month of her pregnancy, even applying
it directly to her cervix.
I had a cervical biopsy done between my third and fourth pregnancies and my
labor for my fourth was very painful, and long. I rubbed evening primrose
oil on my cervix during labor and it seemed to really help things get
I had a primip student in my Bradley class who decided to have a
midwife-attended homebirth. She was in excellent health throughout her
pregnancy and was not particularly concerned about the fact she had had
LEEP surgery many years before. She was in labor for over two days, and at
7 centimeters (midwife could stretch her to 8 centimeters) for twelve
hours. She was handling the experience well, but getting truly fatigued.
The midwife finally suggested they transport to the hospital. On arrival,
the doctor lost his mind that she had been that dilated for that long and
wanted to do an immediate c-section. The couple refused and requested an
epidural and some more time (hoping for sleep and dilation). She did not
dilate any more and they did end up with a section. The midwife's response
to this (according to the mom) was that her cervix was fairly well scarred.
The doctor who examined her said he didn't feel any scarring. I would love
any feedback you can offer on this. The couple is hoping for another baby
and wants a homebirth VBAC.
I have been a labor and delivery nurse for years and am an aspiring
midwife. I have found that often times cervical procedures such as LEEP do
produce tough scarring that takes a bit longer to get going, but once the
scarring has been broken up with a little digital manipulation, the cervix
has the potential to open much more rapidly.
I always list a history of LEEP on the Problem List to remind myself during
labor that there might be a problem. There never has been. Don't worry.
Reprinted from Midwifery Today E-News (Vol 2 Issue 12 March 24, 2000)
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