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unrepaired tear with dc1, do I really have to have a cs next time?

(8 Posts)
Hulla Thu 15-Oct-09 17:47:16

DD was born in Jan, I had a 3rd degree tear (rotational forceps) which was classified and repaired as a 3a (<50% of external anal sphincter). I have had continence problems ever since and follow up investigations have found that my tear was infact a 3c (100% external anal sphincter & internal anal sphincter).

My internal sphincter is unrepaired, my consultant has said its very difficult to repair as he'd have to go through my external sphincter again which has healed well. He has told me I cannot have a vaginal delivery again and this is absolutely breaking my heart.

I know, on one hand, it sounds so silly to be upset about this but I can't get over the fact that I'll never be able to give birth myself. I wanted a home waterbirth and this will never happen. Everytime I think about it I cry and no one understands. My family think I should be pleased I'll never have to experience contractions again, or the tiredness of labour and while I know that labour wasn't great I don't know how to live with this..

I was too upset to think to ask my consultant what would happen if I actually attempted a vaginal delivery. Does anyone know? I am half tempted to try - afterall, I'm already having problems and if I did tear again at least they'd be able to repair my internal sphincter! smile

Does anyone have any experience of this? I see my consultant again next month so he should be able to tell me why I have to have a cs but if anyone has any info in the meantime I'd be very grateful. It's all I think about.

Hulla Thu 15-Oct-09 18:11:01

Oh and I should have said that I am not even pg but this is putting me off having more dc. We always wanted a large family but I just can't bear the thought of a cs "just incase".

Fayrazzled Thu 15-Oct-09 18:19:59

I think the risk from the consultant's point of view is that if you suffer further damage you could be left with long term continence problems. TBH, I'm looking at this problem from the alternative perspective: I had a 3rd degree tear during my second labour and I would only get pregnant again if I knew I could definitely have a c-section. The thought of being incontinent, possibly doubly so, frightens the bejesus out of me.

But given where you are, I think you need to discuss this with your consultant again and really understand what he considers the risks to be and the likelihood of those risks occurring. Only then will you be able to potentially make peace with this. If the risks are low, they can't force you to have a section if you don't want one- but if I were you I'd really want to know what the prognosis is likely to be for the best and worst case scenarios and all in between too.

Good luck.

Hulla Thu 15-Oct-09 19:13:20

Thanks for replying Fay. I think I really want someone to tell me it'll be fine but I know it probably won't be. I have to just accept it don't I?

I wish I knew why it mattered so much to me or that I could get over it. Perhaps by the time we are contemplating more dc I'll have come to terms with it. I will as my surgeon anyway but I think he's unlikely to change his view.

Thanks again

LittleSilver Thu 15-Oct-09 19:40:40

Hulla, yesterday I posted on something very similar over in Health - Sphincter nd Raggedy Bits thread.

I do know how you feel, I really do. I am considering the same issues as you at the moment. I can't bear the thought of not going through labour and birth again either, the thought of a CS is just so depressing, I don't care what CD they'll let me put on, it doesn't come close to the euphoria and achievement of labour. I don't have any answers, but every sympathy to you. Have you discussed this with a colorectal surgeon or just an OB?

Hulla Thu 15-Oct-09 20:24:51

Both, the Ob said no problem but failed to tell me that my internal sphincter was still torn. My colorectal surgeon said all future dc by cs. I suppose if I understand what might happen I might come to terms with it. I don't know the know the euphoria or sense of achievement of giving birth really - dd was pulled out by her head! I think that's my issue, I want to be able to do it.

I post on the ragged bits thread - I replied to you today! Thanks for posting here, it helps that others understand.

hopingforahomebirth Thu 15-Oct-09 21:27:51

Hulla, I don't have any advice as such but just wanted to say to say that I understand where you are coming from. I'm currently planning a HB (I have a thread on here too) after a 3rd deg with my DD (now 2.3 mths). I also do not want a C-section which can sound insane to others who don't feel the same way..

It's almost as if the Dr is on one hand offering a safe procedure (CS) that will cause a few weeks of discomfort versus future incontinence. What would you choose? Well of course the sensible option seems to be the CS... except that you want to be sure that they are looking at you as an individual and that it's not just 'policy' dictating their view. I totally understand that fear.

It may help to remember that you don't HAVE to accept a CS, it's your decision.

From the reading I've done it could be the fact you are experiencing symptoms that is influencing your Colorectal surgeon's view here? Put baldly, he/she will primarily be thinking of minimising risk of further damage to your Schincter, not your feelings on vaginal birth. And to be fair, that's their specialism.

It's a horrible dilemma, I really, really sympathise. There seem to be quite a few of us posting on this subject at the moment which is v sad.

Hulla Fri 16-Oct-09 09:24:19

Thanks for replying hoping. I had a good think about it last night and I while I can rationalise that the safest thing (in terms of risk to my health) would probably be a CS. I was talking to dh about it this morning and got upset and he said I have to do whats best for me (meaning have a CS) and I said the best thing for my body isn't neccessarily the best thing for my mind.

I feel as though everyone I talk to at the hospital has their own slant on it (which of course they do) and I would like more objective information. I am thinking of speaking to the woman who did my hypnobirthing course. She is a former mw and so may be a bit more impartial.

I guess I have to decide if its worth the risk. Right now, I have problems anyway and I wonder if being pg would cause as much damage as giving birth naturally. No one seems to be able to tell me if being pg will make things worse.

My community mw said she thought I should have been given a CS with dd because of the damage rotational forceps cause. At least then I could be looking at VBAC but now I just feel like I have no option and its putting me off ever having anymore dc.

Oh why didn't I have "No forceps" in my birth plan. I wish I'd taken more control.

You're right, there are far too many of us in this situation and it is extremely sad.

Thanks again, it is a real help to be able to talk to someone who understands.

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