2nd pregnancy following a 3rd degree tear with 1st...

(67 Posts)
pucca Sat 07-Jan-06 23:57:53

Was just wondering if anyone on here had a 3rd degree tear, and what happened with subsequent pregnancies?

Did you get a chance to talk about it with a consultant? and what was advised?

I am pg with no 2, and i am starting to fret a little about giving birth again, i am not concerned about the pain of tearing again (wasn't really that painful!) it is just i did have a few "bathroom" problems for a few weeks afterwards(i am ok now though), and i am scared of being left with a permanent problem if i tore as bad or worse with this one iykwim.

serenity Sun 08-Jan-06 02:05:39

Very quickly (need to go to bed)

Friend has just (23/12) had her 2nd. She tore very badly with her first - had to have surgery afterwards to repair the damage. Second time around the hospital had extra midwife and a consultant on hand during the labour and birth 'just in case'. She didn't need them. She gave birth with just gas and air, and with only a very minor tear.

She was offered the choice of an elective CS due to the previous tear, but is badly hospital phobic and didn't want to do it (and have to stay in) unless totally necessary.

HTH!

agalch Sun 08-Jan-06 09:01:47

Hi pucca
I'm almost in same situation as you. Had 2 normal good deliveries with ds1 14yrs and ds2 10 yrs. Dd1 arrived 17 months ago and i had a 3rd degree tear.I have my booking in at hosp on 31st Janso i'm planning to ask then what i should do.Really dont want to have a section but i had problems after having dd,waterworks probs and no feeling at all in pelvic floor area.Have had months of physio to sort it out.Terrified this time could be worse but spoke to physio and she said the scar tissue is so tough i'm unlikley to tear in the same area,but could tear elsewhere obviously.Btw my boys were 6lbs 6oz and 6lbs 13oz and dd was 9lbs 14 oz so they are also going to moniter babes growth,don't know if her being so big was why i tore or not? What weight was your lo?And when are you due?

pucca Sun 08-Jan-06 09:51:04

Thanks for answering Serenity & Agalch.

My dd was almost 9lb, so i will be worried that this baby will be a big one too! I am due in August so have got a good while yet.

Have been reading up on 3rd degree tears on the internet and it is said if a episiotomy is performed that you could still end up with a extensive tear.

Good news for your friend Serenity

SoupDragon Sun 08-Jan-06 10:18:26

DS1, 10lb 1oz, ventouse, 3rd degree tear and a good long time in theatre having it repaired. Had a delightful ultrasound scan of the (ahem) torn region about 10 weeks after DS1s birth and was pronounced "fit" to have further babies "naturally". All healed with no problems.

Fast forward 2 years, DS2, 8lb 4oz, "elective" episiotomy when the tear looked vulnerable (requested that this be kept an eye on to prevent further tearing) No further tear that time and again, all healed fine.

I was offered the option of c-section ir early induction but this was more to dowith the size of DS1 rather than any concern about the tear.

spub Mon 09-Jan-06 14:13:47

DD born Jan 2003. 8llbs 11.5 ozs. 3rd degree tear AND retained placenta (deep joy). Also at risk of needing repair to my sphincter but thank god not needed though a few weeks of scary uncontrolled bottom and poo.....
Baby no 2 due beg of July. Also anxious about the birth. See my consultant (same guy who fixed me at 3am last time) on Jan 17th so I'll let you know what his advice to me is.
I know the chances are supposedly slim but I'd actually heard that scar tissue is less strong and so more likely to tear again. Don't want to be incontinent!!!

agalch Mon 09-Jan-06 17:04:51

It's so difficult i think to know what to do? We are given different facts and advice from different docs midwifes etc. I never know who to believe or what advice to follow.Let us know how you get on spub and what your consultant says.

spub Mon 09-Jan-06 18:06:35

No worries. I'm gonna grill the good doctor and ask all sorts of awkward questions....

grammaticus Mon 09-Jan-06 18:09:45

I had a third degree tear with ds1, thought I might be reluctant to push when pg 2nd time. In labour I discovered that I did not need to push as my body just did it for me (4 hour labour) and though I tore slightly along the line of the first scar it was nothing serious and I was stitched in the delivery room instead of under a spinal anaesthetic in the operating room. So for me it turned out not to be a problem - good luck!

Gem13 Mon 09-Jan-06 18:14:18

I had a 3/4 degree tear after DS (9'11' but hand and arm presentation - elbow came out first!).

When I was expecting my second (she came along 18 months later) the first consultant said it should be fine after a 5 second chat. Second consultant did an examination and said that there was a 2% risk of becoming anally incontinent if it tore again. I had an elective c-section and it is fine.

I want to have more children and would like to try naturally again but I would like to be examined to see if it has healed more over the time period.

I didn't have any problems following DS's birth, thank goodness, but I didn't want to take any chances.

Ask questions and get them to look at it properly (however grim that may be). A chat is not good enough for something with such serious consequences.

spub Mon 09-Jan-06 18:20:31

Good advice, Gem.
I'll wear my best pants and persuade the good doctor to go back and check his handiwork......
You're right - it's too important not to be awkward if that's what's needed!

Gem13 Mon 09-Jan-06 18:36:19

Well done!

The thing that scared me most was that he said they wouldn't be able to fix it if it went horribly wrong (i.e. permanently incontinent!). That was enough to persuade me!

pucca Mon 09-Jan-06 23:12:14

Thanks for all the replies everyone, good to know i am not the only one going through and worrying about this

I have yet to see a midwife never mind a consultant, so i will have to wait and see, as i said i am not bothered about the pain, it's the problems that could stay with me that really bother me...i don't wish to be incontinent at age 26 .

Did anyone that has had a 3rd degree tear get an explaination as to what had happened? i didn't, i read it on my discharge notes, no one bothered to go through anything with me, and to think i will have to have another baby at this hospital from hell that is another story

laurenholly Mon 09-Jan-06 23:25:45

i had to be cut with dd1 due to having a vontues(cant spell) and it hurt me when i went to the toilet but when i had dd2 i was ok

jabberwocky Mon 09-Jan-06 23:26:02

Hi pucca, I did not have a tear but did have an emergency c-section. Just wanted to say that, as someone who was terrified of a c-section before, it really wasn't that bad. Am hoping to start TTC in a couple of months and if things go well I will definitely have another c-section. HTH

pucca Mon 09-Jan-06 23:28:55

Jabberwocky...I think that is my problem...I am soooo scared of c-section, i know of course if i had to have one to make sure my baby was safe i would, but just the thought of it <<<<shudder>>>> and feeling them in your belly but it not hurting, just makes me feel ill.

pucca Mon 09-Jan-06 23:33:11

Laurenholly...Did you have a 3rd degree tear? Did you speak to a consultant before giving birth with your dd2?

agalch Tue 10-Jan-06 07:14:44

I don't actually why i had a 3rd degree,i have always assumed it was because my dd was 9lbs 14 oz but i really didn't want to know at the time tbh.Will i be able to find out at my booking in vist do you think? I remember the mw yanking dd out and having to really pull hard and thats when i tore as her head came out fine.Iremember looking at my friends face (who was one of my birth partners) and thinking oh god what is that mw doing to my baby? My friends said afterwards they didn't know babies were hauled out like that. Pretty horrible when i think about it.

pucca Tue 10-Jan-06 11:49:38

I mean i thought i had just a a little tear, the midwives and doctor didn't explain why i had to be stitched under a spinal or anything, i had never heard of a 3rd degree tear until i read it when on my own on my notes they gave me, and i had a appointment 6 weeks after birth but they didn't check me "down there", so tbh i don't know if all is ok iykwim.

I tore because i wasn't told when to pant so dd came out in one push, in fact they struggled to catch her lol, she shot out like a bullet.

SoupDragon Tue 10-Jan-06 12:01:43

I tore because DS1 was over 10lb and came out in one push/pull with the ventouse. I knew I had one because I was stitched under spinal in theatre for aaaaaaaaaaaages, had a dose of IV antibiotics and was sent home with a raft of antibiotics, lactulose, fibrogel and an appointment for the ultrasound scan.

Meanoldmummy Tue 10-Jan-06 13:06:20

I had two third degree tears, multiple lacerations and God knows what else after DS1...had DS2 23 months later and did tear again but not anything like as badly and it wasn't unbearable. With DS1 it was all awful as I had to go to theatre to have the placenta removed/I haemorrhaged etc, and DS1 had to go to intensive care, but with DS2 I was playing with him while they did the stitches and I barely felt it. I did haemorrhage again but for a totally separate reason. I was terrified when I was pregnant the second time because I was sure the scars would be like fault lines and it would all rip open..but it didn't!!! Even with shoulder dystocia! I hope your second will be easier, as mine was

bubblepop Tue 10-Jan-06 13:54:14

someone i know of has just had an elective c-section with her 2nd because of this.

spub Tue 10-Jan-06 14:31:16

That's interesting and practice obviously varies then.
I was told by the midwife at my booking in that not only would I not be offered an elective section (previous 3rd degree and retained placenta fixed/removed under spinal block respectively) but I'd be unlikely to be given an episiotomy, "as the thinking now is that to tear is better" - Oh, really???
I'll grill the consultant on Jan 17th.
Bet none of the medical staff involved fancy being faecally incontinent, eh?

jabberwocky Tue 10-Jan-06 15:34:31

pucca, I thought maybe that was part of it. It's always hard to advise someone as there are risks with either way. However, if someone had told me before I had ds that I would be a strong supporter of c-sections I would have laughed in their face! Now I am adamant that it's the only way to go if I have a second. Look into both things and hopefully you will get lots more posts from others with similar experiences.

omtmum Tue 10-Jan-06 15:46:11

I had a third degree tear with ds1 and was in surgery being "repaired" longer than I was in labour. However they did a fab job and I have gone on to have two more ds's naturally and very quickly with no further tearing or repair work needed. There was talk of a section with ds2 but it was only an option and one I didn't want to persue unless absolutely necesaary. Good luck

Verso Wed 11-Jan-06 06:57:02

I had a 3rd degree tear and multiple internal lacerations and was sent home with all the antibiotics, fybogel, lactulose etc like a PP. Went on to develop full incontinence and after a week of begging to be taken seriously, was readmitted to hospital and put under the care of a consultant. The subsequent ultrasound showed permanent damage and I have a 40% chance of permanent faecal incontinence with any further deliveries.

So I do think I would opt for an elective next time. I am still having physio nine months on, and while I know the seriousness and pain of a c-section is not to be underestimated, it is the only way I would even consider having any more babies.

(Do bear in mind my experience is exceptional, though!!)

TuttiFrutti Wed 11-Jan-06 09:47:26

Pucca and Verso, I second Jabberwocky's comments about C-sections - they are fine, honestly! I actually enjoyed mine. You get to see your little baby being pulled out in a calm, pain-free environment. The recovery is longer than for most natural births, but it's really not that bad and compared to the nightmarish natural births described on this thread where people are still having physio 9 months later, I know which option I'd choose!

CaptainDippy Wed 11-Jan-06 10:21:08

Hi pucca!! I had a horrid third degree tear with DD1 and was absolutely terrified of delivering DD2 - With DD1 I had to be stiched up in theatre and I have had quite a few little "problems" since (still a little tender!!)

However, I gave birth to DD2 in May last year - and I felt much more in control cos I had already had a baby and knew roughly what to do and what to expect - as a consequnce I delivered in three pushes (as opposed to the five hours of pushing DD1 took!) and had no tear and no stiches - wonderful - I felt pretty much "back to normal down there" within days of having her -

I have to admit though - DD1 was 8lb and DD2 5lb, so that might have had something to do with it - but I do not think it is necessarily the size of the baby, but the force at which they shoot out!!

sniff Fri 13-Jan-06 18:52:34

I had a horrid 3 rd degree tear with first and had to have an op under general after wards I have had my second since and had an episiotomy and am now pregnant with my third

everything was fine second time but I must admit when it came to pushing I paniced a bit because of what had happened and I had a spinal this time so that if it did happen I wouldnt have to have a general but most of the problem was me panicking

I dont have any incontinence problems but sometimes I get desperate to go!!!!(TMI)

I spoke to my consultant and he says I can have an elective section if I wanted but he wouldnt reccommend it as all susequent births are monitered alot more after a 3rd degree tear so it is unlikley to happen again

I see my consultant in 2 weeks to discuss the options for this birth

spub Wed 18-Jan-06 14:36:44

I saw my consultant yesterday and we discussed my 3rd degree tear last time in quite some detail.

It probably helped that he was the same guy who had to come to theatre at 3am and sew me up but after we chatted, he has suggested that I should go and see a couple of his colleagues and have my sphincter function assessed (this apparently involves a sonograph which I had heard of and putting a balloon up my bum which I hadn't!!)

I am not incontinent and haven't been since about 6 weeks post delivery BUT I also sometimes get the urge to go and couldn't hold on for a million quid. Thankfully, it's never happened when I haven't been able to get to a loo quickly.

On that basis, they want to assess my "reserve strength" in the sphincter muscle. If it's dodgy then a section will be recommended.

All other things being equal, I'd far rather deliver vaginally but not at any price!

So, I see the bum doctors and then the consultant again at the start of May when I'm 30 weeks.

Re the retained placenta - apparently there's a 2% chance of anyone having this. Having had it, you then run a 10% chance of it happening again. In my case, the syntometerine made no difference. The placenta was stuck to my uterine wall so wasn't going to budge regardless!

I feel that the consultant was pretty good so will add any more info later if it seems relevant/helpful.

The balloon up the bum is going to be a great dinner party piece for AGES

pucca Wed 18-Jan-06 16:17:28

Spub...Thankyou so much for remembering to tell us about your appointment, the balloon thing sounds interesting lol, i am really hoping that i can have a vaginal birth as i really don't want a section.

At least the consultant put your mind at ease, and they will investigate fully before saying what they reccommend.

Good luck, hope all goes well for you.



xx

spub Wed 18-Jan-06 19:04:55

You too, Pucca. when are you due?

pucca Wed 18-Jan-06 19:05:41

Not till August, and i am fretting already lol, when are you due?

spub Wed 18-Jan-06 19:45:15

Start of July! I've been fretting since I got a positive pg test!!!

Will be good to hear about others' experieces on here if poss.

Will definitely post about the bum balloon....

SoupDragon Wed 18-Jan-06 19:49:43

Don't forget to ask for pictures if you have an ultrasound scan! You can add them to one of your baby books

pucca Wed 18-Jan-06 22:24:16

Let us know how you get on with the tests, i think we should all post if we do have normal delivery if it happens again (3rd degree tear).

The balloon test sounds lovely, definately let me know how you get on

spub Fri 20-Jan-06 08:13:57

Pucca and SD - will absolutely post and share all! SD - PMSL at the photo for the baby book!

SoupDragon Fri 20-Jan-06 08:15:29

Have to say I wasn't offered any photos to take away Sonographer did insist on showing me them on the screen though "If you look just here you can see the scar line!" Didn't really need to know TBH!!

Meanoldmummy Fri 20-Jan-06 08:32:10

I didn't get told what damage/repair had been done until four days after the birth, the day after my transfusion, when I collared a midwife and asked her. She drew me a little diagram with a biro. Maybe I should have kept that for my baby book

cathyspam Fri 20-Jan-06 08:53:19

I also had a 3rd degree tear with DS1 despite having an episiotomy - took a long time in theatre to repair and a long time to heal, had to go to a special clinic a few months later to have my 'control' assessed which, thankfully, was fine and it was 6 months before sex was comfortable again. I was worried when I was pregnant with DS2 only 8 months after ds1 was born but went on to have a natural delivery with gas and air and a small tear which was repaired by the midwife very quickly. Apparently you are less likely to tear if you deliver in water so maybe that could be considered - I laboured in water with DS2 but that hospital does not allow delivery in the pool so I had to get out at 7cm. Good luck you guys and dont worry too much!

Verso Fri 20-Jan-06 12:59:41

spub - the balloon up the bum is not to be recommended - lol. Make sure you think of something - ANYTHING - else at the time. It's really weird and uncomfortable, but compared to being incontinent and/or in pain it's fine. Also, my sonographer was really sweet and made a balloon dachshund for my DD out of a spare .

Are you having all the other tests as well? Mine took about an hour and a half. I took my cousin with me to look after DD as I was on maternity leave at the time and DH FORGOT TO BOOK THE DAY OFF. Still haven't forgiven him for that one .

Best of luck!!!

notasheep Fri 20-Jan-06 13:44:52

dd born,then they took about an hour to sew me back together
ds 2 pound heavier and NOT a stitch!

Good luck to you all

spub Fri 20-Jan-06 17:09:50

Verso - PMSL at the daschund.....
Think I may be having the other tests - er, what do they involve????
Did you end up with a section or not?

Verso Sat 21-Jan-06 20:01:26

No I didn't have a section. DD was failed ventouse, followed by forceps, and it was the forceps that did the damage. Next time round (if I ever get brave enough!) would be a section, definitely. I sometimes read things where people have had perfectly successful vaginal deliveries after a tear, and I wish I was brave enough to try, because I would really prefer that deep down, but I just could not risk being permanently incontinent. I get flashbacks of the whole thing, too, and I know I couldn't go through it again.

The other tests... let me see if I can remember... one involved a metal probe and electric current. It didn't hurt or anything, just testing nerve function. Made me think (obviously in extremis I go a bit mad) of Cartman from South Park... Hmm. Then there was the balloon one, a 'normal' ultrasound, but done internally and a fourth one that I now can't remember.

It was all pretty revolting, really, but nothing nothing nothing like as bad as coping with the aftermath of the tear and incontinence. It scares me to think that years ago women used to go through all this and had no medical support afterwards at all. I suppose we're quite lucky, really!

spub Mon 23-Jan-06 09:48:32

Cheers, Verso.
Know what you mean. Am beginning to think that an elective section might be a more guaranteed outcome though I am in under no illusions about it being major surgery. The thing is, I was in for 5 days last time anyway and then had 6-8 weeks of real pain and incontinence. The women on my ward (who I now see each week and am great mates with)both had sections and have said that they reckon I was in more pain and discomfort for longer than they were! The section would also ensure that my placenta came out this time!

Will go for the tests when I get the letter and then I will update here. Balloons up bums - who'd have thought that this is what can happen as a consequence of childbirth, eh?

And you are so right - imagine our lives if we'd had this happen years ago!

spub Mon 23-Jan-06 09:49:30

ps - Cartman!!!!
You KNOW that I'm going to be hearing his voice in my head whent he balloon goes in

Verso Tue 24-Jan-06 20:39:51

I agree that compared to what you went through (by the sound of it) it is unlikely that you would find recovery from a c-section any worse. FWIW, I've got friends who had emergency c-sections who had better recoveries than I did. At least with a scheduled c-section you can at least attempt to prepare beforehand and it's less of a shock. (And more importantly, your bottom should still function relatively normally, constipation and trapped wind aside.)

(Oh the delights of childbirth!! )

Still, probably best to get the results of the tests first and then make an objective decision.


>chuckles< at thought of you with Cartman's voice in your head. My work here is done! >evil grin emoticon<

Azure Tue 24-Jan-06 20:50:56

Just wanted to add that I chose to have an elective c-section for DS2 after a 3rd-degree tear with DS1. I was in hospital for the same length of time (2 nights) and after the initial couple of days felt the recovery was just as quick - I was driving after 2.5 weeks. A straight-forward vaginal delivery is by far the best way to give birth, but I couldn't bear the risk. Sorry if that sounds cowardly.

spub Wed 25-Jan-06 09:01:00

Azure - don't be daft. Cowardly?
I'm of the "live and let live" school of childbirth. We all do our best and make our choices and ultimately, those choices are what we are "happy" with. You had an "unexpected outome" with your first vaginal delivery just as I and others here did. I think having had that experience you are more than entitled to explore alternatives and to go with those if you want to for any future births.
Having my dd via a "standard" birth is the thing that I'm most proud of. The pain was doable and the experience of birth itself was pretty good BUT the consequences were not. I'm going to weight up the risks for next time but may well opt for the elective section to minimise certain risks.
I do understand that some women are genuinely scared of childbirth and see a section as a more manageable method of birth. I'm really glad to have had the chance to deliver vaginally (at least the once so far!).
It's easy to judge other people but we don't like it much when it happens to us, eh?

Tonker Wed 25-Jan-06 16:37:23

Hi,

I had a 3rd degree tear with my 1st , I think it was pretty bad, right around the sphincter. They forgot me for my 6 week check, so I went at 13 weeks when I requested and I still had a small tear that hadn't healed so they gave me some cream. But since then I've had no problems and haven't been offered any checkups. My 2nd baby was born 16 months later. I didn't have any idea that the 3rd degree tear would be a problem until a consultant told me at my 20 week appointment that I would need a c-section, but he wouldn't discuss it or tell me why! I researched on-line, and couldn't find a reason so saw another consultant for a 2nd opinion who couldn't understand why I was told I'd need a c-section. I went with a natural birth, there are things you can do to reduce the risk of tearing, I have a note collection on my research I took with me. The midwife was really good and helpful and understood ( the midwife for my first baby gave me no help at all which I think is why I tore, she told me it was time for pushing so I started pushing really hard with no contractions!) My 2nd baby was born no problem and I actually enjoyed the birth. He was 9lb 8oz (13 days overdue, only had reflexology for inducing)compared to my 1st baby which was 8lb. I just had 1hour of gas and air for pain relief. I got a small 2nd degree tear. I'm now pg with no.3 due in May and will have an 18 month gap, so 2 years 10 months since my first and the 3rd degree tear. This time I'm planning a homebirth. I had a fantastic lady consultant who said that would be fine. She said that the latest research on 3rd degree tears from the top doc (Sultan or something?)is that its fine for natural childbirth. There are very few cases where a c-section is needed. If the tear has healed ok, then its fine, if the tear has healed badly, then you're better to have a natural birth and get it repaired properly when you're finished having children. She said the only time they'd recommend a c-section is if you think you've healed well, but the scans show that its not, in which case you're better not to risk making it worse. I have no idea how mine actually is. If I need the loo I can't hold it but thats because I have tummy problems from before I was pg, and I get terrible tummy pain so when I have to go, I have to go. If you google 3rd degree tear, I got loads of info. from there, and from asking some independent midwives for advice. I'm looking forward to this birth as I've always wanted a homebirth. Hope you get the birth that you want.

spub Mon 10-Apr-06 11:06:38

Guys,
Resurrecting this thread as today I see the general surgeon to assess my sphincter function with a view to discussing my best delivery options!(EDD July 4th)
Am slightly apprehensive and NOT looking forward to the no knickers part of the exam but I will let you all know how it goes and if there's any wisdom forthcoming!!
Have a good one!

hunkermunker Mon 10-Apr-06 11:18:00

Hope it goes well x x x

spub Mon 10-Apr-06 11:31:08

Thanks hunker!
Mumsnet: the only place where you feel somehow comfortable posting a blow by blow account of a rectal exam.....

hunkermunker Tue 11-Apr-06 08:41:43

ROFL Spub - perhaps MN Towers could consider that for their strapline?!

Hope it went well.

spub Tue 11-Apr-06 09:05:39

Hunker

Yup. I feel a career in advertising beckoning!
Maybe we should start a thread on alternative straplines for Mumsnet. I imagine we'd get a few doozies!!

It all went ok yesterday. Had a very thorough exam with the surgeon. The most cringeworthy bit was when he had his hand inside my sphincter and asked me to squeeze!!!
Apparently my muscle tone isn't too bad but he was surprised that my 3rd degree had come about independently of any intervention such as ventouse, forceps or an episiotomy.
He thinks that I was lucky and "got away with it" without too much trauma last time but given that it did happen and that I also retained the placenta he's recommending an elective section.
I'm okay with that on the basis that the outcomes are more predictable though I'm fully aware that a section is no easy option either.
Basically:
Have section - deliver baby and placenta with no risk of incontinence though 6 week recuperation and all that entails including wound management, no driving etc.
Have vaginal delivery - things may be fine
Have vaginal delivery - various scenarios possible including okay delivery but surgery to remove placenta or not an okay delivery which might necessitate surgery to remove placenta, repair to another bad tear and/or future surgery on the sphincter. None of those options are great with a toddler and newborn on the go!

If there's any more news I'll post!
Best to all!

isidora Fri 14-Apr-06 15:36:25

Hi spub, I have the same dilema as you. Had a bad 3rd degree tear last time and am due in less than two months. The hospital suggests c/s but they never offered any examinations to work out how bad the tear was. Did you have to ask to be seen by a surgeon? Is there any other test/scan that can be requested? I have almost decided to go for the elective c/s cause I don't want to be incontinent but I realise that I still haven't got all the facts.

Also, like you, I still don't know why the tear happened as there was no intervention involved. It was a very quick labour, but apart from that no other complications and baby wasnt very big either.

Verso Sat 15-Apr-06 20:47:53

Hi spub and isidora. Can I just say I'm a bit that you both tore w/o intervention. Mine was a failed ventouse, forceps delivery, so at least there was a direct reason for it. What happened to you? Do you know why it happened?

Spub - glad you survived the examinations. I've been thinking of you.

Isidora - I didn't have to ask to be evaluated - but I did have to beg for physio. The reason I didn't have to ask was because I developed frank incontinence a few days after the birth. Mind you, I was discharged with painkillers and antibiotics etc, so if I hadn't gone on to develop incontinence and be readmitted to hospital, maybe I would never have had the follow-up ultrasound?

I think you should ask lots of questions and push to get seen if you think you don't have enough information at the moment to make a fully-informed choice about c/s.

I would go for c/s next time, but this is after being told I have a 40% chance of permanent faecal incontinence if I have another vaginal delivery - WAY too high odds IMO.

Good luck - to both of you.

spub Mon 17-Apr-06 18:00:28

Hi Verso and thanks for thinking about me!
Isidora, I was referred to a general surgeon by my consultant. It maybe helped that he was the same consultant that I had last time and was the poor sod that got woken up at 2am to come in and fix up the tear for me.
The only anal examination I had post birth was from the midwives on the ward and then with the Health Visitor at home and that was really only to make sure that the tear was healing without infection.
I saw my consultant 12 weeks post natally and he didn't examine me. I explained that I had had ver bad incontinence for the first 6-8 weeks but that it was slowly improving and that seemed satisfactory.
When I saw him again a few weeks back for this pg I explained that whilst I had never been incontinent I also didn't have great control of my bowel and felt I'd been lucky to always be close enough to a loo when I had the sensation of needing to poo! That sensation is often when things are pretty close to call; I don't seem to have the advance warning and ability to hold it that I used to. I think these symtoms propmted him to seek a second opinion.
Whilst I didn't have more than a physical exam this time I have heard of ultrasound being used to assess the area.
The surgeon I was referred to suggested that I may just have a natural dispensation to this type of tear given the lack of intervention. Isidora, it is worrying; I just decided to cut my losses and go for a more predictable outcome.
My dd was quite big (nearly 9llbs) and was also a quick delivery plus she had her hand up at her face just to add insult to injury!
When are you due?
Hope we all get through this as intactly as poss!!

spudballoo Mon 26-Jun-06 21:08:11

I'm very late to this, but thought I'd dive in.

I had a 4th degree tear after my son was born by forceps last September, which was repaired immediately in theatre and a colostomy performed. I was told it was for 6 weeks to let everything heal, although I still have it 9 months later. i had all the delightful bum tests including the comedy balloon. Alas the repair was not successful as I have wrecked sphinter muscles. That said, it 'seems' as though I might be continent as I have also had the 'porridge test' where they put porridge up your bum and make you walk round the hospital to see if you can hold it in. Lovely.

So the reversal of the colostomy is booked for September.

Exept....I just found out I'm pregnant again! My colorectal surgeon told me the day after my baby was born that any future deliveries would have to be by section, and early, because even a few hours of labour could do irreversible damage to my pelvic floor, or what is left of it.

So, as long as this pregnancy progresses, i will be having a section next Jan. And then have the colostomy reversed later in the year, once I've finished breastfeeding. And if I'm not continent, I will be having a pacemaker fitted - a new technique which works the sphincter muscles. It's major surgery.

x

bramblina Mon 26-Jun-06 21:14:33

What we do for our babies!

spub Thu 06-Jul-06 11:59:31

Spudballoo, I'm sorry that you had such a horrific time.
I had my elective c/s a week ago and it was fine. I'm very relieved not to have exacerbated any problems with my bowel and not to have taken a chance with another tear.
Very best of luck with your pg and next delivery and also to Isadora.
Best wishes

spub Thu 06-Jul-06 20:21:32

I have posted on the birth announcements thread...

F1ona Tue 11-Sep-07 14:50:57

Spudballo poor you. I had a third degree tear with my 1st baby and and I am expecting again and trying to work out what to do. The hospital is fine about me choosing natural or elective. I have no idea what to do but I am sure if I have another largish baby that is posterior I will tear again. I have been fortunate to have regained control after v. undignified physio (Wind is an issue that seems worse now I am pregnant again.) Think the c section may be the safest way.

pregnabrain Tue 11-Sep-07 15:09:24

Hello

I didn't have a third degree tear but had some bad pelvic floor probs after my first. I posted about it recently, and a couple of people responded who did have third degree tears. Might be helpful to you to read the thread.

www.mumsnet.com/Talk/1365/377750

Good luck with it all. I'm just embarking on ttc number 2 now and feeling really panicky about the birth already (not even preg yet hmm).

happy40 Thu 05-Nov-09 18:45:49

Hi

Has anybody got problems with 'wind' after 3rd degree tear. I am months down the line and still having problems with wind - I have control but I have loads of wind every day. Have changed my diet numerous times so I know this isn't the issue.

SIM78 Thu 19-Nov-09 07:12:59

Hi
I had a 3rd degree tear with my first baby after the doc had to use the air suction method to remove the baby.
Had to be stiched up by a surgeon. I then fell pregenant 4mths later with no 2 and had her naturally as well and tore with a 2nd degree. I have had two anorectal ultrasounds done to check the spincter muscle and have been been lucky enough to be seen by a specialst in our hospital who deals with tears. They measure how the rectal passage is doing. My measurment after the first baby were well withing the normal range. Now three year on I am pregenenat with baby 3 and was scanned last year for some reasercher and they have found that certain functions in the rectal passage have decreased considerabely. I have opted to have this baby by csection as there is too much risk I can tear again. Which will make me incontinent permanently. If you feel you body can take another natural delivery I would consider it. Depends on how the neather region is with water works and the other department. I wish I had had a csection with baby two. All things considering.Good luck and hope all works out

Hulla Fri 20-Nov-09 12:07:45

Happy, I suffer incontinence of faeces & flatus following a 3rd degree tear in Jan. Mine was misclassified as a 3a when in fact the tear extended to my internal sphincter too. I am an extreme case though ans

Have you been to follow up perineal clinic? Womens health pysio? Scans can check how your tear has healed.

There is a support thread for women suffering problems following birth injuries here

Feel free to join us. There is lots of support, advice & positive outcomes smile

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