C-section after nasty labour, including third degree tear-advice please!

[watercress]

I'll try and keep this brief, but I'm not very good at this so forgive me...

After a low maintenance pregnancy, I had a really nasty labour last time I was pg: went two weeks over, several attempts at sweeps failed, then a nasty induction, culminating in a very long second stage with an epidural, eventual ventouse and a third degree tear.

A couple of weeks later, I thought all was going well, when I developed fissure on top of my tear stitches. Everyone I saw said it would resolve, but it didn't. It became chronic and I ended up having it operated on a year later to remove the scar tissue and haveing it all restitched. This then became infected, so wasn't terribly pleasant either.

I am now pg with DC2 and am seeing a consultant tomorrow. I am very nervous, mainly because while some people (excellent gynae dept at my local hosp and some horrified midwives) have said I must have a section this time round, others have said that I should trial by labour, and there;s nothing to say it will happen again.

My issue is that I had around 15 months of pain with all of this last time round, and I still have to be incredibly careful about what I eat to make sure the problem doesn't recur (I've managed to nip it in the bud a couple of times).

If anyone is still reading, thank you for bearing with such a long post, and do you have any support or advice or stories or hope?

[reikizen]

We offer elective section following a third degree tear at my trust. Check out the Royal College of Obs & Gynae green top guidance on their website relating to third degree tears if you want the official line consultants will probably follow. If you do want a section your medical history sounds as if it would back this request up in my opinion.
Sorry it was so bloody awful for you though.

[engelbart]

Hi Watercress, your message is very timely as I'm currently going through the same thing. Had my dd 4 years ago and suffered a third degree tear. Took me about a year to physically recover- I had loads of problems with the tear, infection after infection, problems with scar tissue which I had to have removed, stitches not dissolving after six months, problems walking, pain having sex etc etc. A really horrible time. Sounds like you have really suffered too.

I'm pregnant with dc 2 and although I'm only 16 weeks have been petrified about the birth since my positive pregnancy test. Had an appointment at the hospital today and after seeing a very junior doctor who seemed to have no idea what I was talking about I insisted on seeing a consultant. He said that he recommended I try for a vaginal birth (just like you) despite me saying there was no way I could go through another horrendous birth experience again. I get really annoyed that these (usually male) gynae consultants have no idea the pain assocated with third degree tears and are so keen to force women to go through a vaginal birth again.

I told the consultant there is no way on earth I will go for a vaginal birth unless a consultant is supervising my labour. I also said that I will refuse to have forceps or ventouse and an episiotomy and that I would prefer to have a c-sectin rather than any of these things. The consultant said he would agree to all these things and a note be put on my note. It might be worth saying something similar at your appointment? (unless of course you don't mind forceps or ventouse).

Good luck with your appointment tomorrow!

[engelbart]

a note put on my records, that should say!

[watercress]

Thanks for your comments, engelbart and reikizen. I'm usually quite an assertive person, but this issue just makes me well up and become pathetic, so DH has promised he'll fight my corner for me with the consultant as well (he usually leaves such battles to me as I work in healthcare).

Has anyone else got any words of wisdom for me?

[biggernow]

Hi Watercress. I am due in 3 weeks with DC2 and I had a 3rd degree tear with DS 2 years ago which has been unpleasant. I have opted not to have a c-section (unless emergency) as I am one of those types who would be more terrified of having major surgery than another tear...(which shows you how scared I am of surgery because let's face it- a 3rd degree tear is completely ghastly)
I have been completely reassured that my delivery will be much more closely monitored- I won't be pushing as hard this time, and also may try and avoid epidural as this is very likely cause behind why I tore coz I couldn't feel a thing. I am TERRIFIED about it all- but neither birth option is appealing, but clearly the baby has to come out....so I am opting for Vaginal birth with standby episiotomy....they have said it is highly unlikely to happen again............

Good luck with your desicion and I am certain they will allow you a c-section if you wish- mine were very happy to book one in...it was me who went white at the notion!!! Each to their own!

Bless you. You are not alone......many broken fanjos out there......

[LittleSilver]

Hi Watercress

Three things to say:

1. I'm sorry you had such a rotten time.
2. You're not alone.
3. I also had 3rd degree tear with DD1 and was offered elCS with DD2 - well, pushed very hard to have elCS with DD2. Like biggernow I am more bothered by major surgery than by the thought of another tear so declined it and had a VB - 1st degree tear only. With DD3 I got round being pushed for CS by declining to see any medical staff at all. DD3 born intact perinuem except for labial grazes (ouch ouch ouch!)

BUT. Incontinence has been an issue and has got worse since birth of DD3. I am very much undecided as to what I will do for DC4.

That's not terribly useful "advice" is it? I am sorry, but I hope my experience may help you come to a decision as to what you want to do. Incidentally, I am sure you would get a CS if you pushed (no pun intended) for it. Good luck.

[is3morefun]

Hi Watercress, you poor thing! I had an ECS with my third dd this time last year. I'd had 2nd degree tear with first and third with second so looking at odds was a bit worried about what would happen third time around. DH and mum were also worried about what I would have to go through again. Obs team needed persuading but not too much to give me CS but baby was breach any way. I was really scared about CS but really glad in the end. I can honestly say that within a week pain was OK and after 2 weeks I was up and down to school with a 2 1/2 year old and baby in a not very light P&T pushchair with little problem and after 5 weeks totally pain free. Admitedly took till after the christmas holidays to feel totally normal again but if you don't have to do a school run you may get better quicker. This is really long too but thought I'd give you the other perspective. Hope this helps.

[Oumasrusks]

I'm sorry you had such an awful time Watercress. I can related to it!

I had a 3rd degree tear with DD1 as she was born after a horrendous forceps delivery. I was terrified of a repeat when I fell pregnant with DD2 (who was born 13 months later). I was not offered a CS at all with DD2. I kind of just went with the flow and it was a much better birth and no forceps were needed and I only had a 2nd degree tear. I couldn't believe the difference between the two births!

However, if I fell pregnant again, I would go for the CS as I've read articles online that suggest that even if the birth after the 3rd degree tear is okay, this increases the risks further of incontinence later.

What happened at your appointment with the consultant?