Fertility after Cesarean and Stillbirth

[JayBowyer]

Hello,

I had a cesarean in October of 2008 - so, approaching seven months ago. Very sadly, our little girl was stillborn because of a placental abruption, most likely caused by extreme stress at my place of work for many weeks (I was a district manager, working hours as long as 5am-11pm some days, under enormous pressure).

I healed very well. I never had an infection - just an annoying stitch that was removed in my PP appointment. After that, everything went well. I made sure to take a lots of vitamin C and E, and my cycles returned a month after the cesarean.

However, there are some things that have changed. Instead of ovulating around day 17-18 and having 13 or more day LP's, I am ovulating on day 21-23 and having 10 day LP with spotting. This month, I ovulated on day 31! I think that may have been because of sickness though - the link to my chart is: http://www.fertilityfriend.com/home/1eb1ef

Anyhow, I am worried that things are not right. In my early pregnancy with Josie, I had a cyst on my ovary that grew to 5cm or so - I wonder if it is still there. They were going to check after delivery but they didn't. Part of me wonders if that corpus luteum cyst was the only reason I held on to that pregnancy, since I had never been pregnant before. Would that be a medical possibility?

Also, I am having pain during intercourse. I feel like my womb sits lower than before, not allowing my guy to go as deep as before without bumping against my cervix. It's really quite uncomfortable at times, though that does vary.

So we are trying to conceive now, and I was just looking for some input and advice. Had Josie lived, we wouldn't be trying like this, but she didn't, and we are.

Thank you so much for any help you can provide in advance!

[Elaine Brown, MD]

Hi!
I'm so sorry you lost your little girl! That must have been extremely difficult.  Its a tribute to your fortitude that you can try again.
It sounds like something is not quite right with your cycles.  You are probably aware that ovulation should occur about day 14, and any cycle that is longer than 31 days is not "normal". The spotting is also not quite right.
If you were my patient, I would check prolactin, thyroid, and progesterone levels.  I would also discuss the possibility of Clomid or Femara to help regulate the ovulation.

You really should bring up the subject of the cyst to your doctor again, a quick ultrasound would be all that you would need to know if it is still there.  A cyst that persists and grows during pregnancy is not a "normal" cyst.  The corpus luteum should disappear by the second trimester.

Finally, it is possible that you have some scar tissue from the csection that is contributing to the discomfort during intercourse.  It can be a good idea to start out with the female on top. so you can control the depth of penetration.  Usually once the woman is fully aroused, the cervix moves out of the way, so after a bit, you could try some other options!

Hope some of this is helpful!
Next time around, slow down a bit.  And don't smoke whatever else you do!
Dr B

[JayBowyer]

Thank you very much! That answer was so helpful. I have an appointment with a great OB on May 22nd, so hopefully he can shed some light on what is going on with my innards (via ultrasound, hopefully). Perhaps soon, something can be done and things with even out so that we can become parents again.

Again, thank you so much for taking the time to reply to my question. I appreciate it so much!