Mumsnet has not checked the qualifications of anyone posting here. If you have any medical concerns we suggest you consult your GP.

4th degree tear, feeling sad.

(43 Posts)
PeanutButter1 Thu 25-Jul-13 21:06:35

Hi all. I had a 4th degree tear after giving birth in February. Labour was going so well but he ended up back to back. Forceps. Blah.

I feel so sad and cheated.

He's great and I've been doing better. But today I got hospital report and while it could be worse, seeing it all in black and white has brought it all back.

I have 'poor anal resting pressure' - I guess that refers to the constant feeling I have of not quite being 'cleared out.'

I feel ok most of the time but now and then feel cheated and sad and hopeless. I just need some perspective and some hope I'll feel normal again.

I haven't had any continence issues and after a rocky start me and my son are bonding more and more each day.

My friend was also my midwife and that's confused feelings of anger/blame at the hospital. They seemed to think I didn't want a c section under any circa and I never said that.

I feel so confused and sad right now. I'll be ok but I just needed to vent. This time last year I was so happy and hopeful and positive.

Thanks x

Shakey1500 Thu 25-Jul-13 21:13:31

4th degree tear veteran here <waves.

It's bloody awful isn't it? How was your stitching?

Vent away grin

I'm almost 6 years down the line now, and it was only after 2 years and 4 operations that I was able to wear a tampon and have sex again. I'm over it all now thank goodness but can totally relate to feeling angry/confused/sad about it all.

Hi Peanut, sorry you are feeling down. I am sorry I don't have any help but you may want to join this thread where there may be more advice.

Good luck x

PeanutButter1 Thu 25-Jul-13 21:42:05

Gosh, thanks for these replies already. Just wailing into the ether and to have people actually respond is amazing. Has made me do a bit of a blub. It really helps, not feeling so alone.

I've been so much better last two months but this letter had jut brought it ll back up again. I had loads of debilitating infections and have lost so much confidence: my body feels alien, and I've been nervous to go out. I hate how I look and don't think I'll ever be able to have sex again!

Mostly I'm just so so sad because I feel cheated from the birth experience I'd hoped for. I'm a staunch republican but actually cried (!!) at seeing the Kate Middleton looking tired but happy after birth. I wanted to feel like that. I wanted him on my chest. I wanted to fall in love instantly.

I know that many people don't have smooth experiences and that my wants lists above are best case scenarios/ridiculous idealism.

A couple of close friends ate due to give birth and I am ashamed to admit I feel jealous and envious that statistically their experiences are far less likely to be as hideous as mine. I feel like I failed. I feel like I'm there to be wheeled out as a cautionary tale.


Shakey1500 Thu 25-Jul-13 21:48:44

Oh you will have sex again my lovely thanks

And don't believe everything you see! Kate probably had two lots of breast pads on and about 7 maternity duvets pads. Add to that a fistful of painkillers and she probably doubled over as soon as she was out of the public view.

You didn't fail. I know it feels like it but you did the very best you could and had little to no control over what happened. x

PeanutButter1 Thu 25-Jul-13 21:51:51

Thanks so much, Shakey. And thanks for telling me about your tears/operations. I'm going back to see the physio this week. I'm guessing that as I haven't had any incontinence they prob won't refer me for surgery. The way I understand it, my internal sphincter is badly damaged and that's just how it's going to be.

Sorry to hear about all you went through but inspiring to hear you've made it through to the other side.


PeanutButter1 Thu 25-Jul-13 21:58:07

Oh and in answer to your q, the repair has been deemed 'adequate'. It was a consultant surgeon, so for that I am v grateful.

CheungFun Thu 25-Jul-13 21:58:07

Un-mumsnetty hugs peanutbutter ((()))

I had a third degree tear, but it was stitched up well and healed quite quickly, so I can't say that I know exactly what you've gone through, but I can relate to what you're saying about your own body feeling 'alien'.

My midwife who came to visit us at home and discharge us from midwife care on day 10 said she always recommends her ladies to get a mirror out and have a look 'down there'. I must admit, I was scared as I didn't know what on earth kind of horror I was going to see, but I did look and it wasn't too bad. Now DS is 19 months old and I still have a visible scar, but I'm more interested than scared of it. It might help to have a look and re-familiarise yourself?

I was relieved to see Kate Middleton have a bump when she came out of the hospital with William and baby George. I felt so shocked at mine, I knew I wouldn't have a flat stomach, but I felt like I had to pick my tummy up to roll onto my side and get out of bed. Very strange and scary.

With bonding, I can only recommend taking one day at a time. I found it hard to remember the good parts of my day, so I kept a little diary and wrote it to DS of what we had done that day, e.g read a book, etc and also wrote down what had made him smile or laugh. I'm not saying to ignore any feelings you have, but I found in the early days it helped to concentrate on the good bits even if I only had one smile that day from DS.

CheungFun Thu 25-Jul-13 21:59:57

I've just read back my post and I hope I don't sound like an idiot! It's so much easier to talk to someone on real life sometimes!

lottieandmia Thu 25-Jul-13 22:01:10

I didn't have a 4th degree tear but I did have a badly stitched episiotomy with my first baby and it did not heal well and hurt all the time. Sex was really painful so I couldn't do it. It took about 6 years for me to feel normal again and I totally relate to the feeling of body feeling alien. But I'm happy to say that after 2 more babies I have recovered in that area and now it feels almost the same as pre-babies. So it can happen.

You do need to push for an operation though if you feel you need it. Why should you put up with this just because you aren't incontinent??! I found that the staff were very dismissive of my problems after the episiotomy and tried to say it was psychological hmm so don't be fobbed off.

Shakey1500 Thu 25-Jul-13 22:01:26

I had mild incontinence but the debilitating thing for me was nerve damage and scar granulation. And I only really found that out after trying to insert tampon/have sex (not at the same time wink ). The pain was inside the vaginal wall and at the entrance.

Have you attempted tampon/sex? If you feel able to give it a go, it might give you some idea how things are on that score, which is important. I also had to go through physio, dildo type things (I forget the name), anaesthetic gel. It was only when all those things still didn't improve that further surgery was considered. I had a "modified Fentons procedure". After that, all was well but I was pretty desperate by that point to be honest.

I well remember the infections-ouch. The only comfortable position was lying flat on my stomach on the floor sad

Good idea is to bite the bullet, have a good look at the area, try insertion and write everything down.

PeanutButter1 Thu 25-Jul-13 22:05:08

Thanks CheungFun - no you don't sound like an idiot at all! I made my husband have a look down there quite early on and he reported nothing freaky.

I love the idea of writing stuff down to help with bonding. My son is now almost 6 months and I feel a bit sad I won't have remembered much of this time, especially the first three months which were just hellish.

It's the feeling of shame and failure that I just don't understand. I'm a reasonably intelligent logical person - I know this wasn't my fault, yet I feel like such a loser! God. What we do to ourselves.

Thanks so much for responding. Can't tell you how wonderful it is to finally 'speak' with people wove been through this.


PeanutButter1 Thu 25-Jul-13 22:09:49

reads all the posts Sounds like its time for me to fire up he ol' Rampant Rabbit again!

GherkinsAreAce Thu 25-Jul-13 22:12:41

Hi peanut, just sending you some huge hugs. My bf had a 3c tear and although it wasn't 4th degree and I have no personal experience, from supporting her I have a bit of an idea about how difficult major tears can be to get over.

I think you sound like you are doing brilliantly and don't forget that if you have another dc you may get that calm easy immediate post birth moment that you wanted - my bf is having an elcs next time.

Also, you did not fail - some positions for the baby are very very difficult to have a normal vb. forceps are so commonly used now and you were just so unlucky to get such a bad tear sad

You might want to talk to Sheila kitxingers Birth trauma organisation and the hospital ask for a birth debrief - both have helped people on here.

How awkward for you that the mw was also your friend. Is she a close friend?

Shakey1500 Thu 25-Jul-13 22:15:36

Mine was a consultant surgeon as well but he made a hash really <wonders if it's the same one??>

Four years after, he came into the shop where I worked. I slammed the change into his hand <small but petty victory> grin

PeanutButter1 Thu 25-Jul-13 22:20:57

Hi Gherkins (yes they are ace). MW is my bf's mum. I hope she didn't make an error of judgement but am avoiding the hospital debrief as I feel apportioning blame may just make me feel more depressed about things.

Have thought about the birth trauma thing but tbh just knackered all the time as my lovely son doesn't like sleeping much!

If I ever have another baby if will be through elective c section. I have to focus on how lucky I am to have a healthy happy baby/ I try to, I really do. Just gets the better of me sometimes:


Peanut <squidge> I also had a fourth degree year when I was opened up for an emergency section and they were unable to deliver my son so had to resort to a pretty brutal forceps delivery. I know how awful a fourthdegree feels and I'm sorry you're experiencing that.

You will get back to having sex again, but it takes time for you to be comfortable with it again. It's been nearly two years for us and I no longer feel the fear smile Have youbeen to a women's health physio for help with the after effects of your tear? That made a big difference forme.

I get the feeling when other people have babies too. I love that they look so happy but then am consumed with jealousy that I never got that and feel angry about it. I was diagnosed with ptsd and depression and having professional help with that had really made a difference to how I feel about the birth. It's a slow prices but it will get better.

About the debrief- it's worth considering. Even if you get your notes and go to your GP.

I was convinced that something went horribly wrong on the hospital's part because relatives who had been midwives told me that it must have been the hospital's fault, should have fine something dinner etc.

The debrief was so thorough and after spending over 2 hours with the consultant who delivered my son, I felt worn out emotionally and really sad but it's helped me to let go of a lot of the anger and guilt I had about his birth.

GherkinsAreAce Thu 25-Jul-13 22:27:39

Quite a close friend really, then sad In case it helps, my bf was told (and believes) that in her case there was no way the tear could have been predicted as a result if the delivery and so she actually found the debrief comforting. I can see why you wouldn't necessarily want to go down that route though.

lottieandmia Thu 25-Jul-13 22:28:03

I think that nobody prepares you for how you might feel psychologically after you've given birth (especially if something happens to damage you). I felt so awful after dd1's birth that I couldn't understand (and yes felt jealous) of people who spoke of an amazing birth experience.

Fine something dinner? I meant done something better.

GherkinsAreAce Thu 25-Jul-13 22:29:26

I think major tearing is one of the last taboos, so it is very hard to get understanding and sympathy because they are lot talked about.

GherkinsAreAce Thu 25-Jul-13 22:29:46

Not rather than lot blush

NonnoMum Thu 25-Jul-13 22:32:47

Lots of wise advice on this thread... Please look after yourself and your baby... One day at a time...

PeanutButter1 Thu 25-Jul-13 22:37:58

Thanks everyone. Maybe the debrief is a good idea. I don't know. I do know that this is already v helpful and is the first time I've discussed any of this with other people who have had tears.

I want to be able to accept what happened and stop feeling
upset and cheated.

When I think back to the weeks and pregnancy yoga and hypnobirthing and aaaargh! Though it did help, actually.

I don't want to be the person who had the 'terrible' labour. Most of it was fine. But I was so full of drugs by the end and I don't remember holding him.

He's next to me now and is wonderful and sunny and smiley. So I should let go of the past and relish every second I have with him now. And yet.

Thanks everyone. It has been so wonderful to hear from you all. I'm reading your posts and having a big cry and it is helping. Xxxx

GherkinsAreAce Thu 25-Jul-13 22:43:12

He is lucky to have you as a mummy!

I don't know of this helps, but my yoga-birth / pregnancy yoga teacher, who was one of the fittest, best prepared and calmest mothers to be ever had a c section. Some babies are just not positioned in a way that will allow hypno/yoga birthing to be of any use.

PeanutButter1 Thu 25-Jul-13 23:03:10

That really does help, Gherkins, thank you. It helps known I really really tried and did my best. I'm lucky that I live in a country where he was delivered safely and I had transfusions and antibiotics and good care was available to me. Xx

I'm still known for meeting the one who had the terrible labour, but I promise it gets better. It won't hurt like this forever.

Writing down your birth story might help. Keeping a diary is a good idea too.

Take care of yourself and give some serious thought about talking to a GP about how you're feeling, they might be able to put you in touch with people who can help

MairyHoles Thu 25-Jul-13 23:13:21

I have never had a 4th degree tear but had 3rd degree tears with both my eldest children, for me it was horrific and I felt like everyone got sick of listening to me moan and somewhat dismissed how I was feeling or sympathised by saying "i know, I needed stitches too". I still suffer from incontinence like you describe, having to go back to the loo later on. I had a debrief after my second and I felt it helped. The hospital are unlikely to apportion any blame for risk of a lawsuit, so it may well give you more insight into what happened. In my case both my children were back to back and both had the cords round their necks requiring assisted deliveries, so seeing the ctg (?) reassured me they had to get the baby out quickly and it wasn't my fault. It will get better, I promise.

onelittlepiglet Thu 25-Jul-13 23:28:55

You poor thing. No wonder you are feeling overwhelmed and sad.
Quite apart from the physical recovery, the psychological impact of a bad tear is awful. Give yourself lots of time and don't feel like you are being unreasonable. This is about you and your feelings and not what you 'should' be feeling.

I had a third degree tear which came as a big shock to me as I hadn't even really considered that I might tear badly! Stupid really but I just didn't. I was whisked off to theatre for stitches leaving Dh with dd. it was not the start I imagined, especially having to have a spinal block and so being paralyzed from the waist down for several hours after a natural pain-relief free birth. It has taken a long time to get over it and I cried many times during the first year or two about it.

I had some physio which I found invaluable (if rather embarrassing and shocking at first - wasn't quite expecting to have to have someone's fingers up me while I practiced my clenching!). The physio was a wonderful woman and let me cry on her several times and talk about it. She had also had a difficult birth (in a different way) and so completely understood the feelings and upset it can cause. It was more physio and counseling!

Going to the toilet was also not right for quite a while, but it did heal up well and I have been back to 'normal' now for a good long time. I do have to be careful to eat enough fibre though. Do go and see your doctor if you have any concerns at it - feelings or anything else. Don't put up with it not being right - it can bring you down so much worrying about this.

Sex (not that we did it much...) didn't feel right for well over 18 months and I would say it has only got 'good' again in the last 6 months. DD is 2.8. Take it slowly and at your pace. It helps to have a very understanding Dh...

Keep talking - if you want to talk about it then do. Don't bottle up the feelings and if it helps, definitely ask your gp about counseling or look into it privately. It might help you make peace with it.

Take time to recover, be kind to yourself and if anyone gives you grief, remind them what a massive thing you have been through! It really is a big deal to recover from especially when looking after a new baby.

Good luck and congratulations on your new baby - give him a lovely snuggle! Xx

PeanutButter1 Thu 25-Jul-13 23:36:25

Oh thank you, onelittlepiglet. Every kind message is making me cry! I haven't really cried much in a while so this is probably a good thing.

I have a lovely and kind husband who just wants me to feel better.

Sigh. It's all so overwhelming, isn't it?

I think I'm definitely going to seek out some kind of ongoing therapy.

Thank you all so much. I joined mumsnet a couple of hours ago and it really has been worth it already!


GherkinsAreAce Thu 25-Jul-13 23:38:38

There is so much support on here, Peanut. MN was a lifeline for me when I had my mmc and the ability to get anonymous support 24 hours is amazing smile

cravingcake Fri 26-Jul-13 04:50:09

I'm another who had a 4th degree tear. Totally understand how you are feeling.

I had counselling after being diagnosed with ptsd & pnd and it really helped. It gave me a safe space to talk things through.

Some people in real life just dont get how horrible it is. Even simple check ups are intrusive and uncomfortable.

Regarding when you say you feel like you failed, you did not fail. You delivered your baby safely with assistance. Can you try to imagine how you might have felt if you had laboured, got to 10cm and then had a c-section? Would you have felt like you had missed out on a natural birth (obviously you couldnt predict the tear) and then felt like you had failed that way? I know this is something i would have felt, even with the months of recovery and pain. A lot of the first 8 weeks or so after my DS was born is a complete blur for me, due to sleep deprivation & pain killers.

I'm now expecting another baby and will be having elcs. During my booking in appointment the midwife said that i could go through my notes from my previous birth if i want to. I have already done this but its nice to know the option is there to do it again.

PeanutButter1 Fri 26-Jul-13 04:57:44

It sounds like we've had very similar experiences, cravingcake. Yes, those first weeks are just a blur of pain and no sleep! I forced myself to stick with bf after not being able to for a week (we were kept in hosp for a week due to tear/blood loss but also my baby had suspected infection, so was on antibiotics/had x-rays/lumbar puncture. On top of that I couldn't produce milk and had approx 1532 different people come round and show me how to bf!)

Recovering from major surgery a challenge but it's compounded by having to look after a baby and just never sleeping!

Congratulations on second pregnancy, wish you all the best. Good to know they are being sensitive about your first experience. Xx

GherkinsAreAce Fri 26-Jul-13 06:00:26

Peanut if you managed to bf at all after your experience I am in awe. It is notoriously difficult to initiate bf after a traumatic birth.

ListWriter Fri 26-Jul-13 06:35:10

Hi peanut. Another one here with a birth like yours. All the yoga in the world didn't stop a back to back birth, forceps, 4th degree tear, infection for DS, transfusions etc. DS is 21 months now and it does get better. You need to give yourself time. I really valued the debrief - for us, they said they hadn't realised DS was back to back and if they'd have known, they could have tried to turn him. Things turned badly so quickly at 10cm dilated, it was good to have the reassurance that forceps and not emcs was the way forward.

Counselling has also helped me deal with it but I must admit I am hesitant about getting pregnant again even tho next any birth would be by elcs. You just have take each day as it comes.

Take care and congratulations on your baby and the breastfeeding. Well done!

Notafoodbabyanymore Fri 26-Jul-13 06:48:26

My first child's birth was traumatic for other reasons, ended up with an emcs and was gutted. I can relate to feeling like a failure, I know I did, especially when breastfeeding was a nightmare too. I just felt like my body had failed and I had failed. I actually started hoping that the other people around me having babies would end up with an emcs too, so I wouldn't be the only one who was rubbish at having babies! blush

The early days were a blur for me too, and I struggled to bond, but she's 3 1/2 now and my best mate. It took me about 18 months to get to the point where I felt at peace with it all, and I can honestly say I feel fine about it now. The birth reflections at the hospital really helped.

I've also had a second dd recently (vbac, 2nd degree tear) but in comparison so much easier.

I hope you get the physical and emotional support you need to move on from this and really enjoy every minute with your lovely baby.

PeanutButter1 Fri 26-Jul-13 08:11:18

Wow, thankyou everyone. Can't tell you what it means to hear these similar stories. I might try and find out why emcs didn't happen - think they wanted to try forceps as a first method.

I thought I was mentally moving on but I think I really need to make my peace with all this. I wish all of us didn't feel that ridiculous sense of failure. One of my bfs had a 'perfect' labour and another is due soon. It shouldn't bother me that I'm the 'weak' one, it's so childish of me and nobody has called me that.

I really want to re-frame it so that in future my boy's birthday is about him and not me!

I'm not evangelical about bf but it be and a focus for me and I thought it might 'prove' my body wasn't totally useless and I hadn't failed him yet again. I bloody love formula as without it he'd be dead! My husband fed him from a tiny cup for that first week. Obv its great for the baby, but realised that bf was more about me being desperate to create a bond and 'succeed' at something (NB: i do not rationally think not being able to bf is a failing. None of these emptional responses have been in the least bit rational.) Our egos are funny things.

Wow, writing this all out is helping a lot. Thanks for listening. Xx

PeanutButter1 Fri 26-Jul-13 08:14:00

Sorry for the myriad of typos. To clarify: my slightly insane focus on trying to breastfeed was more about my ego than anything else. I don't think people who don't want to or can't breastfeed have 'failed' at all - just wanted to clarify!

In fact, reading this whole thread I'd like to say you're all bloody amazing. X

GherkinsAreAce Fri 26-Jul-13 08:24:28

Peanut, bf him was obviously important to you and it is wonderful that you had the determination to make it work. My bf who had the 3c tear was unable to bf her son who simply wouldn't latch. With better support maybe it would have worked out but it is so hard after a major tear. I think you did wonderfully.


onelittlepiglet Fri 26-Jul-13 13:22:12

Just to say - your body is not useless! I also felt like this and in low times still do, but your body is an amazing thing and sometimes tears do happen. My dd shot out of me in one go and took everyone by surprise which is why I tore - no one could have known that would happen.

You have carried your son safely for 9months and given birth to him and your body has done an amazing job. Your body is now providing food for him as you are breastfeeding and at the same time recovering from major trauma - you are awesome!

Matildathecat Fri 26-Jul-13 15:53:30

One littlepiglet is right, you are totally amazing and you will recover.

As a midwife can I say that looking after friends and family is a nightmare. The worry is always if something goes wrong what if? Is your judgement clouded at all? I bet your friend is devastated. A tear like that is extremely uncommon and she probably blames herself.'s not her fault.only a doctor does a forceps delivery or makes the decision whether to progress to cs. It's not really the doctors fault either, probably. Sometimes these things do happen.

I agree a debrief is an excellent idea. Not with your GP but most units will have a senior midwife who does this and can go through your labour notes and explain anything you aren't sure about. Not as a fault finding exercise but to make sense of it. They may also be able to provide access to a counsellor. Contact the Head of Midwifery to request an appt.

I hope you will in time talk to your friend and accept what happened.i bet she is horrified and mortified.

Finally, enjoy your little one. If you ever choose to have another baby you will have a totally different experience.

Best wishes.xx

PeanutButter1 Fri 26-Jul-13 21:05:22

I'm so grateful you are all taking the time to write. Thank you.

I feel a bit brighter today - still not great but I'm really hoping my physio appointment on Wednesday will help explain my injuries and if there is any scope for further recovery. I'm dubious any muscles can get better after 5 months but you never know.

I will arrange a debrief soon. My poor midwife friend was utterly devastated. I haven't really spoken to her at length since (not unusual as she's actually a mate's mum), though we've exchanged a few FB messages. I don't blame her as I believe she always had my best interests at heart.


Join the discussion

Join the discussion

Registering is free, easy, and means you can join in the discussion, get discounts, win prizes and lots more.

Register now