C-Section Scar Defect
- xxARxx
- Apr 2
- 4 min read
If you have read the previous blog post ‘C Section Scar Ectopic Pregnancy’ you will know that in 2023 I experienced exactly that, a pregnancy that implanted into my C Section scar from having my first baby in 2020. The 2023 pregnancy was unfortunately not viable.
This pregnancy was surgically removed at 7 weeks and I was invited back to have a review 6 weeks later to check for something known as a ‘Niche’ (aka C Section Scar Defect or Isthmocele).
In Jan 2024 I attended an appointment for an ultrasound scan and within the first minute the consultant confirmed I did have a defect. It measured 5x7x9mm. I had no idea this was a possible complication of having a C Section or the impact it can have on fertility and future pregnancies.
Following this appointment I went away and did a lot of my own research into the issue, I found articles online, studies and forums which were very informative. I was then faced with a decision… do we try to conceive again and hope that we are successful and a baby implants away from the defect or do we wait and pursue a repair followed by some time to allow recovery?
Looking back now with new knowledge and hindsight I did have symptoms of a scar defect following my 2020 C Section however I had naively assumed these were normal after having a baby.
Some women who have a scar defect struggle with secondary infertility, which unless investigated and diagnosed can be classed as unexplained. This is because a defect acts like a pocket inside the uterus, during a period it collects/traps blood that isn’t released, this blood can then create a ‘toxic’ environment that prevents sperm or a fertilised egg surviving.
Occasionally women are unable to conceive at all, whilst some find they can get pregnant however experience reoccurring early miscarriages and others like me experience Scar Ectopic Pregnancies.
My main symptom of the defect was brown spotting mid cycle. I would have a normal (on the heavy side) period, then 2ish days of nothing followed by a few days of brown (old blood) spotting in the lead up to ovulation. Following ovulation all bleeding would stop until start of next period/cycle.
As I was symptomatic and had just recovered from the ectopic pregnancy I decided I wanted to do everything I could to give us the best change at a viable pregnancy, this meant waiting to TTC and seeking repair surgery.
The repair via NHS was possible however the wait would have been at least 12 months as the procedure isn’t classed as urgent. Luckily I have private medical insurance through work so I started to enquire if it was possible to utilise it for this. It proved stressful and involved many long phone calls trying to explain the situation to the insurance company but eventually it was approved. I found a surgeon in the North West who had experience with defect repairs, I had consultations, more scans and reviews and then had laparoscopic repair surgery on 8th April 2024.
I didn’t look into the procedure much beforehand as was already hesitant about surgery but it’s safe to say I underestimated the recovery. I was very tender and sore for a while and mobility was reduced, I also couldn’t drive at first and heavy lifting was not allowed. I spent a lot of the first week in bed fully off work and then managed to work from home for the second week.
Following the procedure I just had to wait and try to find some patience, it was recommended to wait at least 4 months before trying to conceive again to allow full healing, I tried to make this time count so looked after myself physically, tracked my cycle, tested for ovulation each month and took a multitude of supplements, this was all in an attempt to give us the best chance of conceiving once we got the green light.
At a follow up appointment I had a scan and there was no sign of the defect. This was music to my ears. I did still have some spotting though, not sure why, perhaps just my body still recovering. After a bit of googling and chatting to other women in the Facebook forum I started taking/doing a couple of things to try and help reduce this.
Month 1 of TTC again we were lucky, it worked. All the preparation paid off. What’s strange is I just knew from around 5dpo (days post ovulation) that something was happening, I had a feeling I was pregnant and I was willing it with everything I had to stick high up in my uterus away from my scar.
I became slightly obsessed with testing and watched the positive line get darker and darker as the days went by (see photo). I needed to wait until I was 6 weeks pregnant to have my first scan to see where it had implanted, this was a loooong wait and again I had to dig deep, trust the process and be patient. Luckily we got the news we wanted and the baby was high up in my uterus with a little heartbeat flickering away. What a huge step in the right direction.
As many of you will know pregnancy after a loss is not easy, constant worry intertwined with joy and excitement. The whole thing is a paradox of emotions. Throughout this experience I have had to accept that some things are out of my control, I have taken a lot of deep breaths and tried to understand that what’s meant for me will find it’s way. Luckily I have had great support from my amazing husband, friends, family and work for which I am very grateful.
As I write this I am in the final weeks of pregnancy with equal measures of gratitude, excitement and anxiety. Trying to soak up the last bit of time of Tommy being our only child whilst also wishing the days away in the hopes of holding our new baby in my arms.
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