Women who've had sections & are told their uterus is "paper thin"

[plain jane]

I've heard this mentioned a few times both here and IRL and I'm curious about this. I've heard it said that this is a reason for not having more children because during their last c-section the surgeon said that the uterus was too thin.

 

What about women who have not had c-sections but have had the same number of pregnancies? Is there not a chance (even a good chance) that their uterus is just as thin but nobody knows because they didn't have a surgical birth?

 

For women who have a uterus that is "paper think" - Is the risk with more pregnancies in the giving birth (because it will be surgical again) or in the actual pregnancies themselves? Or both?

 

Also, can't a uterus "thicken up?" I thought that over time some women get a thickening of the uterine wall. I've heard this as a bad thing but couldn't it be good if one has a "paper thin" uterus?

 

How come some women can have 10+ children and not have a thin uterus while others are told this when they "only" have 3 or 4? Is it luck of the draw? Is there something that factors into uterine health/thickness?

 

Clearly I'm completely clueless so I'd love you folks to educate me. :D :bigear:

 

FWIW, I haven't been told this or anything as nobody has seen my uterus, but it's something that I've wondered since I first heard of this. :)

[chepyl]

I don't know women who have been told that specific thing, but I know some who were told not to have anymore after repeat c-sections. I assume it has to do with the ability for the same incision to heal multiple times withput fear of rupture late in pregnancy. I have not researched much beyond the fact that a repeat c-section was not best for me.

[Changed]

I'm one of those women who were told, during her third section, that she shouldn't have more kids because her uterus was thin...and now I'm pregnant with number 4. I'm very curious to hear other people's experiences. I'll find out from my doc in June.

[caitlinsmom]

I was told this with my last 2 births. All mine have been c-section with each getting progressively more high risk for me.

 

I was told that each time you have a c-section the scar tissue builds up but because it is a nice and smooth cut, the scar tissue isn't as strong as the original wall (basically not enough jagged points to cause a strong tissue layer). With each section that scar tissue is built again over a place that has already been compromised. After each section a Dr will make the incision just a little different at the ends as this is the point where the tissue is the weakest. As you have more babies and your uterus naturally looses its tone and is stretched with pregnancy, the tissue becomes compromised even more. This leads to most doctors saying things like "It was so thin.." Most doctors have an issue with the contraction part of birth more than the being pregnant. The theory is that the scar tissue can not handle the contraction and therefore will rip and rupture. Hence the reason that most are not allowed to vbac.

 

With my last two sections I was told I was so lucky because the tissue was too thin. I can't decide if it really was compromised or if my Dr. said it because he knew I had planned home births. ;) There is research to show the idea is bogus and some to back it up. Who knows.

[Colleen in NS]

After my second unplanned c-section, I was told my previous uterine *scar* was thinned out. Because of complications discovered during the surgery, it took the doc awhile to even find the previous uterine scar. He told me I was lucky it hadn't ruptured during the 30+ hour labour. And this is why I only have birthed two children.

[amy g.]

Well, I know in goats......Are you scared to read more yet?

 

They can have what appears to be a normal pregnancy and birth, but really have a section of the uterus worn thin, but there is no way you would know until they were in labor the next time.

 

If they have a C section, the vet can see it, and tell you not to breed them again. If not, the uterus can rupture as soon as labor starts, even though there have been no complications with the current pregnancy.

 

I've seen it happen, and it is so horrific, that I wish I could forget.

[Changed]

So the risk appears to be labor itself, not pregnancy?

[Kathryn]

I have a friend who had a C-section with her first and was told her uterus was thin then. She went in for a planned C-section with her second and was told that there was actually a hole in the uterus but the position of the baby was covering it up, but if she'd gone into labor it would have been very dangerous.

[deacongirl]

The risk is uterine rupture.

[Colleen in NS]

So the risk appears to be labor itself, not pregnancy?

 

No. I was told a third pregnancy for me would be very risky. The weight of the baby could cause the scar to rupture.

[Jpoy85]

The risk is uterine rupture.

 

:iagree:

 

I had 2 c-sections without complications and then an induced VBA2C. After MUCH research with I-Can and DONA. The risk is Uterine Rupture with a thin uterine wall. The risk is greater with repeat sections specifically.

 

You really have to have an OB who knows what he/she is doing. For EX: its hard to find an OB to give a VBA2C, let alone Induction. I had to look around and find a good OB who knew what he was doing and wasnt going to just give me PIT and walk away. The risks were there, but i was fully monitored. The same is true even without a VBAC or Induction...for a 3rd Section, i would of needed Monitoring as well. HTH

[BakersDozen]

What about women who have not had c-sections but have had the same number of pregnancies? Is there not a chance (even a good chance) that their uterus is just as thin but nobody knows because they didn't have a surgical birth?

 

 

I had my first (and hopefully last!) c/s with the twins and was told my uterus looked great so I don't know that the # of pregnancies affects the uterus (at least not for all women).

 

Of course the doctor kept pushing me to get my tubes tied because he simply couldn't understand why I would want more babies...I finally told him to shut up. :glare:

[Acorn]

At the start of my second c-sec at the first view of the uterus, I was told that there was a paper thin window and then she saw a uterine rupture. My ob said that the uterine muscle was just falling apart as she touched it. It was recommended to not have further pregnancies. If I did, then they should be at least 2-3 years later. She said that some woman rupture with the first labor in extremely rare situations so it isn't always caused by multiple pregnancies.

[pfamilygal]

I had 2 vaginal births first.

 

Then a c/s for transverse lie after PROM.

Wanted to VBAC with #4, but his head was all wonky and he was way bigger than my others (all less that 5 1/2 lb - he was 8 lb 3 oz at 36 wks). Had PIH, chose a c/s instead of induction.

 

With #5 I wanted a VBA2C. Had prodromal labor for weeks. Ended up getting cut at 38 wks due to crazy high pressure. When the doc got in there, my uterus was partially ruptured (several cm) along the old scar line. Probably from the weeks of contractions. He didn't share with me that it was partially ruptured.

 

I get pg with #6, planning a c/s. At 34 wks, my OB gets the records from my previous birth (different hospital/doc than #5). He reads about the previous rupture and is all "why the HECK did you get pg again?" Well, because I didn't know! He does an amnio at 35 1/2 wks, determines Leah is mature and takes her via c/s. My uterus is so thin that he just nicks a corner of the scar and rips it open with his hands like a perforated worksheet. Nice.

 

So I had a hyst and we are done :) Would have loved a #7, but I love my kids and will not risk leaving them mommy-less. Adoption is a great option!

[MedicMom]

Funny this is posted now.

I had my second child yesterday. It was a repeat scheduled c-section, but I went into labor at 2 am the day of the scheduled c-section. By the time we had arrived at the hospital at 6:30, when I was supposed to be there for the pre-op stuff and the section, I was seven cm dilated with contractions 2 minutes apart. At that point my OB recommended I attempt a VBAC since there were staffing issues and my c-section had to be pushed back till noon--he figured I would deliver before noon. He had been encouraging me to VBAC all along as I was the "perfect candidate" but I had a bad premonition about it and wanted a c-section. There was nothing to do though since I couldn't get into the OR before noon now, so I continued in labor.

 

At 9:15 I was rushed into emergency c-section with a uterine rupture. I tore through the original scar and had the second largest window in my upper uterus that my OB had ever seen in 35 years of practice. It was a random, freak thing that happened with no warning signs. My uterus look fantastic when they sewed it up after my first child's birth and this pregnancy has had no complications.

 

I am 30 years old and will never have another child. I can't tell you how much I wish I had just come in at 2 am and followed my premonition that I shouldn't VBAC.

Edited May 31, 2012 by MedicMom
because I am exhausted and on a lot of pain meds...

[LizzyBee]

I have a friend who had this. We were pregnant at the same time with our 3rd babies. She had to have a c-section before her due date to prevent the baby from getting too large or natural labor, since that would have put her at risk of the uterus rupturing before birth. During the c-section, the dr's thumb went right through the uterus, so it most likely would have ruptured if she'd labored. As far as women who don't know they have a thin uterus because they haven't had a c-section, perhaps that is the cause of uterine rupture. Someone at my church nearly bled to death when her uterus ruptured with her last baby.

[gardening momma]

With my last two sections I was told I was so lucky because the tissue was too thin. I can't decide if it really was compromised or if my Dr. said it because he knew I had planned home births. ;) There is research to show the idea is bogus and some to back it up. Who knows.

I have a friend who had a c-section with her 2nd and during surgery the Dr showed the husband how thin the uterus was before he cut through. They were advised to not get pregnant again.

[Tiramisu]

I also had a friend with this. She's had several children, though, and multiple C-sections. For the last one, she had such a risk of uterine rupture that she had to be hospitalized for the last couple of months of her pregnancy. It was a hard time, but everything turned out well.

[eloquacious]

I have a friend who had a c-section with her 2nd and during surgery the Dr showed the husband how thin the uterus was before he cut through. They were advised to not get pregnant again.

 

Wow. My husband has put his foot down that 3 is it for us, so I can have one more... but if I don't, he's fine with the two we have. I always whined that we shouldn't limit ourselves to 3 just because some super "helpful" nurse said we should - we have several friends who have had 4, 5, and one even had 6 Cesareans. Granted, the friend with 6's youngest is 18 years younger than her oldest, so she spaced them better.

 

Reading this just makes me think perhaps my husband is right after all. I have to admit, and this is awful saying it, but ... I almost wish I would "have" to have a hysterectomy, because I don't want to have my tubes tied, and I don't want my husband to have to join the V-club...but what's the point of preventing (and having to endure Aunt Flo) for the rest of my life if there won't be anymore babies? Of coures, I could never actually decide it, or want it... only if I were told that my uterus was super thin, I wouldn't say no, you know?

[plain jane]

Funny this is posted now.

I had my second child yesterday. It was a repeat scheduled c-section, but I went into labor at 2 am the day of the scheduled c-section. By the time we had arrived at the hospital at 6:30, when I was supposed to be there for the pre-op stuff and the section, I was seven cm dilated with contractions 2 minutes apart. At that point my OB recommended I attempt a VBAC since there were staffing issues and my c-section had to be pushed back till noon--he figured I would deliver before noon. He had been encouraging me to VBAC all along as I was the "perfect candidate" but I had a bad premonition about it and wanted a c-section. There was nothing to do though since I couldn't get into the OR before noon now, so I continued in labor.

 

At 9:15 I was rushed into emergency c-section with a uterine rupture. I tore through the original scar and had the second largest window in my upper uterus that my OB had ever seen in 35 years of practice. It was a random, freak thing that happened with no warning signs. My uterus look fantastic when they sewed it up after my first child's birth and this pregnancy has had no complications.

 

I am 30 years old and will never have another child. I can't tell you how much I wish I had just come in at 2 am and followed my premonition that I shouldn't VBAC.

 

:grouphug: This post of yours just took my breath away! I'm so sorry you had to endure but I'm glad that you and baby are ok. How frightening for you all! :grouphug::grouphug:

[plain jane]

 

At 9:15 I was rushed into emergency c-section with a uterine rupture. I tore through the original scar and had the second largest window in my upper uterus that my OB had ever seen in 35 years of practice. It was a random, freak thing that happened with no warning signs. My uterus look fantastic when they sewed it up after my first child's birth and this pregnancy has had no complications.

 

I am 30 years old and will never have another child. I can't tell you how much I wish I had just come in at 2 am and followed my premonition that I shouldn't VBAC.

 

During the c-section, the dr's thumb went right through the uterus, so it most likely would have ruptured if she'd labored. As far as women who don't know they have a thin uterus because they haven't had a c-section, perhaps that is the cause of uterine rupture. Someone at my church nearly bled to death when her uterus ruptured with her last baby.

 

I have a friend who had a c-section with her 2nd and during surgery the Dr showed the husband how thin the uterus was before he cut through. They were advised to not get pregnant again.

 

Gosh. That just stinks. :( Reading these makes my gut ache. I'll admit I hope to have more kids one day but ... I dunno. It's always in the back of my mind as I have more kids- what if I'm one of those with a thin uterus? ::shudder:: It does kind of scare me. :tongue_smilie::confused:

Edited June 2, 2012 by plain jane

[joyfulhomeschooler]

This post has got me questioning our recent decision to VBAC. I had a natural birth with our first, csec with 2nd (she was breech) but I was dialated to 9cm when they finally got me in for the csec, lost our third at 20 weeks and birthed her naturally, then our 4th we did a successful VBAC.... but I am worried because I start laboring really early. I am already having pretty strong contractions at 31 weeks. Can this cause my uterus to thin early making it riskier? :001_huh: I am starting to get a little worried.

[Pammy]

who had seven kids within 9 years (no multiples). Three of them were C-sections in between Vag. The last baby was an emergency c section due to placenta previa, and the mom died. The dad had a lot to deal with as the baby was in NICU for a few months too.

 

This isn't something I would take lightly. I ended up having a tubal with my last baby, after my fourth baby died at 20 weeks and my fifth was a section due to placenta previa also. I always wanted to try natural childbirth, but I had extremely risky pregnancies.

 

I also know that we should listen to our gut instinct. If I hadn't requested a section with my last baby, he would have died. There was no room in the cord for him to drop down, he tied several knots in it and he was 11.5 lbs! That boy was stuck!

[Jpoy85]

This post has got me questioning our recent decision to VBAC. I had a natural birth with our first, csec with 2nd (she was breech) but I was dialated to 9cm when they finally got me in for the csec, lost our third at 20 weeks and birthed her naturally, then our 4th we did a successful VBAC.... but I am worried because I start laboring really early. I am already having pretty strong contractions at 31 weeks. Can this cause my uterus to thin early making it riskier? :001_huh: I am starting to get a little worried.

 

I would talk to your midwife/doula/OB and ask.

[Bluegoat]

I was told this with my last pregnancy, however, I wouldn't tend to believe it just based on the fact the doctors said it - they also told me I had a 10% chance of dying in labour.:glare:

 

As far as I'm aware, the research on this is pretty inconclusive - they don't actually have a good idea how common a very thin area of the uterus is in labour or what percentage of them have a rupture.

[Dealea86]

Do you know how when you sew up a hole in fabric, the fabric tends to wear out faster near the patch, instead of evenly around the garment? Or if you have to patch a bicycle tire or a beach ball, leaks tend to happen in the old spot rather than in a new one? I think it's the same sort of theory here.

 

The scar causes a weak spot in the uterus, and the muscle fibers attached to the scar tissue are under greater stress because of this and can thin out quicker. That's not to say that a uterus won't thin out without a scar, but without the surgery, the thinning is going to be more uniform around the uterus and less concentrated in one spot. That's why rupture is so rare in women who haven't had c-sections.

 

That my theory, anyway. ;)

[Stayseeliz]

With baby #3 (all c-sections) I was told my uterus was very thin and I had an extremely thin window that made a rupture very likely. I was told not to get pregnant again. 2 1/2 years later we got pregnant with a surprise baby. 8 weeks of premature labor and tons and tons of contractions, HBP, etc. It was a crazy pregnancy! My dr (who is on the conservative side and not an alarmist) wanted to deliver as close to 36-37 weeks as possible to keep the baby from getting too big and putting pressure on my scar, the window, etc. I had her at 36w5d and she was my tiniest baby of them all. My c-section went incredibly smoothly with no complications.

 

It's a VERY hard call to make when you don't feel like your family is complete. I had made peace with the fact that we were only going to have 3 children. My last pregnancy was very stressful with 8 weeks of bedrest but we made it and she's now an energetic 14mo. We did choose not to get pregnant again. We were very blessed to make it through my last pregnancy. I am not chancing that again.