Second baby after tear/epi

[Nosenosebounds]

Sorry for long post and possible TMI.

I'm currently 30 weeks with DC2. First birth I was induced on drip after waters went at 40 weeks and ended up with forceps, episiotomy and 2nd degree tear both internal and external. It took over an hour to stitch me up and consultant had to do it. It was agony from day 1 as I couldn't walk or sit.
The wound got badly infected and broke down. I asked the midwives to check it every day but no one picked up that it wasn't healing properly. Stitches had to be removed without anaesthetic (agony) after 4 days. I was left with what looked like a gaping hole in my nether regions - nearly fainted upon inspection with the hand mirror. I wasnt restitched but left to heal by secondary intention (ie naturally) which took 6 months. I had granulated scar tissue which had to be removed with silver nitrate- also really rather painful - and still have a patch even after 14 months. My perineum is basically just one big scar.

I know my tear wasn't as bad as some poor mothers with 3rd/4th degree, but I felt so traumatised by the whole thing and angry that I hadn't been warned this could happen.

So now with baby 2 I just don't know what to do. No one has mentioned a c section as I "only" had a 2nd degree tear and I feel I've just been pushed down the vaginal route despite describing to every midwife and doctor what happened last time. Part of me thinks I should go for the VB as second births generally easier and any tear should be smaller, plus I'll know what to expect and can really ensure healing is properly checked and looked after.
The other part feels that I don't think I can go through all that again, my scar tissue isn't going to stretch and there's every chance of ending up unable to move much which will be doubly hard with a toddler as well.

Just after some wise advice- especially as I'm not too far away from giving birth and feel I need to speak now if I do decide on the section (and probably be prepared for a battle!)

First ever post (and on such a lovely topic) so please be gentle! Thanks in advance for any replies.

[Fugghetaboutit]

No advice but watching. I'm 32 weeks with dc2 too and had a bad second degree tear which was left gaping too. If i do tear again, I'm making sure I'm stitched up right this time.

[stairway]

Oh poor you.. My episiotimy also became infected.
I found it much harder to heal from then my c section.
I will be begging for a c section if I get pregnant again.
No way am I going through that again.

[TinklyLittleLaugh]

With DC1 I had a bad tear that took a lot of stitching and a lot of time to heal, though thankfully it did not get infected. I was really worried because I have a less than two year gap between DC1 and 2 and I felt that my concerns were not being listened to at all.

Fortunately DC2's birth went very well and I had no tearing at all. To be honest I think that was very much down to the skill of the midwife; she made sure DC2 didn't come too quickly, kept making me stop pushing etc.

I can't see why they can't just give you a Section if you insist. Are they not available on demand if you dig your heels in enough?

[Nosenosebounds]

Thank you for your replies.

I'm sure I could get a section if I was determined. The problem is that I know a section isn't exactly a walk in the park either so I can't decide whether that is the best option. I know I need to make a decision!

I keep hoping for a great 2nd time VB experience like yours Tinkly but Sod's law says I'll probably end up with an 11lb monster baby and a huge tear. I did the whole positive attitude thing last time round and ended up so gutted that I couldn't walk further than the end of the road for 2 months, so this time round am probably going too far the other way and expecting the worst!

[Scattymum101]

I had a second degree tear with dd1 as she was back to back and had her arm around her neck.
I delivered on my back.

Dd2 was delivered in pool upright and only a small graze that didn't need stitches.

Hopefully if you were able to have a more active labour without induction it might be easier on you in terms of tearing.
However if you're very worried and stressed over it then you have a right to have an elective section. My friend had an episiotomy that never healed properly and had an elective for her second which she said was a very positive experience.

Good luck and do what's right for you xx

[cornishglos]

had a large episiotomy for my first birth, which took months to heal, and was very nervous then for the second birth. I ended up with a small tear and 3 stitches.

[minipie]

Poor you.

Here is one possible compromise: avoiding induction. So you say "if I go into labour naturally I will try for a VB, if not then I do not want the drip I want a CS instead".

Other compromise options:

• ask for a late scan to check size and position and opt for a CS if not favourable
  

• say you want CS rather than forceps/ventouse
  

Basically these are all ways of saying you will have a go at VB if everything looks ideal, but the moment it looks less than perfect you want to go for a CS please.

[OhMakeMeOver]

I think I would follow the advice minipie has said.
I had internal and external tearing and an episiotomy. If I got pregnant again I would be worrying about it all just coming open again and the blood loss from it, again!
I would probably be begging for a CS for the fear of any more damage to my precious vagina! (another factor is baby's heart rate for me, with a CS that will be fine) The recovery was absolutely shit, and the stitches came apart, no one said anything until I saw for myself and couldn't feel inside for a good while (sorry TMI). I think what made it worse for me was not knowing why I was cut, or being told about any of the other injuries I had!

So because I can't trust them again (currently) and I don't know what will happen with my downstairs, I'd want a CS so I know what injury I would have and know where the stitches are! (that is of course if I could face being pregnant again!)

But I think it's the size of baby's head that is the biggest factor. The weight doesn't necessarily matter, it's just a rough guide as to how big the baby is in proportion I think.
I was told getting into water can help reduce it but I don't think it's ideal to stay in water as it can soften the skin too. Maybe getting in when you feel the urge to push after a while?

[Nosenosebounds]

minipie thank you, that is really helpful advice. I would like a VB ideally but feel there is so much scope for things to go wrong. The midwife has advised perineal massage and a managed third stage, which is all well and good but I feel I need more certainty (although obviously I appreciate anything can happen).

I do have a 36 week scan booked (for high BMI) so I could review things then, although agree with OhMakeMe that size of the head is all important- I come from a family of massive heads and apparently my DD's head was large.

Thanks again for all your advice. It's made me realise I do have options and a degree of control over what happens!

[waitingforsomething]

Poor you it's horrible to worry. With DD I had a 3rd degree tear (although only just) a ventouse and an epidural. The whole thing took days it was horrible.
DS was born 2.5 years later and it couldn't have been better. Quicker, no epi and brilliant midwives who helped control my pushing and massaged the perenium with warm water - I had no tear just a tiny graze.
Just to show you it can be fine even if first experience wasn't great

[waitingforsomething]

Ps dds head was 75th centile and DS only 25th - they can get smaller!

[Fugghetaboutit]

My ds' head was measuring two weeks ahead, and had his arm up when he came out so no wonder I tore badly. Still sore after sex so god knows how it'll feel after this baby comes out.

Definitely investing in a pelvic floor toner this time!