Scared of tearing again with baby number 2

[Truffy18]

I was wondering if anyone had any advice. I had a waterbirth with ds1 who was 8lbs. Pregnancy fine, birth quick but had long pushing phase as I was scared of tearing. I ended up with 2nd degree tear. Felt every stich as it was done (despite 2 lots of aneasthetic) and felt a lot of pain after. Stitches were far worse than any of the labour/birth.

I'm not worried about this birth (due in May) except tearing again and being unable to push properly as I'm so worried. Am i more likely to tear as I have done so before? Any tips for preventing it? Anyone torn with first but not subsequent babies?

[KaybeeandZak]

Hi,
I am in a similar situation to you, I had 3rd degree tear so had to be stitched up in theatre and it hurt like hell for ages after. I am due in May and am worried too about pushing - I feel like I might just tear myself in two completely!!!!!!!
Sorry I can't offer any advice, but others I have asked have suggested that 2nd time around we are usually a bit more stretchy so not as likely to tear so badly...
Good luck

[Heated]

With my first birth I got to the 2nd stage (3hrs) far more quickly than the mws expected but had a really long pushing out stage (4hrs) as he got stuck, no pain relief, tore high up (and knew it) and was another hour later ds was born. Had a third degree tear & a repair that broke down later, plus womb infection. Nightmarish time.

So as you can imagine very worried about 2nd delivery, which in all likelihood would likely be even faster.

I had a guaranteed epidural which slowed the labour (still 5hrs from start to finish), allowed me to be in control of the pushing. I had a very minor tear at the exit point. I know that some mws are anti-epidural as you can't feel the contractions or know when to push, but that's exactly what I needed, controlled pushing at the instruction of the mw when I needed to, rather than be ruled my body and it's response to pain. It was a fab delivery.

I was reassured by the stats as well - of the women who had 3rd degree or worse the first time, 75% went on to have a 'good' delivery which meant either no tear or a very small tear. 25% reported as bad or worsened symptoms but again out of those 25%, 75% of these achieved a 'good' or better surgical outcome.

I was referred to a consultant because of my difficult delivery early in 2nd pg. She was slightly in favour of a cs but respected my choice since it had been well researched.

[Maidamess]

I tore badly with no 1 and was cack handedly stitched up by a Doctor. My 2nd was better, only a tiny tear, and yes I agree with you the injection and stitches are worse than ANY part of the birth itself.

I did heal much faster and with minimal discomfort the 2nd time around and was even 'back in the saddle' after a few weeks! Sorry if TMI..

No 3 was fine, again a tiny tear but my experienced midwife who prided herself on her seamstress skills made me as comfortable as she could.

[Twigy]

Hi girls i didnt actually tear but had to be cut and used a cream Treatree + Witch hazel from Tesco about £2.50. I put it on a tissue and wiped it on my bits each time i used the loo. I healed up in no time and the cooling affect of the cream was soooooo lovely. Its worth a try!!!

[mangojuice]

I had 2nd degree tears with my 1st and was so worried about the birth of my second. As it was, it was fine. No stitches, not even a graze. And he was 9lb4oz.

First time I was so desperate to get it over with I pushed like mad and didnt listen to the midwifes guidance. Second time I really focussed on not pushing at all as he crowned, and he sort of pushed himself out. I was up and about immediately and home within 8hours. Such a different experience. Wishing you all the best

[notnowbernard]

Like you, tore with 1st baby following water birth (2n2 degree tear). Didn't have trouble with the stitching, though. Healed reasonably well after.

Had 2nd baby in pool, got another 2nd degree tear. Absoutely no probs with stitches this time, actually healed much quicker than with no.1.

Good luck!

[yomellamoHelly]

Could have been me posting this.
It was the only thing I was worried about with ds2.
In the event I totally ignored the midwife urging me to push when actually I didn't feel that I was quite ready to (she got a bit stroppy with me about it, but I was the one labour so heh ....). Took two big pushes when I felt I was ready and he was out. No tearing. Felt fantastic afterwards.

[yogabird]

perineal massage for the last couple of months with oil - just ordinary olive is fine. Stretching and massaging the area, not particularly pleasant to think about but ok to do and the big pay off is no tears with either of my dc's. Hope it goes well for you

[Truffy18]

Thanks for the responses ladies. Interesting that it seems those of you who 'refrained' from pushing towards the end tore less. Not sure if it was because I was in the water, but no one really examined me and no one at any point told me to stop pushing and pant, which I'm convinced is why I tore as I pushed all the way! Maybe this time i'll try not pushing at the very end and let the baby make it's own way out once crowning.

Very reassuring to know that it isn't a certainty that I'll tear again as that's what I'd thought (cause I'd have scar tissue).

Do you think it would help to have something written in my birth plan to encourage the midwives to 'look out for any problems'? Not sure if they'll think I'm being stupid considering the ordeal's some people go through.

[pooka]

I had a bad-ish tear with dd. And then a god-awful stitch job that ended up having to be redone when she was 7 months. So I was also rather nervous of the second delivery.
I am convinced that the epidural I had with dd was too strong, such that I just pushed and pushed and pushed with no pain or panting (also bit of a misunderstanding of the midwife who instead of panting told me to cough and, what with the pethidine, I didn't understand that that was my cue to not push).
With ds, had a 2.5 hour labour. Pushed for about 30mins of that. No epidural and not much gas and air. So when I pushed I did it much more gingerly than before, carefully and also did plenty of panting. I still tore, but the stitching was much better and I had no problems as a result. No infection and not too tight. But crikey it hurt (having an epidural with dd meant that I felt nothing then). Had heaps and heaps of gas and air for the stitching, and local injection. But perhaps I was just desensitised having had hideous restitch under local when dd was little. Anyways....it wasn't so bad and was quickly forgotten with the euphoria of having a lovely labour.

[mangojuice]

I would put soemthing in saying that you would appreciate guidance with the emergence of the baby. I think a lot of people like to go with what their body is telling them but I personally needed someone telling me very firmly to breathe and NOT PUSH (had a great midwife 2nd time)

Also my husband was fantastic and when we reached this point made me look straight in his eyes and breathe with him to try and keep me focussed. Perhaps you could brief your birth partner too. I found a stern talking to helped keep me from panicking and trying to get it over with as fast as possible!

[pooka]

Oh and next time I'm planning not to consciously push!
(And WRT me tearing the second time, that was having had bad tear with dd, subsequent episiotomy and so 2 lots of stitches).
Have you looked into perineal massage? Some people swear by it. I don't think I did it enough, but maybe it helped me tear less.

[fingerwoman]

hi truffy, I had a second degree tear and lost a fair bit of blood with ds1
ds2 was bigger, but I only had the teeniest tear which required the grand total of one stitch,. and it was purely external skin, nothing internal.

so, it doesn't necessarily follow that you'll tear again just because you did first time.
I didn't do any perineal massage or anything like that either. though have heard it's very good for preventing/limiting tearing

[Truffy18]

I have heard that perineal massage is good. Didn't try it with ds1. Suppose I hoped that the water would help as I'd heard and read that water reduces chances of tearing. I'm willing to try anything this time however and it can't do any harm.

[Spoo]

Was cut on my first labour for forceps. Second delivery, the midwife pushed against that side to stop it tearing. Seemed to work - I had a very small tear on opposite side. Definately put it in your notes that you are concerned about tearing again and ask them to assist with delivery.

BTW Delivery second time round was SOOO much easier!

[mom2latinoboys]

I had a second degree tear with ds1 and with ds2 I tore along the scar again. It wasn't that bad.

[JackBlackRoady]

I am worried about this too, that's interesting those of you who pushed and pushed tore, I am sure that's what I did first time. I want to put something in my notes too but unsure what to write!
I am due in May too - Truffy18 and KaybeeandZak - there is an antenatal thread for ppl due in May here and it is lovely to ask and winge to others due same time as you! Also, how do you know if they are going to cut you instead of waiting for the tear? Do they tell you?
JBR xxx

[thequietone]

Had a 3rd degree tear with DS. 3 years on and I still bleed when going to the loo, sometimes quite a lot. 4 months after the birth visited chief consultant for the hospital who examined and in his opinion, I should not attempt further nautral births for fear that the damage will be much worse should I tear again. He did admit there is a chance that I won't tear, but if I did, I would suffer further, and permanently worse.
After much consideration, I've decided to have a C section - in about 3 week's time for second child.

[Truffy18]

JackBlackRoady - you'll have to let me know what you write cause I think I do want to add something but not sure how to phrase it and don't know if they will actually take it seriously? Don't want to look like a complete wimp! I'm sure there's worse things that can happen but it doesn't stop you worrying about it does it?!

I always heard that midwives rarely look at birth plans as they are too busy. DO people really think it would make a difference?

[Spoo]

Truffy Please please please write it in your birth plan. MW second time read my borth plan. I was afraid of a forceps delivery and after 30 mins in labour room mentioned that I was scared of doing forceps again. She said ' no sh"t sherlock - you've mentioned forceps three times. She looked me straight in the eye and assured me I would not have forceps delivery again. This reassured me though I realise that she couldn't have really known. I think you should go in this time a lot more confident. If you are worried about it then it WILL affect your experience and perhaps your ability to deliver.

BTW - have you asked to see your previous labour notes. I saw these before giving borth second time and was surprised at the notes as it was not quite how I remembered it. I felt that I had only pushed a couple of times before they said 'oh well we will have to pull it out as she can't seem to push'. The reality was that I was pushing for over an hour, the baby was getting tired and I needed a SMALL amount of assistance to help. If you have issues with your first delivery - you need to deal with these now. Hope this helps.

[Elkat]

Sorry to hijack - but thequietone - Are you doing anything about the bleeding? I'm 14 months post birth and have similar problems - going to the loo can be agony. Getting to the stage where I'm becoming neurotic about it - but can anything be done, or is it just something I've got to put up with?

I've been told something similar to you - about not having another natural birth... and for that reason (amongst others) we're not having any more.

[thequietone]

Hi Elkat,
I've not done anything about the bleeding as it's OK most of the time. It's just that when I get constipated (sorry if TMI), when I eventually go to the loo, it invariably seems to tear slightly again. Doesn't take more than 24 hours to heal again and I just watch my diet. Doesn't help being pregnant again, as this is playing havic with my digestion and the pressure down there is making it worse again.
Off to doctors this afternoon to discuss C section...

[Truffy18]

Spoo - how do you get hold of your previous labour notes? I'd be really interested to read them and think it would be really helpful.