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Questions about homebirth and also episiotomy after a 3rd deg tear(10 Posts)
You have a risk of about 5 % of having another third degree tear. If it happened at home you could be transferred in a non emergency fashion. If you have an episiotomy you may still have a third degree tear, for most women this is not necessarily a protective thing to do. You are much less likely to need forceps second time around and therefore of course less likely to tear. I don't see why it should stop you from having a homebirth as long as you are aware that you have a slightly higher risk of transferring afterwards. Good luck in your decision making.
I recently (as a doula) supported MN-er secondtimelucky through a homebirth after a very similar first birth (though hers was a 2nd degree tear).
I'm dashing off so will be back later but run a search for her and you'll see her journey and experiences - it was a very positive homebirth.
Do look at [www.homebirth.org.uk for more info on tearing etc.
If you've had a bad tear in your first birth, the worry is that you will have another bad tear and will need to transfer to hospital for stitching. Yet the risk of severe tearing is smaller at a home birth, particular as many bad tears are associated with assisted deliveries, which do not happen at home. You may have more chance of a gentle, controlled second stage at home, in a position thought to reduce the risk of tearing - such as on all fours. Although your risk of having another tear is higher if you have previously had a bad tear, you are still less likely to have this problem with a second or subsequent baby than with your first. It is up to you to decide whether you want to take the risk of having to transfer to hospital after the birth if you need repair - women who have transferred after the birth nearly always say that they are still glad they gave birth at home; they just wish they hadn't had to transfer afterwards.
I had a large tear with my first son, but the labour was very straightforward ( though long) and my consultant -Yheudi Gordon - daid there was no reason at all not to have no 2 at home, which I did. DS2 was 9 1/2 lb, and got a bit stuck with his shoulders on the way out - it all ended in a painfull and difficult tussle with the midwife dragging at him - but no tear! I much prefered giving birth at home.
I tore with DS2 at a hone birth and was stitched by the MW so no need for a transfer. Check their policy
I had a home birth for DC2 after a very similar birth for DC1 to yours. I did have a small second degree tear which did not require suturing ..... and healed so so so much better than my previous wound.
Wishing you all the best with your decision.
I tore after having DD1 at home - only 2nd degree, but all internal and quite awkward to get to, plus it went through a vein that wouldn't stop bleeding and after a few hours the blood loss was starting to have an effect.
I don't regret having DD at home even though I had to go in - although I'd rather not have transferred at all. Then again, if I've got to transfer into hospital I'd rather do it once the birth is over and done with than sit in a car whilst in strong labour...
Its also worth bearing in mind that you're more likely to get an experienced MW at home than in hospital. If you do decide on a hospital birth it might be worth considering a doula, so that you have someone there all the time who's familiar with what's going on and can provide you with support.
Fingers crossed everything goes more smoothly for you this time, whatever you decide
Episiotomy is not recommended for preventing tears, frequently extend further than needed to get baby out and is so much less likely at home.
Tbh I am horrified you were even subject to it the first time. An hour 2nd stage and baby was fine? Why couldn't they let you get on with it?
Anyway, to add my personal experience, my NHS MW claims I am high risk after having 3rd degree tear with DD. She said I'd probably be *told *by consultant to have an ELCS. she told me it was just policy but couldn't say why.
My consultant was the complete opposite. Happy for me to birth vaginally and at home. I stressed for nothing.
Chances of another 3rd degree tear are somewhere between 5-7% and a tear heals much better than an episiotomy generally speaking so I've decided to take my chances at home.
I won't be pushing on my back, no epidural and no assisted delivery (or less risk of that unless I have to transfer) so I am minimising my chance of a another tear as much as I can.
I second the point about all fours, appears to be favoured for avoiding tears.
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