Q: I have a client who is expecting her third baby. She planned a homebirth
with her first baby, but transferred to a hospital after her cervix became
very edematous. During her second labor (planned hospital birth), she again
developed a very edematous cervix in active labor. She had a CNM as a birth
attendant, and many things were tried, including water therapy, hands &
knees, ice to the cervix, other position changes. She eventually requested
and received an epidural at 9 cm, due to exhaustion, and delivered with
vacuum assistance. Does anyone have any ideas, such as herbal treatments
during pregnancy, other options during labor, hopefully to prevent the
edema, or at least to more effectively reduce it? Has anyone used arnica
during labor, either sublingually or directly to the cervix? Is that safe?
-Rose Evans
A: I find there are several situations where I am more likely to see an
edematous cervix or cervical lip. If the mother's cervix is tilted way
toward the back, if she has a very large baby carried high, if she begins
pushing too soon or if she has no stretch marks, you are more likely to
have a problem. I know that the "no stretch marks" may sound unusual but I
really see a connection. The mother's skin is so stretchy and so is her
cervix. It stretches right down with the baby's head as it moves down
instead of pulling up over it.
The best thing I have found is to put evening primrose oil directly on the
edematous area. The hard part is getting it in there in a sufficient
quantity. I am working on some kind of delivery system. After it has been
applied, give the mother a break for at least 15-20 minutes. Be sure she
does not do any pushing with her contractions. The evening primrose oil
will shrink the swollen tissue very well. Occasionally you may still need
to push the lip up over the baby's head once the swelling has decreased.
By the way, evening primrose oil works very well on swollen perineal
tissues and varicosities both before and after birth as well. It also will
reduce any hematoma on the baby or any swelling and bruising of soft
tissues as in a breech delivery. I have not heard of any dangers connected
with its use.
-Judy Jones, CPM
Reprinted from Midwifery Today E-News (Vol 2 Issue 20 May 19, 2000)
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