Joss Stone has welcomed her second child, but has revealed she underwent a difficult birth during which her womb split, known as a uterine rupture.
The Mind, Body and Soul singer, 35, had to undergo an emergency caesarean while giving birth to son, Shackleton, her second child with partner Cody DaLuz.
Stone said doctors have told her she can have another child but would need to have another C-section, as a vaginal birth wouldn't be possible.
However, the couple, who also share daughter Violet, may also explore adoption anyway.
“I definitely want to have more children," Stone told Hello! magazine.
“The doctor has said I can have another one but I definitely can’t give birth naturally because my uterus split.
“I’ve always wanted to adopt and Cody was adopted so he wants to adopt, too.
“We’ll see but I’d like as many kids as I can.”
It isn't the first time Stone has discussed her experience of welcoming her son, having previously revealed she needed an emergency C-section after 30 hours of labour and her uterus splitting when the baby came down the birth canal.
“He was coming down the birth canal, and when my uterus split, his head went into my abdomen and he went back up,” Stone told People. “They had to bring him back to breathing again.”
Stone went on to share how she was taken into the operating room where a doctor told her that she was going to sleep.
“And then I woke up, I had my baby, and everything was okay,” she continued.
Stone announced she was expecting another child earlier this year after revealing she had suffered a miscarriage in October 2021.
What is a split uterus?
Also known as a uterine rupture, a split uterus is a rare and serious complication of labour that is estimated to occur in just two out of 10,000 pregnancies in the UK.
"It requires immediate medical intervention to safeguard the wellbeing of the woman and her baby," explains Lesley Gilchrist, registered midwife and co-founder of My Expert Midwife.
"During a complete uterine rupture, the wall of the uterus tears open, or ‘splits’, leaving an opening through which the fetus (baby) can exit into the peritoneal cavity (abdomen)."
Mr Hemant Vakharia, consultant gynaecologist at London Gynaecology, explains that as a pregnancy progresses, the womb stretches and during labour, the contractions create stresses across the scar and uterine muscle.
"In cases where there is a weakness, this causes the scar to open," he explains. "The baby can then go through this defect which can put both mother and baby in a life-threatening situation.
"The scar opening can also sometimes lead to tearing of the blood vessels and other surrounding structures (e.g. bladder) which can lead to significant blood loss," he adds.
Watch: Joss Stone gives birth a year after suffering heartbreaking miscarriage
What can cause a uterine rupture?
The most common cause of uterine rupture, according to Gilchrist, is having a previous Caesarean section (C-section) scar. This increases the incidence of uterine rupture to one in 200 women, or 0.5%.
Other risk factors for uterine rupture include:
Previous uterine rupture (increases risk by 5% or more)
Previous C-section scar
Having more than one C-section scar (this increases the risk further)
Previous surgery to the uterus
Induction of labour when there is a previous C-section scar
Polyhydramnios (excess amniotic fluid)
Multiple pregnancy (twins, triplets, etc)
Excessive use of oxytocic drugs in labour
Grand multiparity (having had more than five pregnancies)
"Spontaneous rupture of uterus without any risk factors is uncommon in modern obstetrics," Mr Vakharia adds. "Risk factors include previous uterine surgery such as caesarean section or myomectomy (removal of fibroids from uterus), which can create a weakness in the uterine wall.
"This combined with the contractions in labour can lead to tension across the uterine scar and rupture."
However, having a vaginal birth after one caesarean section is still regarded as being safe and many women go on to do so.
"Uterine rupture is also a concern in some patient who have a uterine developmental abnormality," he adds.
How is a uterine rupture treated?
Midwives and doctors are trained to recognise signs of a possible uterine rupture, so they can act promptly.
"If they suspect a uterine rupture has occurred, help will be immediately summoned, the mother will be stabilised with oxygen and IV fluids, any oxytocic drugs (hormone drip) will be stopped, and rapid preparations will be made to take the woman to theatre to deliver baby via C-section," Gilchrist explains.
"Once the baby has been born, a senior obstetrician will repair the uterus."
Does a uterine rupture mean you won't be able to have a vaginal birth following subsequent pregnancies?
If you have had a previous uterine rupture, then you can discuss having a vaginal birth after a C-section (VBAC) but Gilchrist says it is likely that it would be recommended that the safest route for birth would be a repeat C-section.
Additional reporting PA.