Any reassurance on (gulp) tearing?

[misscreosote]

I'm planning a home VBAC in a couple of months after a pretty horrible induction experience last time ending in a crash C section and both me and DD staying in hospital for a couple of weeks. The only good thing about it is that I'm still intact 'down there'.

We've blown caution to the wind and got an independent midwife this time, so am feeling pretty reassured that, whatever course the birth takes, it will be the right course for me (and baby), if you see what I mean. So I'm getting my head around the pain, the mess, the possible complications that might mean I don't get a nice home birth, and have a hospital birth or another C section, and am generally pretty positive about the VBAC.

But, the one thing I can't quite get my head around is the potential for damage to my lady bits - especially after having read some pretty horrific stories of 3rd degree tears and subsequent complications on here.

I'm wondering, just how likely is a tear? Will it help that I will hopefully have pretty good midwifery care? Has anyone found that the fear of tearing has interfered with their willingness to push the baby out? I'm just panicking a bit, so any reassurance welcome pretty please! Its tempting to go for the elective C section, but I know there are possible complications with that and I'd rather just be happy with all possible aspects of the VBAC attempt really, to give it my best shot. Thanks in advance....

[misscreosote]

Oh - obviously the only other good thing about the C section being my gorgeous DD! oops...

[CaptainKarvol]

I don't know how likely a tear is. Personally I had an episiotomy with my first, and tore with my second. It was a second degree tear, so some vaginal muscle and then skin across the perineum.

I had no idea I was tearing - none at all. I always thought you'd feel it or hear it or something ghastly. But not a clue. I knew I was likely to tear due to the scarring from the epi, but nothing on earth would have stopped me pushing!

It was stitched at home (was a home birth) with local anasthetic and G&A. Totally uneventful (and I'm a big wimp who was requesting a general anasthetic for the stitchy bit!)

DD is not 4 weeks old yet, and I took a look today and it is healed. Just a thin line where the tear was.

So, tearing not always bad. Was less uncomfortable and healed a lot faster than the episiotomy too.

[becstarlitsea]

I don't think fear of tearing will stop you pushing - instinct kinda takes over at that moment, I think! I had a tear myself and it was upsetting, but I'd rather have a tear than a C-section scar to heal from. Baths with a couple of drops of lavender oil helped with healing.

[amidaiwish]

i didn't tear with either of my 2 DDs so it is not inevitable. But as many other posters have said you won't notice it amongst everything else going on.

have you tried perineum massage? it is reported to help prevent tearing.oil

[ilovesummer]

If you are very concerned you could ask the midwife tyo not encourage you to push,it's best not to push as the baby is crowning, just breathe the baby out. Also the midwife could be hands on, and hold the perinium as the baby crowns to help you not to tear and to control the head so that the baby doesn't shoot out. I only know about this as I had a 3rd degree tear the first time and spent a lot of time talking to my mw the 2nd time round to try and avoid a tear, and I didn't need a stitch. I am expecting my 3rd on 3 weeks and will definitely ask the midwife for a hands on approach, I couldn't feel the midwife touch me, I only knew because of the excellent result afterwards. Good luck with the birth.

[fluffyanimal]

Sorry to contradict other posters and put the fear of God into you OP, but I had a 2nd degree tear and for me it was definitely the worst and most painful part of childbirth. However, like others have said, I couldn't have stopped myself pushing even if I wanted to, and the tearing pain, whilst horrible, was over very quickly and the wound afterwards wasn't that painful (any more than I'd imagine a C-section wound to be).
The weirdest thing was that as they said it was a clean tear, I didn't need stitching, and for a few weeks afterwards while washing I was conscious of a very different geography down there which was so bizarre (never had the courage to look). But it all healed fine, and have had no after-effects.

[misscreosote]

OK, phew, you've helped talk me down from the edge! Good to be reminded that tearing per se isn't too much of a problem (and although it migh tbe painful at the time, anything temporary doesn't scare me too much). So, I guess my issue is the likelihood of continiung problems caused by bad tears.... anyone know of any research on this? Also, I'm willing to try the perineal massage, but not too sure whether it really makes a difference, so if anyone knows any links to research on this as well that would be useful.

StarlightM - LOL at designer vagina! It'll be th eonly bit of me that is after all these kids.

ilovesummer (me too - great time to be off on maternity leave, hooray!) - yes, will def. talk to midwife about this. I imagine she will help to calm me down as well, but she's generally pretty positive about everything, so wanted to get some real life experiences as well!

[georgiemum]

Perineal massage www.childbirth.org/articles/massage.html

Keeping upright as much as poss in labour

Do not push/breath at final stages without contraction/surge

[georgiemum]

Perineal massage www.childbirth.org/articles/massage.html

Keeping upright as much as poss in labour

Do not push/breath at final stages without contraction/surge

[misscreosote]

Thanks georgiemum, helpful link.

But at the rates - 75%, and even 69% with massage. Argh!

"Comparison of the group assigned to massage with the group assigned to no massage showed a reduction of 6.1% in second or third degree tears or episiotomies. This corresponded to tear rates of 75.1% in the no-massage group and 69.0% in the massage group"

[reluctant1stimer]

Sorry to put the fear of god into you again but I had second degree tear after being cut and it was almost the worst part of childbirth, the actual worst part was the stitches. They took about 45 minutes and gas and air did not work for me. Maybe I had a bad experience, lets hope so as I usually have a high pain threshold.
I feel bad leaving this post as I don't want to scare you. Personally I chose to go into labour completely ignorant of how much it might hurt as I didn't want to be scared beforehand but you asked so hopefully you'll appreciate both sides.

[reluctant1stimer]

On the other hand, I was all better after 8 weeks, DS is lovely and it works better than it did before, which is fab! It was very very painful though.

[LuluisgoingtobeanAunty]

3rd & 4th degree tears are rare.

are you planning on labouring in water? that can reduce the risk of tearing

i had a VBAC and did not tear.

[MoshiMoshi]

My first time I was induced as had PROM and then had several doctors etc have a good grope as DS was stuck (DH remarked on how it reminded him of the scene from All Creatures Great and Small where the vet has his hand shoved up the cow's bottom). After an assisted ventouse delivery I still managed to escape with a first degree tear. The second and third times, spontaneous natural labours, I remained intact. The difference? Not sure, as I massaged religiously all three times. But I do know that I tried to make sure I did what the midwife said about breathing and pushing! Having looked into hypnobirthing, it seems even less likely you would tear if you let the contractions push the baby gently out without any conscious involvement on your part. But I am not sure whether I will manage to get into a sufficiently relaxed state to let go enough... I am due in three weeks and plan to stay as relaxed as possible and just listen to those midwives! Am sure you will be fine..

[izzybiz]

I dont know if I should be proud of this or not but 6 months ago I had a natural delivery with Ds2 10lb 10oz, and no tear!!
I think his head came through so slowly(excruciatingly slowly) but therefore no tear!

I tore with Ds1 and he was only 7lb 4oz!!
Didn't feel it though, and all healed in a couple of weeks
Try not to worry, its what you are made for!

[PinkTulips]

with dd and ds1 i had labial tears and with ds2 a perineum tear.

with dd they stitched but the stitches had me in agony so with both boys i asked not to be stitched and it was fine, bit tender for a few weeks and the perineal one from ds2's birth feels a bit odd.... but apparently looks good according to dp

the only one i really felt the tearing with was ds2 and he did shoot out even with me trying to breathe him out!

[fluffyanimal]

Starlight, I guess I don't know if it was crowning or tearing - but correct me if I'm wrong, doesn't the crowning cause the tearing? With me there was a distinct sensation of something suddenly giving as ds's head emerged and it hurt like f*!

[georgiemum]

Using HypnoBirthing really does cut down tearing or epesiotomy. Letme get onto the HB Institute and see of they have the figures...

[Gillyan]

Sorry if my horror story about a 3rd degree tear has appeared on here and upset you.

There isn't anything you can do to predict a tear as it depends on so many different things such as your position giving birth and the babys position coming out, the weight and your own body. I tore for none of the above reasons so I'm having an elective section this time. I asked MW about the massaging the perineum and she doesn't think that makes any difference.

I think the only thing you can do if your worried is make sure the babies head is born slowly and don't push if your told not to and ask them to keep a watchful eye on your bits and give you an episiotomy if they think you are going to tear. They think DD's shoulders did me and her head looked fine hence no episotomy given.

I would be happy to listen to my own advice if I hadn't already torn so for me it's a section but I'm not happy about it...if only we could have a crystal ball and predict what will happen hey??

Of all my friends who have ahd kids I'm the only one to have had a 3rd degree tear so it's not like it is dead common. Theres probably lots of threads about it but it's not like people feel the need to discuss a trouble free birth

Good luck xx

[notnowbernard]

I've torn both times

Both 2nd degree tears requiring stitches (1st tore "at an awkward angle" )

HOWEVER

I can honestly say that I did not know I had torn until the MW checked after

Had no problems with the stitches (either during procedure - maimum gas&air again - or afterward, from a healing pov

Sex felt completely normal again after about 8-9 months, but was comfortable from about 5

Both births water births, btw

Good luck!

[misscreosote]

Thanks again all - I've got the midwife tomorrow, so will raise it with her and hope she can offer the same reassurances. I'm planning a water birth, so that's reassuring as well... thanks everyone

[Gemzooks]

misscreosote, I did perineal massage a lot before my first child, (unpleasantly stretching your bits, not actual massage), and it really worked. I didn't tear. Had DD 15 days ago, home water birth and also did not tear. The water birth was great. I would say definitely try the perineal massage, not tearing was a big priority for me. But a lot is down to the position of the baby on the day..