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Childbirth

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

66 replies

pucca · 07/01/2006 23:57

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.

OP posts:

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serenity · 08/01/2006 02:05

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 · 08/01/2006 09:01

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 · 08/01/2006 09:51

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

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SoupDragon · 08/01/2006 10:18

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 · 09/01/2006 14:13

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 · 09/01/2006 17:04

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 · 09/01/2006 18:06

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

grammaticus · 09/01/2006 18:09

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 · 09/01/2006 18:14

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 · 09/01/2006 18:20

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 · 09/01/2006 18:36

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 · 09/01/2006 23:12

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

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laurenholly · 09/01/2006 23:25

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 · 09/01/2006 23:26

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 · 09/01/2006 23:28

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 and feeling them in your belly but it not hurting, just makes me feel ill.

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pucca · 09/01/2006 23:33

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

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agalch · 10/01/2006 07:14

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 · 10/01/2006 11:49

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.

OP posts:

SoupDragon · 10/01/2006 12:01

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 · 10/01/2006 13:06

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 · 10/01/2006 13:54

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

spub · 10/01/2006 14:31

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?

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jabberwocky · 10/01/2006 15:34

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 · 10/01/2006 15:46

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 · 11/01/2006 06:57

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!!)

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