Thin Uterus Lining. What's This All About??

L., I am a labor and delivery nurse of 5 yrs. This is not a common thing, but it does happen. The "thin" part of your uterus is the most important, where the incision is. It can also be called a window. Basically your uterus grew back very thin where your previous incision was. The risk in this is uterine rupture (uterus breaks wide open). Depending on how thin it was, if you were pregnant again, it could take as little as 2 or 3 contractions to break that old scar open and cause a uterine rupture. This can be life threatening for mom and baby. I would take your Dr's advice very seriously. I also have to add that Ellen's advice in the previous message scares me. She is wrong in sooo many ways. A VBAC is not an option for you. And YES, moms and babies die from uterine rupture. That is why it is such a big deal....

It is not uncommon for the usterus to br thin around a scar rom previou ssurgery. It is also best to wait 18 months between conceptions. Just becasue there was a thin spot does not ean you were headed for certain doom. You have to keep in mind while the condition does need to be monitored, physicians are also in CYA mode most of the time form the litigious environment they practice medicine in.

That being said, the decision is yours and your alson on whether or not to conceive again. However, After 3 c/s I would certainly do alot of research starting with:

ICAN_ International Ceserean Network www.ican-online.org there is also a local chapter finally! Run by Julienne Gooden.

Childbirth Connection: www.childbirthconnection.org

Cochrane Database: www.cochrane.org ( this is where credible research on all medical topics is complied and cataloged)

Try reading:
Silent Knife: Ceserean Prevention and VBAC By Nancy Cohen
Obstetrical Myths VS Research Realities By Henci Goer ( her website is great www.hencigoer.com)

VBAC Companion Guide By Biane Korte ( great whether you are planning VBAC or repeast c/s)

The Vaginal Birth After Ceserean Experience : Birth Stories by Parents and Professionals By Lynn Baptisiti Richards.

Going into the decision should be made with knowledge from research you have done and will help you make the most informed choice about your one health.

Good Luck!

K.
CD(DONA)- DONA Certified Birth Doula
LCCE_ Lamaze Certified Childbirth Educator
Midiwves Assisitant

Take it very seriously. Had you ruptured outside the hospital, you would have most likely died. I was told after my second c-section that my uterus was way too thin and had I labored, I would have ruptured. She advised no more kiddos. She said that if I decided on another, we would discuss it and take the baby early. Well, we decided no more kids but....surprise! Three and a half years later, we found out that I had conceived.... after calculation, it ends up that the conception date had been 2 days before my husband's vasectomy! Oops. Anyway, the Dr. watched me very closely, sent me to a Perinatologist who gave me sonograms every few weeks to measure the thickness of my uterus, I ended up on bedrest for bleeding, and they took the baby 3 weeks early. The Dr. said I was okay when she finished the C-section; most likely because it had been almost 4 1/2 years and that they took the baby so early before he got very big.

In any case, it is a VERY big deal and yes, you dodged a VERY big bullet. Take your Dr.'s advice seriously. If you do decide on another, wait as long as you can so your uterus has plenty of time to heal and make sure, if you end up with another Dr., that they know about your uterus so you can receive High Risk care.

Congratulations and good luck!

I don't have any advice really, but wanted to sympathize with you as I can sympathize with "having the decision made for you". I am going through something like that now too. It is devastating when someone tells you no more children, even if you are on the fence about it. I have one child. My pregnacy was rough and ended with a placental abruption - which if I hadn't been in the doctors office when it happened I would have died. My daugter also, having nothing to do with that, had a heart transplant last year. Going through these 2 things have made us nervous about having more kids, even though our hearts want to. On Monday I was told I had cervial cancer, which was removed in a biopsy they were doing. They said they got it all, but that I have abnormal cells in my uterus as well that are likely to grow caner if it isn't removed. We were told that if we want another child it can be done but there are a lot of risks and I would be watched carefully, probbly be on bed rest, etc. They said if we are finished having children I need a hysterectomy ASAP. We are nowhere near prepared to make this descision. I just wanted to say, I know how you feel. Sometimes we have to really think hard about are own health for the good of the children we do have. I feel very blessed with the miracle of the one child I have and may have to decide that this is it. I'm 39, so wouldn't have long to dilly dally about this. I am so conflicted. Sometimes I think we just have to count our blessings and not push the envelope too far - our children need us. Good luck with the decision you make. I know you are freaked out - I am too. You are not alone. You are very lucky to have 3 beautiful children. I wish you peace with what you decide. L.

I had two c-sections, the first an emergancy one so its up and down, so the second one was open the same way. They told me the same thing, and it is beacuse of the surgeries have made the uterus weak. My doctor told me to wait at least 7 years, if not longer. I am 23 my first son was born in 2004 and the second 2006. So i don't know if its cause they were too close together, and there wasn't enough time for it to heal. So good luck and congrats on your Baby!!

L.,
It's not the lining of the uterus that is thin, it is the uterus itself. Sometimes the uterus get so thin that you can actually see the baby through the uterine wall. This is most likely what happened. No one knows for sure what causes this other than your uterus stretching during your other pregnancies and scarring at the incision site from your other c/sections. The reason that your doctor told you not to get pregnant again is that next time your uterus may rupture. This is extremely dangerous and may be fatal to you and/or your baby. As for "dodging the bullet", sounds like your uterus was so thin that your were close to having it rupture this time. Next time you may not be so lucky. Please talk to your doctor about what he/she saw during your section and give some serious thought to the danger that you and your baby may be in if you get pregnant again.

My Dr. did the same thing. In the delivery room he called my husband over to show him how thin my uterus was. My husband later told me that the Dr. Actually demonstrated by showing that he could see his own had through my uterus, known as windowing. This was my 4th baby, 2nd section. At my follow up I asked many questions, basically the Dr. said that many factors play into this, heredity (how well you stretch and bounce back), size of babies (mine were all 8 pounders except my preemie) and c sections vs. natural. I got a second opinion too. That Dr. said the same. They both said that having more would potentially put my life and the babies at risk. Our decision was for my husband to have a vasectomy and now we are adopting. Good luck and welcome to the area, we have been here 5 years this aug!!

Its likely the doctor was talking mostly about your uterus being thin around the incision line. This is fairly common in women who have had multiple c-sections. The main concern with the thinning of your uterus and subsequent pregnancies would be the possibility of uterine rupture, especially if you happened to go into labor. When you go to your doctor for your check up, have a list of questions ready for him and don't let him put you off. You have a right to know what the implications are and your doctor should take the time to answer you satisfactorily. If you don't get the answers you are seeking, get a second opinion.
N.

I alos had a c-section with my frist child and was told I would continue to have them due to hospital policy. The death rate among v-bacs is 1 in 100 so they don't take chances. I would aks your doctor as I was told with each c-section the uterus can rupture due to the scar tissue build in the uterus.

When you have a C-section, the uterus is cut. Each time produces stress and scar tissue. If your uterus is thin and you get pregnant, the pressure (child & fluids) can cause a rupture of the uterus. Pretty scary. If you really have questions, I would suggest talking to your Dr. at your next appt. or consider asking a 2nd opinion to put your mind at ease.

I've have 3 C-sections too and my Dr. suggested no more children too. I don't believe that I have a thin uterus, but I was told the limit on the bikini line incision is 3, perhaps due to the scar tissue issue. I was told a 4th c-section would be a classical incision running vertically. The fear of a classical incision and having 3 children in 4 years was enough of an incentive to have my tubes tied. My DH and I decided that if we wanted more children in the future we'd consider adoption.

K.
Mom to 3 ages 6, 5 & 3 - Semi new to the area too (5-06) - I live in Plano

Your uterus is like a balloon that keeps getting stretched out. It never goes back the same.

It does suck when the decision is made for you, but your health is more important. I know what I'm talking about.

L.-

It's great that you have such faith in your doc but when making a decision like this, you should really consider getting a second opinion and research for yourself. This is a very big deal and you should be given all of the facts before you and your husband decide. I certainly would not make this decision right now if I were you. You have plenty of time for that. You just had a baby and are very emotional/hormonal. I'd be a bit leery of anyone pushing me to decide "right now". There's just no reason for that. You guys can practice birth control until you are ready to make up your mind and you feel at peace with your decision. Good luck!

Hey L.! Well, since I am the 20th person to post I am sure by now you have seen your doctor and hopefully you got the answers from him you were looking for!

I just wanted to add that my cousin had a thin utreus as well. This was her 1st baby and she was told that she may not be able to have anymore. It depends on how strong her uterus gets over the next 4-5 yrs. After the 4-5 yrs pass the doctor will talk to her about it. It has been 3 yrs this summer and I don't think she wants another one b/c she does not want to go through what she went through in delivery with the 2nd baby. Not to scare you, but she lost alot of blood and had major complications. Today her and her baby are healthy and fine, but she is still freaked out by her delivery of her 1st born. Everyone is different and again I don't mean to throw this out there to scare you ... I just wanted to share her experience.

I'm not positive, but when it is thin, it could rupture, and then the new baby and possibly you may not survive.I'm sure this is what they were concerned about.And you certianly want to be around to raise the three you have. It isn't like the Dr. is trying to make your decision for you on regualr things, he was trying to protect you and your family.

Your uterus must not have healed normally from your last 2 sections and that area must be thinner than the rest of the uterine wall. It is dangerous because your uterus could rupture during labor and maybe even during the last part of a subsequent pregnancy. You risk bleeding to death if that happens.

A former coworker of mine lost her niece and the baby she was expecting 4 years ago because her uterus was thin. It ruptured and she bled to death before they could get her to the hospital. This isn't something to take lightly - get a second and even a third opinion to find out just how thin and whether anything else can be done about it. And in the end, consider your three other children and whether you would want them to grow up without their mother because you took an unnecessary risk. Think about your husband and whether you want to leave him behind to take care of your children after you're gone.

I know you don't like the decision being made for you but if my doctor says this should be your last child please listen to him. The decision is being made by your body and if you don't think your body is in charge of what you can produce ask the millions of women who have no children or the women who have premature infants with severe problems who would have done anything to spare those children all the pain they have went though. "Dodging a bullet" doesn't make you appreciate what you have?! Proverbs says "Teach me to number my days so I might apply my heart to wisdom". Value the days you have with 3 kids and please listen to wisdom!
B.

i think i know what you are talking about. when my son was born <he was my second c-section> all the drs and nurses seemed very excited, all i heard was (we have a window-) they all came to see, you could actually see him through the uterus without having to cut! the dr said, you are getting your tubes tied right?! she said i wouldnt be able to have another child. one contraction and my uterus would have ruptured and both my son and i would have died.. its very scary! from what i was told, its very rare