Infected incision

[WantsALittle1]

For the second time in the last month, my C-section incision/scar (almost 14 months old now) is inflamed, painful, and very infected/oozing. I went to my OB today and she put me on mupirocin topical 3x a day until the infection clears.

My C-section incision was closed over numerous hair follicles, so starting at 3-4 weeks PP I was pulling dead hairs out of it and dealing with pain and bleeding. When the scar was fully healed over, the hairs and inflammation stopped, but as soon as I got pregnant it's like the scar was put under stress because it started hurting again.

About a month ago various knots of scar tissue began raising up, becoming very inflamed, forming whiteheads (TMI), bursting, bleeding, tearing, ugh, it's awful. My current OB thinks that since my C-section was an emergency (done at another hospital), it was not done as 'neatly' as could be done under controlled circumstances. It's not the surgeon's faults--I just scar really thickly, and now knowing it, my OB feels that she could do a better job reconstructing it. I was planning to do a VBAC this time around, but sadly am now leaning toward a C-section so that my scars, both internal and external, can be redone properly.

What would you do? The pain and inflammation are absolutely awful, and I fear this will keep happening unless the scar is re-opened and closed better.

 

[JessPape]

Do you shave? a lot of times ingrown hairs can cause csection scars to become infected again. In general unless you had an infection trapped, it should get infected once it was healed.

I would still VBAC, but I would look for a cause as to why it keeps getting infected. There is also always the risk that the scars turns out worse, or you still end up with the same problem.

 

[WantsALittle1]

I don't shave, I just clip. I have never really been able to shave because I've had problems with ingrown hairs since I was 12. Good point about it happening again though. The doctor thinks she would be able to do a better incision under more controlled circumstances, which is why I thought there might be some hope with a second C-section.

 

[patch2006uk]

I'd opt for a VBAC, too. I assume the internal scar is fine, otherwise it'd surely be causing you more problems at 23 weeks pregnant! You can always have surgery on the external scar after you've had the baby, right? And then it would only need to be a skin incision, not one that goes through muscle and your uterus, and you wouldn't have a newborn to look after while it healed.

Sorry you've had such a crappy time of it - mine was an EMCS, and though I think it was definitely more rushed and traumatic than a planned, they took their time sewing me back up again, I haven't had any problems since it healed.

Hope you're comfortable with whatever decision you make

 

[JessPape]

if you have had an issue with in grown hairs, my bet is the cause of this is from in grown hairs, even if your not noticing them. Or even just an infected hair follicle around your csection scar, sadly with them doing lower binki cuts this is a big risk we csection moms face.

They can do a scar clean up on the outside, but as mentioned above, its not a good reason just to do a full csection.

 

[WantsALittle1]

I was worried that if it looked bad on the outside (lumpy, jagged, thick knots of scar tissue), maybe it was equally bad on the inside :/

 

[JessPape]

The problem with the inside is adhesions are a risk with a csection, and they can not be avoided the level one gets is unknown. So it may not solve anything, if your prone to bad scars, your prone to bad scars.

Have you looked at the risks of a RCS vs the risks of a VBAC? And im talking on your own not from your doctors point of view?

To your OB of course reconstructing it may be better.. As this means planned date, easy birth, so goes in for 2 hours does her work and she's done.. All in all may even make more money than a natural birth. I hate to say it, but that's the vibe im getting here.

 

[WantsALittle1]

Actually my OB is very supportive of my VBAC but said that if I want a section she will be equally supportive. Because of the trauma of DD's pre-term birth, this OB said she is completely deferring to me. If I want a VBAC, she will make a VBAC happen and she said that at any time I can change my mind and she will totally support it.

It's really me pushing for the section, maybe a bit of fear of the unknown and just wanting to go back to what I know? I also secretly fear rupture or a cord accident during birth (DD had an in-utero life threatening cord entanglement). I just feel like the 'pros' of a C-section are stacking up, including the chance to rebuild my incision/scar.

And I'm glad you mention adhesions because I very likely had/have them! From 0-8 weeks after my section I was in pretty bad pain and my doctor said it was likely adhesions and that if the pain didn't resolve, he could try steroid injections or surgical repair.

 

[JessPape]

Actually my OB is very supportive of my VBAC but said that if I want a section she will be equally supportive. Because of the trauma of DD's pre-term birth, this OB said she is completely deferring to me. If I want a VBAC, she will make a VBAC happen and she said that at any time I can change my mind and she will totally support it.

It's really me pushing for the section, maybe a bit of fear of the unknown and just wanting to go back to what I know? I also secretly fear rupture or a cord accident during birth (DD had an in-utero life threatening cord entanglement). I just feel like the 'pros' of a C-section are stacking up, including the chance to rebuild my incision/scar.

And I'm glad you mention adhesions because I very likely had/have them! From 0-8 weeks after my section I was in pretty bad pain and my doctor said it was likely adhesions and that if the pain didn't resolve, he could try steroid injections or surgical repair.

Risk of a rupture is 1% so you have a 99% chance that its not going to rupture. Fear of the unknown is normal, this is common with any birth, vbac, first time mom, multiples there is always a fear. Cord Entanglement is also very common 1/3 babies are born with their cords around their necks. The umbilicord is a neat thing, my friends son had THREE knots in his cord and around his neck. He was fine. Look up 'Wharton's jelly' its what's in the umbical cord and makes knots and stuff almost impossible for death to happen... Now I can't say 100% of the time because the risk is there, but none the less this is a good read and will help decrease your worries with it. Fears are normal, and it means your body is working through them.

https://en.wikipedia.org/wiki/Wharton's_jelly -- Im not a huge fan of Wikipedia, but its a start to some info for you

As for a csection, the risks are there aswell, and will be there. I've been on and off the table of a csection or a vbac. I keep going back to section because its easier, I can plan childcare, no mother in law staying at my house weeks on end. But in the end the recovery may be a nightmare.

Imagine from ICAN-online.org

https://ican-online.org/images/mychel/Infographic%20color.jpg

Most people have adhesions after a csection, its just the degree of them no one really knows. Sometimes they can be seen via an ultrasound sometimes not. Rarely do they cause complications with another birth. There is also a massage you can do on your scar to help break down the adhesions too.

 

[WantsALittle1]

The thing with cord accidents is we were told how extremely rare they are, and then we had one, and DD almost died from it. So I don't feel any ease when I hear how rare they are haha

Thank you for that chart, though. It is really helpful I love how all the risks go UP with subsequent C-sections and down with subsequent VBACs!

 

[JessPape]

The thing with cord accidents is we were told how extremely rare they are, and then we had one, and DD almost died from it. So I don't feel any ease when I hear how rare they are haha

Thank you for that chart, though. It is really helpful I love how all the risks go UP with subsequent C-sections and down with subsequent VBACs!

I know its hard, especially when you are that small percentage, but luckily the odds of it happening again to you are low (I know doesn't make u feel better)...

Just make an informed choice, and do what you feel is best . I know its a hard choice to make, and some days I feel like a csection is easier and the way to go (and I don't have a 2 hour drive to make if I do it)... but than a VBAC is better.... its a tough choice, I wont lie.