C section after 3rd degree tear???

[hannahintheworks]

Hi all,

My DP and I are trying for baby number 2! We have a son who is 18 months old. My labour with our son was 36 hours long, and ended in a forceps delivery. I had an episiotomy and a 3rd degree tear which narrowly missed being 4th degree. My question is do I try for a natural delivery with number 2 (when the time comes) and risk permanent, life-changing damage, or do I go for a c section and not have the excitement or the amazing experience of being labour? Anyone else had the same dilemma?

TIA xx

[MargaretCabbage]

I had a third degree tear with my first baby. It was fixed in theatre and I never experienced any problems after it had healed.

I had a 20 month age gap and was really worried about suffering another bad tear that could cause lasting damage. I did a lot of Googling and you are at higher risk of a tear if you've had one, but I think it's a 6% chance. I decided I wanted to try and have a vaginal birth. The birth went well, but I had a second degree tear. The recovery was fine, and I honestly felt great within a week - I was running about with my toddler in the park. Neither tear has caused any problems.

I'm glad I opted for a vaginal birth, but I may have made a different decision if I'd suffered any problems after the first birth.

[Laineymc7]

It really depends on if you are symptomatic and have problems from the last delivery. Can you have a scan to check the area again. You should be able to request this if it wasn't already offered. My scan showed that I still had defects in my spincster muscle so a c section was recommended. Ultimately they said it was my decision. I didn't want to risk further damage so went with it. C section was fine I'd choose it over the forceps delivery and bad third degree tear but then everyone is different. Ask to be referred to a consultant. Congratulations and good luck.

[SweepTheHalls]

I had 2 bad second degree tears with my first 2 deliveries, so opted for a c section for number 3. Much tougher recovery, but definitely the right decision for me as I wasn't worried about doing further damage. Good luck

[DuggeeHugs]

I had an ELCS after an EMCS first delivery (failed induction) and, although not in your position, I would say a CS can still be exciting and an amazing experience. We found the theatre atmosphere to be great at the arrival of both our children and I would certainly have a third CS were we to expand our family further (DD is not yet 2 weeks old so a bit early for those decisions!).

I guess what I'm saying is that being a different experience from labour doesn't make it a worse one, so don't be automatically put off on that basis

[Metalhead]

Without wanting to sound too harsh, if you did suffer lasting damage during a second vaginal delivery do you think you'd still look back at it and think "I'm glad I had that 'amazing experience'"? Just seems a very strange way to look at things... but then there was nothing 'magical' about my first delivery for me.

Also agree with duggee, you still get excited about meeting your baby when you have a CS.

At the end of the day you have to decide what's more important to you, the type of delivery you have or any potential medical risks (and I'm not saying one option is better than the other).

[hannahintheworks]

Thank you for all of your comments. I didn't know about the scan, the only post baby check up I had was 16 weeks later where the doctor put her finger up there (sorry!) and told me to squeeze! She said it all seemed ok. If there are more professional tests I may request them before making a decision.

I am sure a c section is still as exciting in terms f the actual birth and I wouldn't want to find out the sex of baby number 2 so that would also add to the excitement for us.

Thanks again for the comments!

[Tchoutchou]

Just to point you in the right direction. You should ask for a (standard) rectal scan. If you have no symptoms (faecal urgency for example or inability to control your wind) I don't think you'll need a rectalmanometry (strength test) but there is that too.

[stoplickingthetelly]

I had a very similar first experience to you and decided before I was even pregnant with dc2 that I would have cs. I told my midwife at my booking in appointment that was what I wanted. My decision was never questioned at all. Everyone I spoke to read my notes than said 'that's fine, it won't be a problem'. I'm so pleased I opted for this as dc2 was also back to back like dc1 was (which caused most of the probems). My cs went really well and I healed much faster and lost less blood than I did with dc1.

[MondieBee]

I had a 3b tear with my first. I saw a physio who stuck her finger in and made me squeeze too! But I also had an ultrasound of my back passage and the strength test mentioned above which showed some defect and weakness.

I was determined to have normal delivery second time round which everyone supported despite the rest results recommending a csection. However at about 38 weeks I read in my hospitals own clinical guidance that women who've had a third degree tear have a 20%-40% chance of faecal incontinence if they have another vaginal birth. I went back to see a consultant again and had a chat and we went with an elcs in the end. It was a tearful difficult decision for me. My midwife who had been supportive of my VB said after that she felt I did the right thing to "protect the repair" of my tear.

I didn't enjoy the section at all and found the recovery very difficult to start with, and thought I'd made a mistake. However now 5 weeks post section and nicely healed and I can see it was the right decision. It would be awful to have ongoing continence issues.

The csection was still amazing. I had almost immediate skin to skin, I was very clear I wanted this so had him on me the whole time they stitched me up (they out the electrodes on my shoulders to allow for this) and initiated breastfeeding in recovery. It was also handy for arranging childcare for DS1

[Speechie14]

I had a 3rd degree tear with my first. I'm now newly pregnant with my second. After doing my own research I have decided on a c section, which my midwife thought would be fine at my booking in appointment. The op and the recovery worries me but considerably less than incontinence does.

[SweepTheHalls]

That was exact the conclusion I came to Speechie. Consultants varied in their levels of support at each appointment, but as I was confident in my decision it was never really an issue.