Giving birth after third degree tear

(20 Posts)
MargaretCabbage Tue 22-Mar-16 22:00:40

DS was born 14 months ago. I actually enjoyed my labour but ended up with a third degree tear (I don't know why!). It was repaired in theatre and I've never suffered any problems and it was checked after 12 weeks and everything looked fine.

In the early days while it was still healing I was terrified of incontinence and swore I'd have an ELCS for any future births but because I've had no issues I'd mostly forgotten about it.

Currently 16 weeks pregnancy with DC2 and recently saw the consultant. At this point I was feeling fine about it all and said I wanted a vaginal birth. I was hoping for a water birth but they said they wouldn't recommend it as they want to monitor me closely and that I won't be able to go the MLU (on the same corridor as the delivery rooms) as I will be consultant led, though I'll be midwife led for the rest of my pregnancy.

Now I'm starting to panic a bit, as it seems much more serious after seeing the consultant, and I have a million questions that I need to ask my midwife. I'm also feeling really sad about not being on the MLU as I was really happy on the birthing couch last time, and feeling a bit miserable about being in a very hospital-y room with just a bed.

If you've had a vaginal birth after a third degree tear how did it go? How much were you monitored and is there anything the midwives did to try and prevent tearing? Were you allowed on an MLU?

ridemesideways Tue 22-Mar-16 22:17:23

It's bollocks. A supervisor of midwives can gain you access to the mlu. Arrange an appointment asap. You can tell them you do not consent to consultant led care and threaten a homebirth

Waterbirth and not rushing the pushing is best way to avoid a bad tear. What was your previous crowning like? Forced pushing on your back? Gentle bearing down? Waiting for your body, or getting impatient?

In any case, even if midwives wanted to control the speed of baby crowning, you could just get out of the water for that?

Birthgeek Tue 22-Mar-16 22:39:35

Birth baby slowly, ideally in water, no pushing - just breathing - let your womb push, not your abs, put your hands down there and feel yourself. Second advice to talk things through with experienced, sympathetic supervisor of midwives, if not consultant midwife if your trust has one.

MargaretCabbage Tue 22-Mar-16 22:43:22

Thank you for your reply. This is what I was starting to think!

I started off on all fours last time, and for crowning I was in a similar position but more vertical with my head and arms propped over the edge of birthing couch. The midwives mostly just let me go along with what my body was doing, but I had a lot of gas and air and my memory is a bit sketchy.

I'm naturally a bit wimpy with authority figures like doctors, but once I'd had a chance to think I wasn't very happy. I will definitely arrange to speak to the supervisor of midwives.

Birthgeek Tue 22-Mar-16 22:54:21

I will definitely arrange to speak to the supervisor of midwives

Excellent. Remember that doctors are NOT authority figures. It's still your choice.

The pp is kind of right - if you refuse consultant led care and say you're having a home birth, it's funny how the mlu door often swings wide open!

learnermummy Tue 22-Mar-16 22:54:44

My first baby was back to back and I ended up with a 3rd degree tear but healed fine without issues. Second baby was a home water birth with just a slight tear without stitches. Birthing slow is the key . Good luck.

MargaretCabbage Tue 22-Mar-16 23:00:46

Thank you. I don't really want a home birth but was considering it because I want to go to the delivery suite even less, so will threaten it to see it changes their minds. There's a stand alone birth centre that's a bit further away but takes women from my area so I might give them a call too.

timeisnotaline Tue 22-Mar-16 23:01:00

I had a 3rd degree tear and healing was slow and awful. It was 12 weeks at least before I could enjoy going for a decent walk, and 8 months before sex was really possible. However I am approved for a vaginal birth next baby (follow up care does an assessment) , I don't know why exactly but there are very few cases of repeat bad tears. Re previous comments, I didn't have a particularly fast birth.

Birthgeek Tue 22-Mar-16 23:13:43

Also meant to add - do lots and lots of perineal massage after 32 weeks or so..

totty12mum Thu 24-Mar-16 04:50:26

I had a third degree with first, second degree with second, barely noticed recovery from the second degree, nothing like a third degree. Good luck!

BettyBitesBums Thu 24-Mar-16 05:02:33

There's absolutely no reason you can't go to the MLU or would need extra monitoring as neither of those things will change the recurrence risk of obstetric anal sphincter injury and in fact will increase your risk of other intervention which in turn can increase the risk of injury. The recurrence risk is between 3-10% depending on various factors and which studies you look at. Birthing in water doesn't decrease the risk (some studies suggest an increased risk) and birthing in a squatting position increases risk slightly although on all fours doesn't. There is good evidence in the latest cochrane review that a midwife having hands on your perineum, preferably with a hot compress, and helping control delivery of the head helps. I certainly wouldn't be dissuading you from going to an MLU unless I had good reason to think an obstetric led unit could decrease the risk or local results suggested that. It's definitely worth booking an appointment with the supervisor of midwives!

Had a bad third degree tear with dd1, and a small second degree tear with Dd2. With dd2 I had to lie in a position that meant they could monitor my scar during the birth. Had two large babies (10 and 9 lbs) and quick labours (5 and 3 hours). Like Totty12mum I scarcely noticed my recovery after dd2 compared to dd1

MargaretCabbage Thu 24-Mar-16 14:58:51

Thanks for all the replies and sharing your stories. I spoke to my midwife today and she agreed it makes no sense (and basically said everything in your post Betty) and has referred me to see someone next week about moving to the MLU and then will refer me to the SOM if no joy.

I feel so much better already.

sidonie1 Thu 24-Mar-16 15:08:57

It's crazy how it varies so much from consultant to consultant. I had twins after a third degree tear and begged for a csection, but the consultant convinced me against it. I had a vaginal, no drugs birth with them (not by choice!) with a second degree tear which I didn't notice in comparison to the third degree. Glad you got some understanding. I definitely think you need to be assertive with what feels right to you (spoken from experience of not being assertive!)

Tfoot75 Fri 25-Mar-16 15:40:17

I had exactly the same with dc1, no issues with healing and due dc2 in 2 weeks. Consultant signed me off back to MLU with no problems. Even he said only thing they can do at the hospital that might prevent it is episiotomy, and I think the nice guidelines say there is no evidence that that prevents tearing anyway, which as a pp said is low risk second time around. I would rather deliver in water at MLU and avoid intervention of possible, even if same happens again.

HarlotBronte Fri 25-Mar-16 16:18:28

It's wrong that you might end up having to go to a stand alone midwife unit. Lots of women wouldn't feel comfortable doing that if they'd had a previous complex birth, they shouldn't be made to feel that's the only option. You push for the hospital MLU if that's what you want! And you could have a non-waterbirth in the MLU, plenty of women choose to give birth there and go nowhere near the pool. Just because there's one in there doesn't mean you have to use it so that's not a reason for you not to attempt delivery there. Good luck!

slightlyinsane Sun 27-Mar-16 00:07:43

I had a nasty third degree with my first, long recovery didn't ever want to repeat the experience. The consultant refused me a section for my second. I spent the whole pregnancy worrying about what would happen. I think the thing that helped me the most by the time I was in labour was the fact that I just new I'd tear again. Surprise! I did, it was only a second degree that time. Third was a second degree again and my fourth (twins) was a second again.

PeppasNanna Sun 27-Mar-16 00:16:33

I had a 3rd degree tear with my first dc.
2nd degree with second dc.
Nothing with dc 3, 4, 5 & 6.
Dc 4&5 were water births.

Don't ask, inform the consultant what you intend to do! Good luck.

MargaretCabbage Tue 29-Mar-16 17:13:18

Thanks for all the support and advice on this thread. Spoke to a hospital midwife today who has completely discharged me from consultant care and is all for a water birth in the MLU. Feeling so much happier now.

BettyBitesBums Wed 30-Mar-16 03:49:17

Great to hear that MargaretCabbage

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