I had a ventouse delivery and episiotomy with my first baby, I could not move without wincing for weeks.

I had 2 elective cs subsequently and had NO pain, and I was up and walking about the next morning.

If I have another baby I would not even consider anything other than a cs.

I had a 10lb baby last time, and 3rd degree tear due to size. no episiotomy. no incontinence (know people with worse problems from lesser tears - but then not realised that coudl afect me post-menopause).
Been offered el-cs this time, not sure what to do. been told not really any more likely to have 3rd degree or worse than if not had it last time.
going to wait and see how big it is looking at scans. mind you last time the scans showed a very big head - off the chart - but dismissed by consultant as error! (head awas 38cm at birth) and midwives at delivery did not seem to take much notice of scans or think he was that big based on feeling him.
anyway - after reading a few posts on here finding it hard to find real downsides for el-cs???

When are you due Mudmaid? Let me know what happens on Monday. I'm seeing a consultant on Monday too!

I had a third degree tear 3 years ago and still have problems. Am expecting again too and cannot bear the thought of going through that again. Took a good year to get over.

Anyway what I have recently discovered is that the Royal College of Obst. and Gyn has produced recommendations for treating women who have 3rd or 4th degree tears. One of them is 'Offering a caesarean delivery for future pregnancies as a recommendation - an offer not an order'.

I am seeing my consultant Monday to discuss. Since the start of my pregancy I have said that I wanted an elective CS, but everyone has ignored me. I have had to demand this appointment with the consultant.

Good luck and hope you get what you want.

More reassurance, thanks, CoteDAzur . If you were candidate for an elective c/s. They'll def tell me that I need one. I even started thinking about childcare, as I'll be in hospital for a little longer, right?

Have an elCS! Seriously, pain is very manageable, and recovery is quite unbelievably quick, especially re all you read on MN referring to "major surgery".

I had one of those mediolateral episiotomies, and it was honestly the worst pain I ever suffered, which lasted for weeks.

I had an elCS last month because consultant said I had 50% chance of needing another episiotomy (big baby and previous epi scar), and I was fine on Day 3. Pain was very manageable throughout.

Try not to worry. It will be a quick and calm birth, and you will wonder what all the fear mongering is about

Ohh thanks! After reading "colostomy bag" a few times, it is becoming easier to make up my mind! I think I now want only the green light form the consultant, for extra reassurance.
Yesterday I saw a great midwife, she was very understanding and didn't dismissed my worries like the last one. I start to feel that I might be in good hands
All the best for the delivery, Gillyan.

And..I'm having my section on Monday 29th June so I'll let you know how it goes.

Helloooo. Welcome to my world!!! I have been deliberating the same as you for ther last 9 months!!! have a search on my name and you will probably find lots of helpful comments off people.

I am 37 +1 and have finally decided on the c/s.

I had a 3rd degree tear last time 3 nhalf yrs ago. Like you I remember thinking never again and was told at my post natal check up I would be allowed an elective c/s next time.

When I got PG this time though I really couldn't decided what to do as for me it seemed hard to turn my back on it all and opt for the c/s.

My tear is un-explained. I had a 7.5 baby, no weird presentation, no insturments, no fast labour etc...they think it just the way my body is that I tore.

I have taken SO much advice from people and as I had no incontinece problems they do suggest a vaginal delivery but consultant aslo said it was down to me and he was more than happy for me to have a elec c/s. I have had so much conflicting advice form different docs and MWs.

Some said they would recommend I have and elective medio - lateral episiotomy to prevent any tearing goingnear my bum while the consultant totally disagreed with this. He recommended maybe a water birth then MW said she though water can make your tissues more likey to tear!???

I went into early labour at 34wks and so have spent the last few weeks in and out of the ante-natal ward..it was good as got to speak to lots of different docs and MWs. I actually saw the MW who delivered DD and she said she just would never of thought I would of torn.

To cut a long story short i finally had a few MWs tell me straight they thought I was mad to attempt a vaginal delivery in light of my circumstances - ie the no massive baby factor or fast delivery etc. They all said it sounds like I just have 'friable' tissue and am destined to tear. I think they have to be quite inpartial with their advice but they got to know me and then said what they felt.

At my 36 wk check they found baby was bloody breech anyway!!!! She turned again though but I am still having the c/s.

My tear was described as half a cm away from leaving me with a colostomy bag and there doesn't seem like there is anything I could try to do differently this time so I am happy with my decision. I may have to a have general as it took 9 times to site the spinal last time for the repair job, I also know of someone who's babies head was cut but baby was fine.

I eneded up thinking that it would not be the end of the world to have a general but it would be the end of my world to have a colostomy bag.

Hope you come to a decision, best of luck xx

Never had a natural birth, so no tearing, but I have had 1 emergency CS and 2 elective CS. Given the choice I would go for the elective CS every time. So much more relaxed!

Pretty unusual though CFC,unfortunately "Birth Trauma" isn't.Alot less spoken about however.

Maxbear, I tore because baby was big. The forceps delivery was in the subsequent birth and there was only an episiotomy, baby was one kilo less than the previous one. I did panic when in this pregnancy they told me in 2 separate scans that the baby was going to be big again.
I'm grateful that you are all pointing out the risks to both options.
I know of someone whose baby was accidentally cut during the c/s . He needed some stitches and recovered well, but one does remember these things. Argggh.

You run a risk of becoming incontinent just from being pregnant alone. There was a push awhile back, that was fostered by some urologists, for all women to have elective c-sections in order to save their vagina and pelvic floor. However, it was short lived because the level of risk, and who was at risk, were not equal.

Obviously you can have worst case scenerios with any birth, but it comes down to risks versus benefits. Which has the potential for the greater risks? The risks for mother and baby associated with another third degree tear....which may or may not happen, or the risks for mother and baby associated with a c-section...which would be a given. Which has the most potential benefits to mother and baby? Will you be one of the few that has problems with either choice?....no one can say.

Do the research on both possibilities and the likelihood of poor outcomes, discuss it with your consultant, think about what risks you are and aren't comfortable with, and then decide. Obviously either way could go very well and there could be no problems....and if you do have problems you will be second guessing yourself about how would things have been if I went the other way...so you will have to make the decision you are most comfortable with.

That is one thing in childbirth....you don't get "do-overs"....you can't go back and see if you would have had a different outcome if you did it a different way....no two births are the same.

But quite often we're talking about being faecally incontinent here with a tear - for those of us who have had even a taste of this, urinary incontinence would still be preferable...

BTW, Choc, the control issue was exactly the problem with me as well - I definitely felt with the cs that I had made that decision so I felt better.

People go on about the risk of being incontinent after a third degree tear (which is still a small risk, although obviously a major concern). No one ever mentions the risks of becoming incontinent if they accidently nick your bladder when they are doing a cs. It can cause major worries and trauma, although obviously much less likely to happen with an elective than an emergency.

Your choice is not a third degree tear or a cs, you are slightly more likely to have a third degree tear than someone who has never had one, but far far more likely not to have one. Your third degree tear was probably caused by forceps which you probably won't need again.

It is true that for most women having 2 cs won't be a problem, but they always have a consultant there for a third as they anticipate problems, it is not a simple procedure and should not be taken lightly. Some people even have major problems after one cs. Your best bet is to talk to your mw and consultant who can look at your notes and see what the chance of a recurrence is and advise you accordingly.

Hope it works out well for you

My section was great and I was back to my active self very quickly, it was elective for personal choice and I don't think I would have recovered from a vaginal birth as well (even if it had gone well as it was definitely not what I wanted to experience however I know some people really find sections tough either emotionally or physically. On the other hand nearly 6 months on 2 of my friends swear they would never have a natural birth again and both reckon things are still not right 'down there'. Think there are pros and cons whichever way you go though so ultimately you just need to read up on all you can and make an informed choice.

for me, i had 2 sections and it was fine! cant imagine 3rd degree tearing! sounds dreadful. not to mention risking being incontinent etc.

so question about it: choose CS

Thanks thanks everyone! I'm really very grateful for all your posts. I feel very overwhelmed because I never talk to people about this, I just worry on my own.
I have booked and app with a consultant in 2 weeks time. I hope it goes well and feel reassured about whatever decision I take. Also because I have suffered from postnatal depression, I wonder if a c/s would help me feel more in control and not isolated as before (I couldn't bring myself to speak about my physical symptoms to people and just try to put a brave face). Maybe I'm just being silly, because it is a major operation... Still, after reading the posts, I'm def. feeling more inclined to have one!
I'm going to read the link, thanks Sawyer.

Quite frankly I'd sooner attempt birth through my left nostril than go for forceps again

Seriously though, having had a forceps birth and it's complications/subsequent repairs followed by a c/s with the second birth, I would also say c/s every time over a possible nasty tear.

Lots of luck

Like you, I had a 3rd degree tear and major problems post-natally. Had the option of an elective 2nd time round but on advice of mws went for vb with epidural which was fab. However, what I did not give enough weight to and which the mws never considered (only focused on the birth) was incontinence post menopause, childbirth trauma being a major contributing factor. If you have already weak muscles there, giving birth is likely to weaken them further even though you may not tear - as happened to me. If we go onto have a third child, I will opt for a c-section; I have every confidence I can vb, but that isn't the issue - making sure I'm not incontinent afterwards is.

Jmo, go for the ec.

2 Cs here, recovery time great. Staples both times, scar barely visible 2yrs on.

This may be relevent to your decision making ...here

I have never had a vaginal birth but recovered very quickly from both my cs.

My friend has had 1 cs and 1 vb which resulted in a 3rd degree tear, which will require future surgery. She has taken longer to recover from her vb as only able to lie on her side for the first 5 weeks and was unable to walk very far so coudn't leave her house.

Realise that her experience is probably at the extreme end of things but she now wishes she had gone for a cs.

Very personal choice....If you decide to go vaginal, ask your midwife about the ways to best help prevent any tearing. You already know that you can give birth without it happening, so that may be something to consider as well. C-section will have all the inherent risks of surgery in addition to some recovery time afterwards.

Both have risks.....you'll have to decide which has the fewer potential risks that you are willing to take.

This is such a personal decision - had a hospital birth which ended up in a 3rd degree tear with my DS1 (hand on head as he came out). I had a spinal tap and was repaired but suffered no ill effects whatsoever - no pain (possibly because of the painkillers I was given??) afterwards and no leaking of any kind.

I was advised to be checked out by the consultant when I had my next child so I duly went along to simply be asked whether I had had any 'problems' since DS1 birth. When I said no they said a natural birth would be fine but were not keen on a home birth. I went for a home birth, had a 2nd degree tear that needed no stitches and healed really well again.

It's such a difficult one to call. I can't comment on CS as I've never had one but all I would say is that if you are worried now then when it comes to the actual birth you are highly likely to be even more worried which is in itself going to affect how the birth goes. I would think carefully over your feelings towards each option and go with your gut instinct, you probably know already which one you want to choose! Good luck

Had a beautiful ELCS 14 weeks ago after 3rd degree tear last time - felt I could take on the world after 4 weeks as opposed to...oooh...about a year after the tear. No contest for me!

Hi. What a decision! I had this debate. My third degree tears were the result of my DS1 having his arm in the wrong place. I recovered really well and had no problems. When I got pregnant again both my midwives and consultants advised me to try having a natural labour. I spent this pregnancy petrified about the birth and getting 3rd degree tears again and horrid long term problems. Anyway, last monday I gave birth (in water) to DS2. I did get 2nd degree tears at the scar site but I have recovered really well - so different to 3rd degree. I can hardly feel them. Hope this helps. Good luck with it all.

Yes, up to 3 is considered to be low risk. I've had two adn would be totally fine with a 3rd if dh was agreeable

I think up to 3 sections is considered OK isn't, before it can start getting a bit dodgy?

Never had a tear but had an emergency section last time and it was fine, easy recovery.

Like others have said, if only we could have a crystal ball to tell us which to do for the next it would make life an awful lot easier

Ooops, just seen that you think you want more children. Ignore my post!

It seems to me that most of the downside of cs comes in the impact that it might have on future pregnancies.

I guess then one thing to bear in mind is how many more children you might want. If you think your family will be complete with this one I would be more inclined to go for a cs.

Ease of recovery is mixed. Like anything else it varies from woman to woman. But even though I had some complications since then (that impacted on getting/staying pregnant) at the time it could have been a lot worse. I did feel quite pants but suspect that had a lot more to do with the 36 torrid hours of labour that went before the section! Don't get me wrong - it is painful after a section, especially the next day IME, but you are in hospital "resting" and should be being given drugs. By the end of the first week I felt a lot better and by 5 weeks I was fine as long as I didn't really overdo it.

Given the choice, if I thought my family was virtually complete, I would probably have a section.

I've also had both - had third degree tear just 5 weeks ago. Got to say I'd take the tear over c sec any day of the week. Has healed quicker and I can pick up my DS1. Mind my section was emergency and I believe an elective is easier. I get the feeling it's all a bit luck of the draw with this birthing lark. You may not tear at all this time and need no stitches, but you'll def be stitched with a section. Good luck to you and I hope you have a great birth whatever you decide.

I had an elective after a third degree tear. For me it was a no brainer-a very well respected consultant in this field mentioned the possibility of double incontinence in the event of a further serious tear, that made the decision really easy for me!

The elective was a joy after my first birth experience-and the recovery was much easier than I had expected.

c/s!! every time.

c/s vs. incontinence with number 2's

no contest!

I was so poorly/messed about with after my 'natural' screwed up birth that I recovered faster from the c/s.

and the care was better as a surgical team are better than bored/inexperienced/tired midwives just about to go off shift.

and you can plan for the delivery

it is really not that bad.

as for multiple c/s, you can have up to 3 with no extra worries.

and as for your midwife of COURSE you'd be granted an elective, with absolutely no problem.

Ive had both!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

the cs was better even though I also had a broken coccyx at same time, was almost impossible to move after spinal wore off..

still not as bad as 3rd deg tear from dd.

Thanks for your posts
My midwife said that I could ask for an elective (not that it means that it will be "granted")only if I was very traumatised after that bad tear, but it sounded like she didn't think it was a good idea. But I WAS very traumatised indeed... On the other hand, I think I will want to have more children, so I worry about having multiple c/s...

When I read that a c/s went well, "a breeze", it makes me very happy

it's a difficult one, but perhaps a cs would be better as the risks of long term damage after another 3rd could be pretty horrid.

but then perhaps it would go well and you wouldn't get a 3rd degree or worse tear again.

if only we had crystal balls for things like this.

its a difficult decision

Just to say though....I would have a cs again if i needed to and where I live (mmiddle east) you can elect so I would definitely consider that next time.

Maybe it was because I could not take anti inflammatories then....I could only take the normal pain killers whereas i think they combine them usually post cs. I just found the staples awful.

my elective was a breeze and teh staples didn't bother me at all. I wouldn't want to think about tearing.

CS recovery is longer but the worst is over by day 3 IMHO. One tip is that although staples give you a neater scar apparently, I found them excruciating, like tiny daggers, but this onlylasted 24 hours. I think stitches probably hurt less, and if I had to do it again I would ask for stitches.

I'd go for the cs (have had episiotomy and then a CS although I tried to avoid it). Neither were pleasant, but I wouldn't much want repeated tearing.

My CS's were fine (both of them) one of them had some further problems but these were related to multiple caesarians rather than the op itself.

The midwife said so. I had a 3rd degree 2 labours ago, then had a forceps delivery and now worrying because perineum feels sore and all muscles there weakish. I'll have an app. in a couple of weeks with the consultant to speak about it. I do remember that after that tear I thought that I'd rather have a c/s than going throught that again, but of course I don't know how bad a c/s is. I'm very worried