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subsequant pregnancys after 4th degree tear ...what did you do cs or vaginal birth

(14 Posts)
kittenbaby Sun 12-Aug-07 20:21:53

hi girls im still struggling to get over my repair op for fourth degree tears in childbirth.
dd will be 7 weeks on wed
for the first three weeks i didnt feel like i was getting better at all
really would be interested to hear from anyone thats had this and if and how they had anymore children


i did so well during the labour and giving birth
only had gas and air during the labour and nothing at the pushing stage
apart from the fact i was in the water
thought everything had gone so well
after dd was born i delivered the plactena naturally after nearly and hour while bf dd
and i thought thats it ive done it!

then when i was examined the mw said we need to get someone more senior to look at you the look of horror on her face im not sure ill forget
then a sister examined me then a doctor then a surgeon they said i had 4th degree tears
i never knew anything like that existed and that id have to have a spinal tap and a repair operation
i was crying my eyes out even though when i was in labour and giving birth i was pretty silent and just got on with it
i found the examinations far far far worse than the labour and birth
thats was the worse bit
never knew natrual childbirth could do this to you
ive been reserching 4th degree tears on the net to see how long its gonna take me to get over it and to see if i can get any tips
and it doesnt sounds good
it seems as if 4th degree tears are v v uncommon and i just cant understand how this has happened to me
like if i had had an epidural or even pethidine and had lost the urge to push and had to had forceps or vontouse and that had caused it then i could understand why it happened
or if dd got stuck and they had to rush her out , or if she came out the wrong way round
or if i pushed before i was 10cm or baby was really big [dd was 8 4 and a half] i could understand it obv im glad those things didnt happen but then id understand what happened

but i only had gas and air
was on all fours
was in the water
only pushed when i was told to do so
i just cant understand it
there seems no reason for this to of happened
so does this make it even more likly to happen again as there is NOTHING i could do differently next time

been thinking about if id ever have another baby in the future
and wondered what your experiences where? esp regarding cs or vb

MrsTittleMouse Mon 13-Aug-07 08:00:03

Hi kittenbaby,
I'm sorry to hear about your tear. I don't have the same experience as yours, DD was ventouse and I was cut, not torn, but I've had lots of problems with my scar. We're thinking about trying for another (not trying yet, just thinking!), and I'm concerned about the same things. I did everything "right" and yet DD still got stuck. I flip between thinking that 2nd babies are usually easier to birth, and being terrified that it will make everything worse. I think what I'm going to do is to ask the consultant about it and whether it's better not to risk vaginal birth again. She knows the scar, and she is the person who has seen whether women who birth vaginally after bad problems with number 1 end up with worse problems with number 2. I'm also going to make sure with the community MWs that I can be treated differently from a "normal" pregnancy (i.e. lots more care and attention during pregnancy due to stress and lots more care taken over the birth). To be honest, DH is pushing for an elective section, and I think that might be the best idea.

kittenbaby Mon 13-Aug-07 16:18:27

mrs mouse i think id agree with your dh i think isd swing more to that side

MrsTittleMouse Mon 13-Aug-07 18:17:03

By the way, it might be early days for you at 7 weeks, but my GP organised counselling for me on the NHS to help me get over the birth bit (the scar bit is proving more of a problem, but that's another story). I left it for ages to push for counselling because I thought that I would "just get over it", which in retrospect was a bit daft. If you're going over and over and over things in your head like me, and getting upset about it, I'd recommend it.

truffaut Mon 13-Aug-07 19:54:07

I had a 4th degree tear, a complete nightmare at the beginning to be honest, but thankfully all well 4 years later. The scar healed really well, did some physiotherapy for about a year after the birth on the nhs. Wish I had done some counselling actually. Anyway, I was told pretty clearly that I would not be allowed to have a vaginal birth, what a relief to be honest. A nice ceasarean for me thank you very much. Wish you well.

RainingCatsandDogs Mon 13-Aug-07 21:46:59

Only (!) had a bad 3rd degree tear last year (2nd baby but bigger than 1st and quick delivery but same presentation with arm at head both times and the first was only a 1st degree tear) but have had some anal incontinence treated with physio the past year and everything it beginning to improve. Painful scar is also getting better - at first they were going to restich me but all seems to be getting better.
If you have any symptoms of urgency to need the loo for a poo! make sure you get physio and gynae. followup.Sometimes noone asks you but I was lucky as my hospital has followup gynae. for bad tears so if you have any symptoms get referred back.
I do think you also need some answers as to why you tore so badly and would ask to speak to someone at the hospital
Because of my problems I was advised to have a C-section if I have another.Personally because of the risk of anal incontinence I would not have a vb after a bad tear but you need to ask a good gynae who can read your case notes. My experienced surgery midwife did deliver someone who had had two third degree tears at her third labour and she didn't tear at all the third time so I think there is a case for the skill and control of the pushing stage in the midwife you get in labour - bit worried it took yours so long to find your tear was so bad, where was she looking at the actual delivery of the head and body?

kittenbaby Tue 14-Aug-07 21:31:28

thanks so much for sharing your stories with me
i truely wish you all well
[hugs] to you all xx

had my6-8 week check up with the gp today and baby saskia is fine and well yippie!!!
my gp said baby looks really healthy and well
gp said he thinks dd is gaining weight fine
dd is 7 weeks tomorrow
last week she gained a 8 and a half oz
and this week [well six days ] she gained 6 and a half oz
so she is gaining weight quite well
so bay is great

with me he said he had never seen anyone sustain a 4th degree tears the whole time he had been a gp and that it was v v rare
and he just thought i was just extremely unlucky as there seems no reason for it have happened
he was really sweet to me his a fab gp
he said as im going for a check up at the hosp he felt they wouldnt really be much point stripping me off and examining me
he said that 4th degree tears take months to get over
which in a way made me feel a bit better oddly
i guess because at least its normal that i feel so sore still
feel a bit better about everything thing now
just got the hospital appointment to get through now, he said hs gonna chase it up today
dont know how im gonna go through with the hospital examination but i guess i have to

MrsTittleMouse Tue 14-Aug-07 21:42:21

Hurray! Glad to hear that your DD is doing so well, and that you have a sympathetic GP. From my experience, that is more than half the battle won.
Can you take someone supportive with you for your hospital appointment? Or at least get someone to babysit your DD? I found that having DD with me was very distracting, and I was worried the whole time that I would cry and that it would upset her. It was better when I could just concentrate on me (which makes a change!).

kittenbaby Tue 14-Aug-07 22:34:07

hi mrs mouse thanks for your support it really helps x
thats a great idea about having someone have dd but sounds like the gp gonna get the appointment though v soon
and at the moment dd is constantly bf ing
like every half an hour really could do with getting hr to go longer im working on it
i also dont want to cry and upset her
dh is v supportive and hes going with me

RainingCatsandDogs Wed 15-Aug-07 10:36:51

At my first hospital checkup the nurse got out the metal thing they use for internals and I really panicked but the consultant didn't use it just examined with gloved hand.
They will probably ask you about your post baby sex and if none yet, get you back at a later date after this and if there is any pain on intercourse as they use this to determine the healing of the scar.
My experience has been a year later things are much better - time is a big factor in healing - but I also had a friend who needed restiching as she has a bodged 1st lot after childbirth and she says she knew from the start it was wrong.
Make sure the hospital follows you up as from the 1st checkup things can change.
I would also ask for a women's health physio checkup anyway to get assessed as they can get you doing some exercises which help longterm and if in any doubt a colorectal surgeon/nurse can ultrasound the anal passage to see how badly the tear affected the sphincter function and if subsequent childbirth may be a risk.It is good you have got a good GP (mine was too) but you do sometimes need to ask for the treatment/follow up you need.It is hard after a bad birth experience as you do feel a bit alone and you may benefit from post birth counselling if your hospital offers this.Congratulations on your baby doing so well - I can empathise with the non stop breastfeeding!

kittenbaby Thu 16-Aug-07 07:16:23

thanks cats and dogs
how many appointments/check ups do you have ?
i was kinda hoping it would just be one

estobi1 Thu 16-Aug-07 07:45:45

I had a third degree tear after my dd 2.5 years ago and I have healed well.

Glad to hear that your little one is doing so well congratulations!

I think it is important to remember that you have been through a horrendous time and that it is important that you recognise that it is ok to grieve over what has happened to you which is why so many women talk about their birth experiences.

We all want everything to go well and if it isn't perfect, it is emotionally difficult to accept, not to mention the physical side of things.

I remember saying to my friend when my dd was 8 weeks old when will i stop thinking about the birth? Her reply was it will fade in time and she was right. I would say that it took me about 6 months to stop thinking about it so much although now that my next one is due in 9 weeks, I am thinking about the last time more and more!

As your baby grows and becomes more and more exciting it will help to banish the memory and hopefully you will really enjoy motherhood.

In terms of the physical recovery, I made a really good recovery, very little pain or discomfort which I attribute to the surgeons doing a great job on the repair. if you feel uncomfortable or that things don't feel right, speak up sooner rather than later.

Make sure you do those pelvic floor exercises if you can - I have had to wear tena lady pads through my pregnancy as I keep peeing myself. Otherwise everything is fine.

As for sex, it took me ages because I was so terrified, my husband was very patient and loving and had to put up with lots of cuddles before I was ready. The first few times hurt but only because I was so tense but once I relaxed everything was fine - we were just too tired to do it!

Good luck with your recovery I really hope all goes well. xx

mamijacacalys Thu 16-Aug-07 14:33:50

I had a 3rd degree tear with DD last July and was stitched in theatre afterwards. Same experience as you - 'normal' labour with only a bit of gas and air but she was back-to-back and 8lb 12 which may account for the tear!
All is now well and dandy but was a bit sore for a few months!
Below is a link re clinical guidance on this issue posted by Mears on another thread (hope it works as am usually useless with links)
www.rcog.org.uk/resources/Public/pdf/green_top29_management_third.pdf
Also, perhaps lulumama or others will be along with the appropriate link to the birth trauma association (or you could try googling it) in case they can be of help to you.
HTH and good luck - it is perfectly normal to feel like you do - I bored everyone stupid with both my birth stories on each occasion!

kittenbaby Sat 18-Aug-07 20:42:26

thanks for your help so nice of you to take the time to reply 2 me xx

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