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    Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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    Dec 08
    2011

    Natural birth after abdominal myomectomy

    Archived User
    Dear Henci,

     

    I was referred to you by a lactation consultant as a source of information related to my previous abdominal myomectomy. I am currently in the second trimester of my pregnancy and have been desperately trying to find evidence to support my desire for a natural birth.

     

    I have been able to find information on natural births after a laparoscopic myomectomy. However, I have not been able to find any information on a natural birth after an abdominal myomectomy.

     

    Can you tell me something about my situation? Or can you refer me to some websites?

    I look forward to hearing from you.
     
    Henci Goer

    I have never researched the topic of planned vaginal birth after myomectomy. That being said, I ran a search on PubMed, the (U.S.) National Library of Medicine's website. I limited the search to studies in English published in the last 10 years and found this one and this one and this one (same authors but different population as the first one) and this one turned up when I looked at "related studies" to the first one. However, all of them were studies of laparoscopic myomectomy. The total number of women planning vaginal birth after laparoscopic myomectomy was not huge, but none had a uterine rupture in labor, and the numbers were big enough to show that scar rupture is not unduly frequent. We don't know, though, whether those results would apply to abdominal myomectomy. I wish I could have been more helpful on this point, although in the U.S., at least, it probably wouldn't matter. Few U.S. obs will agree to planned vaginal birth after cesarean, where we do have a great deal of evidence of safety and efficacy, so I would anticipate that even fewer would be willing to take you on.   

    ~ Henci 

    Archived User

    Hi HHenci,

    Thanks very much for your reply. You are definitely right that there are very few OBs who would recommend a trial of labour with my condition. I have sought the opinion of 4 OBs so far and they all recommend a c-section.

    It is definitely disappointing. However, I do not want to affect my chances of good health and future pregnancies.

    I am hoping for the best. Thanks again.

    JK

    Henci Goer

    If you will be planning a cesarean, I recommend this page on the International Cesarean Awareness Network website to help you plan a family centered experience.

    ~ Henci

    Annamaria Di modugno
    I want to give hope to all women who had a myomectomy and want to have a natural birth. I had a 7cm fibroid removed from the top posterior of my uterus (the uterus cavity was not entered) and after 15 months I delivered my first baby vaginally! I made my research and decided to go against all doctors who discouraged me and made me feel crazy for pursuing a natural birth. I am 37 years old and I had my age as a risk factor for complications and uterus rupture. I did not get induced nor did I receive an epidural. The delivery was totally unmedicated and I feel empowered by it! Reserch your risks based on where your fibroid was. In my case I didn't know how much the surgery had impacted my uterus muscles but I was willing to take a risk. C-sections are risky too only nobody tells you about it. Life is about taking risks. You choose your risk. I chose mine and I am very glad I did because i saved myself from an unnecessary surgery. Be brave! One last advice is to stay home as much as you can once you are in labor. Don't go to the hospital until your contractions are very close apart! I wish everyone the best!
    Henci Goer

    Thank you for sharing your story. I agree completely that every woman has the right to make decisions about her care. Informed consent is meaningless without the possibility of informed refusal.

     

    ~ Henci


    All Times America/New_York

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