Thursday 19 July 2012

How long does a uterus takes to heal?



© Gemini Photography, 2006
I found this interesting article and wanted to share.



VBAC and scar integrity
or "Why my uterus isn't going to explode"



Myth: It takes two years or more for uterine scar tissue to heal.

Fact: Your uterus is just like any other cut that is bound with stitches or staples, and does all the healing it's going to in the first few weeks. While a few studies suggest that the risk of rupture (more on what "rupture" is later) is higher if you get pregnant within 18 months, it is still far less than 1%, and while it is often recommended to wait, this does not reflect whether or not a real risk exists following initial healing. Most authorities agree that by the time your fertility returns (2-3+ months), conception happens and the uterus begins to expand (12 weeks), healing is done. The gentle pressure of a slowly expanding uterus is unlikely to cause any damage, and since we don't go into labour immediately following conception it's likely a year or more would have passed since the surgery. Healing can continue even during pregnancy.

(taken from Birthlove.com)
From BIRTH AFTER CESAREAN by Bruce Flamm: "Rumor has it that its safer to wait several years after a cesearen section before attempting a vaginal birth. There's absolutely no evidence for this belief. Studies on wound healing have shown that tissue regains the majority of its strength within a few weeks of an operation. The tissue that gives a healing wound its strength is called collagen. According to a general surgery textbook, 'Collagen content of the wound tissues rises rapidly between the sixth and the seventeenth days but increase very little after the seventeenth day and none at all after the forty-second day.' Since the uterine scar is almost fully healed within weeks after a cesarean section there is no reason to postpone plans for another baby."



Myth: If you rupture, you and your baby will die.

Fact: Catastrophic ruptures are extremely rare, and much more likely if you have oxytocin induction, cyotec, prostaglandins or lay flat on your back unable to move around. Included in rupture statistics is harmless and asymptomatic dehiscences, which unfairly skews the numbers. When people think of rupture they think of a uterus imploding, they don't think of scar tissue pulling away from where it's gotten stuck, or a small break that heals easily and poses no risk to mother or baby. Dehiscences are the most common type of "rupture", by far. It is usually diagnosed when a second c-section is performed or the doctor physically puts his hand inside a woman's uterus and feels around after birth. Some evidence suggests that many dehiscences actually occur before labour begins.

Catastrophic rupture (the dangerous kind) more often happens due to uterine integrity as a whole (with the vast majority following labour augmentation). The cases of true rupture are not the 1-2% figure we hear all the time, that is for dehiscences. When a true rupture occurs, a cesarean must occur within 30 minutes (ideally 20) to prevent neurological damage to the baby. Death does not occur immediately. Most women attempting a home VBAC are well within 20-30 minutes of a hospital, particularly if 911 is called.
'A Guide to Effective Care in Pregnancy and Childbirth', which is a well-respected summary of evidence-based practice, says that the rate of reported uterine rupture has ranged from 0.09% to 0.8% for women with a single baby, head-down, who planned a vaginal birth after one previous lower-segment cesarean. The authors comment:
"To put these rates into perspective, the probability of requiring an emergency cesarean section for acute other conditions(fetal distress, cord prolapse, or antepartum hemorrhage) in any woman giving birth, is approximately 2.7%, or up to 30 times as high as the risk of uterine rupture with a planned vaginal birth after cesarean"

What does this mean for women who want a VBAC? Up to 99.91% of you will labour normally. 

True rupture is not asymptomatic, and the first signs are a steadily falling heart rate (now heavily debated over whether or not this is a true indicator) and/or intense pain that you'll feel even with an epidural. While external fetal monitors, in theory, are meant to catch this kind of thing as it happens - they often do not. External fetal monitoring has not been shown to save any lives, and has only been shown to increase the amount of unnecessary c-sections being performed. It is just as effective, and safer overall, to have a nurse or midwife come in every so often and have a listen with the doppler or fetoscope - particularly during a contraction. This also keeps you off your back, where you are often strictly told to stay if you are hooked up to EFM. This position increases your chances of complications. Move around! Stay hydrated! Stay strong! Avoid drugs! Labour isn't made so you that you can lie back with your feet up. 

Home dopplers and fetoscopes are available to rent or buy. Fetoscopes can be purchased online or at any medical supply store for $30 or under, and home dopplers can be rented for as little as $35-$40 a month. Do keep in mind that dopplers, being ultrasound, carry risks. A fetoscope poses no risk to the baby.

Risk of rupture also depends on the type of incision you received. Except in rare cases, modern c-sections are performed by low transverse incision (a horizontal scar just along your pubic bone, usually hidden by a bikini). The risk is highest with a vertical incision over the middle of the stomach. This requires more healing time as well.
VBAC.com reads:

Overall, attempted vaginal birth for women with a single previous low transverse cesarean section is associated with a lower risk of complications for both mother and baby than routine repeat cesarean section. The morbidity associated with successful vaginal birth is about one-fifth that of elective cesarean. Failed trials of labor, with subsequent cesarean section, involve almost twice the morbidity of elective section, but the lower morbidity in the 80% of women who successfully give birth vaginally means that overall women who opt for a planned vaginal birth after cesarean suffer only half the morbidity of women who undergo an elective cesarean section.

What does this mean? A repeat c-section is more dangerous than a VBAC. The problem is we don't hear that very often. Some women are only ever offered a repeat c-section by their doctors. If they are truly only ever done in event of "emergencies", how can one justify the risk of denying a woman a VBAC when it is clearly the safest route for both mother and baby?

14 comments:

  1. I got pregnant last year 2015 my bf and I used withdrawal method I got an abortion on September which backfired and I had to be vacuumed a month later after the complication I got it 6 months later and I am pregnant again not sure why we used condoms and after every encounter used to check if the condom had raptured which never happened I am wondering if it is safe to procure another abortion I am 5weeks pregnant.

    ReplyDelete
    Replies
    1. Safe for who? You or the baby? I'm pretty sure killing a human life is never a safe option.

      Delete
    2. To many abortions can cause you more problems then actually having the baby and giving it up for adoption

      Delete
    3. Am Hellen, thanks to Dr oniha who cured me of INREGULAR MENSTRATION and fibroid with his herbal MEDICATION. My marriage was on the verge of collapsing, because I was unable to bear a child for my husband. Until I came across Dr ONIHA's recommendation onLine,of how he has helped numerous of childless couples to have children with the help of his wonderful herbal medication, and I contacted him. And he administered his herbs on me.within the space of two months, i became pregnant, I now have a child I can call my own. In case you want to contact him for a similar problem, or all other infertilty issues, you can reach him through his email:
      DRONIHASPELL@YAHOO.COM or call him on +2347089275769

      Delete
    4. Am Hellen, thanks to Dr oniha who cured me of fallopian tube blockage and fibroid with his herbal tuber cleanser. My marriage was on the verge of collapsing, because I was unable to bear a child for my husband. Until I came across Dr ONIHA's recommendation onLine,of how he has helped numerous of childless couples to have children with the help of his wonderful herbal medication, and I contacted him. And he administered his herbs on me.within the space of two months, i became pregnant, I now have a child I can call my own. In case you want to contact him for a similar problem, or all other infertilty issues, you can reach him through his email:
      DRONIHASPELL@YAHOO.COM or call him on +2347089275769

      Delete
    5. Am Hellen, thanks to Dr oniha who cured me of fallopian tube blockage and fibroid with his herbal tuber cleanser. My marriage was on the verge of collapsing, because I was unable to bear a child for my husband. Until I came across Dr ONIHA's recommendation onLine,of how he has helped numerous of childless couples to have children with the help of his wonderful herbal medication, and I contacted him. And he administered his herbs on me.within the space of two months, i became pregnant, I now have a child I can call my own. In case you want to contact him for a similar problem, or all other infertilty issues, you can reach him through his email:
      DRONIHASPELL@YAHOO.COM or call him on +2347089275769

      Delete
    6. Thankes to Dr OSAZE, who cured me of fallopian tube blockage and fibroid. i married for over eight years wthout a child of my own. because of the problem with my fallopian tubbe and fibroid, until i came in conntact with Dr OSAZE's testimony and recommendations online, on how he has cured and healed so many people of the same illment, and i decided to contact him, and he administered his medicatons on me, and i became pregnant in two monnths. incasse you wannt to reach him for a similar problem, you can call or whatsap him on +2347089275769 or email: DROSAZEHERBAL@GMAIL.COM

      Delete
  2. Really I cannot believe I really just read this. You are not being safe, and are putting your body through torture. But REALLY another one. I am on here trying to figure out how to have another baby safely, and you being ignorant with life ugh I could really snap, but to each their own.

    ReplyDelete
  3. Really I cannot believe I really just read this. You are not being safe, and are putting your body through torture. But REALLY another one. I am on here trying to figure out how to have another baby safely, and you being ignorant with life ugh I could really snap, but to each their own.

    ReplyDelete
  4. Here priestEka we are here to make your dream of pregnancy and other related human diseases over in your life have a happy home. Wespecialise in helping people with their problems such as.
    1 bringing back your lost .
    2 spell to improve your businesses.
    3 spell to bring back your ex-lover( bring back your husband/wife/boyfriend/girlfriend)
    4 spell for business protection from colleague.
    5 spell to prevent witchcraft from your life and that of your family.
    6 spell to prevent you from accident during your business journey.
    7. spell to get employment easily
    We also specialise in providing solutions in any of this spiritual gynaecology diseases affect human existence such as:
    1 fibroid, asthma, ALL STD,
    2 weakness of man organ
    3 infections of all kind (yeast infection)
    4 blockage from the fallopian tube
    5 cyst. From the ovaries
    6 unpleasant smell from the virgina
    7 irregular menstration, menopause
    8 infertility for easy Conception.
    9.skin diseases, Toilet infection and bad body odor…….Etc..
    10.Watering sperm (low sperm count) not able to get woman pregnant.
    Simply contact the spiritualist PriestEka on (dreka14demons@gmail.com) to get his Herbal Medication to cure your disease and put yourself on a motherhood side of life..
    (No more adoption, with PriestEka your problem will solve and you will have your child with ease.
    Contact us at (dreka14demons@gmail.com) your solution home!

    ReplyDelete
  5. ALL THANKS TO DR WILLIAMS WITH HIS HERB MY WIFE WAS COMPLETELY CURED FROM FIBROID.
    Is my pleasure to comment on this site and i thank the admin of this site for his/her great work so far.one of the happiest moment in life is when you see your own wife put to bed.this awesome moments makes you a man, I really don't know how to thank DR WILLIAMS for helping my wife get cured for over how many year of suffering from FIBROID. i came across DR Williams contact through a headline news on internet about how DR Williams help a woman to get cured of his fibroid and so many other with similar body problem ,i contacted him and he told me how to get his herb,few day later he sent me the herbal portion which my wife take every morning for 21 days, and his medicine was able to shrike the fibroid naturally,and now my wife is 4months old pregnant for our second child, and now she very okay without any side effects whatsoever, If you have fibroid, you can contact him on his email address drwilliams098765@gmail.com for advice and for his product.

    ReplyDelete
  6. I have been following this blog for a while now and today i felt like i should share my story because i was a victim too. I had endometriosis for 18 years and i never thought i would ever get a cure due to the terrible symptoms i had and this made it impossible for me to get pregnant even after 12 years of marriage and it was a serious issue. I got to know about Dr. LEETU who treated someone and the person shared a story of how she got a cure and let her contact details, i contacted Dr. LEETU and he actually confirmed it and i decided to give a try too and use his herbal medicine that was how my burden ended completely. My son will be 2 this december and i am greatful to God and thankful to his for medicine too. If you have (Endometriosis, PCOS, Fibroid, Ovarian cyst, Ectopic Pregnancy or any infertility issues) just reach him on (DRLEETU99@GMAIL.COM) Via Whatsapp +8615802318178. he has professional advise and a cure too.

    ReplyDelete