Giving Birth 2nd time_--_--_--after 3rd deg tear& Retained placenta...CS or VB what do you reckon? anyone been there?

[VoodooMama]

Thanks so much, its doing my nut which to go for already...

1st dd was 7lb 15oz, oblique position, I delivered naturally (MW said 99% of primates couldnt have done it )
but ended up epis/tearing 3rd degree, then had retained placenta so had to go to surgery, horrid experience but dd OK, thats all that matters,
would another VB end with me being fecally incontinent? or another 3/4/5th degree tear?
The MW at the hosp. are a mix of experienced and not, so do I trust them for such a tricky delivery?
My stitches and scar are nearly healed now...would a CS be better????
I dont like epidurals/spinal blocks so what circumstances could I have a CS under gen.anaesthetic or am I deluded!!!
Help!!!!

[lulumama]

hmmmmmm..interesting

when are you due?

[VoodooMama]

good question as prob early Dec but could be sooner as I never had a period after dd1 (10mths old)
I reckon I am 7-9 wks,.I know very early days
they will invite me for a scan soon, I am consultant led care due to the complications...

[lulumama]

ok ! bags of time to get sorted 1 just doing some cooking, back in a mo !!

[CoteDAzur]

Sincere sympathies for your painful first birth. I haven't had tears but just an enormous episiotomy, three weeks of sheer agony, and a bad scar that is still not too comfortable.

I can only tell you my personal decision - Next time I get pregnant, I will find convince my gynecologist that I need a cesarean section on psychological grounds (if not on physical ones: DD was 4 kg 10 g, second ones tend to be bigger, especially if they are boys). I will tell him I will commit suicide rather than have another birth with episiotomy (sure I won't, but just to scare him).

Everyone I know who has had c-sections have recovered to reasonable functionality within a week. I was a pathetic mess for weeks, and then took months to feel human. Missed out on the early days of DD and bonding was much delayed.

A quote I like to tell people on this subject: Einstein defined 'stupidity' as doing the same experiment twice and expecting different results. Well, I'd like to think I am not stupid.

Sorry for the rant but I hope that answers your question

[lulumama]

this is what i would do in your shoes!

look into optimal foetal positioning ..

although birthing an oblique baby vaginally is quite something, you would not have a problem birthing a baby in any other position if you can do that !

OFP helps get the baby into the optimum position for birth, and can make labour easier in that respect

Second births are often easier, because your body has done it before, and you know what to expect...tend to be shorter and more copebale with

C.S - well, is it better? well, in some ways yes, and others no ! and c.s under general is not ideal really unless it is a true crash section......also, you will hav a cut in your abdomen , and recovering post surgery with a new born and a toddler, might be hard going

i would look at hiring a doula, to support you and help you get a more positive experience this time..

also, bear in mind, if you would like further children, c.s might make it harder to get a VB in the future, depending on your hospital etc...


if your baby is head down, and not oblique..it should not be a complicated delivery...so a VB should be absolutely fine !

[lulumama]

you certainly have strong feeling about this cotedazur...did you have any counselling after your birth, sound very traumatic...

[VoodooMama]

OFP... Ill get googling.

CoteDazur...those are my initial feelings, but a CS is not necessarily a picnic either..

it is 6 of one, half a dozen of the other, what I would gain with a CS is def. no more damage to my nethers but possibly have a harder time at first...

its hard...

[sniff]

I had a 3rd degree tear and two children since both VB

I was terrified but both births have been much better managed because of history

I asked to be started off both times so not to go to far overdue because the placenta broke up and some retained so I to had to go through surgery after birth with a GA

I would seek advice from your consultant

I chose VB because of being scared of a section
best of luck and if you want to ask me anything at all feel free to

[VoodooMama]

thanks sniff, and kamikazeed you lucky bugger!!!!!!!!!!!!!!

I was induced last time as dd 11 days late, but that meant I couldnt deliver on all fours like I wanted, The OFP stuff Ive read already is v.,interesting, Lulu

[lulumama]

you couldn;'t deliver how you wanted to

all fours is a good postion for taking pressure off the perineum, and good for birthing a big baby.....


i tkae it this is because you were hooked up to drips and monitors etc....

if you are in a situation where you go over again, you can refuse induction until 42 weeks, and ask for monitoring of baby an placenta instead, if you do have induction, you can refuse constant monitoring , and refuse synto first of all, and have intermittent monitoring, start with gel and then ARM.....

so hopefully you don;t end up stuck on the bed

a spontaneous labour,coupled with staying at home as long as possible, gives you a good chance of arriving at hospital without too much delay before baby appears

have you thought about a homebirth? would be more on your terms then...

[VoodooMama]

darent have a homebirth because of the placenta issue..They rushed me down the theatre.

Does retained placenta tend to re-occur? Apparrently I have a heart shaped womb they said makes it more of an issue and harder to clear out?

Should I refuse the womb-closing injection too? Did that make the placenta issue worse as they may have panicked and given it me too early?

[lulumama]

the synotmetrine injection can make a retained placenta a litle bit more likely, so if you wan t to try a pyhsiological 3rd stage, then why not? it works best in the context of a non medicated birth, and also, putting the baby to the breast immediately stimulates the placenta being delivered

by non medicated, i mean, no epi, no pethidine etc

[lulumama]

shape of your uterus might also determine the lie of your baby too

[ZoeC]

Can't help with the retained placenta thing, but I had a third degree tear with dd1 (she was posterior rather than oblique, tried coming out face first in the end). I then had a homebirth with dd2, a midwife who knew how to slow the pushing stage right down but not getting me to push with the contraction but let the contraction work by itself, then I gently pushed inbetween so there was an evenly paced stretch iyswim. Got away with just a scratch from dd2's fingernail. So, whilst there is always the risk of tearing, if you know in advance and plan the management of it then there is no reason why it can't go well.

I personally didn't see how c/s would be a better option given that it is in itself a major procedure with risks to the bladder (my friend had her's perforated during a c/s).

[VoodooMama]

cripes, perforated bladder doesnt sound tasty
.
.
.
.yep lulu, I didnt have an epi last time, just gas and air and peth, and TBH the peth was worthless just made it hard to keep my eyes open.

I need an experienced MW, then, cant gtee that in hosp except for ....
dh's mother is a high grade MW; but I dont know about having her there as
a) will upset my mother
b) if something went wrong I would blame her
c) she would take over completely.

[VoodooMama]

bump...

[KathH]

Hi - I had a retained placenta with dd2 then had a very quick & easy bith with ds1 2 yrs later but then had a retained placenta again with ds2 a few years later - had a very quick birth, actually managed to have him on the bathroom floor! But had to go into hospital afterwards to get placenta removed.

[hk78]

voodoomama. about not being able to deliver on all fours because of being hooked up to machines etc:

i delivered like this with dd1, she was nearly 9lb, and i got away without stitches, i am convinced it was due to the position(before i got into that position, had been pushing for hours with no progress)

and i was hooked up to a drip, monitors, mobile epidural, the works, so dont let anyone tell you it's not possible

saying that, in your shoes, i'd go for the cs (which i did myself with dd2)

[fakeblonde]

Hi
You are at slightly increased risk of having another retained placenta again.With a retained placenta the main risk is bleeding, for which syntometrime (injection or IV ) reduces this risk considerably.
Thats what i thought anyway.
Is there some research to back up that a natural 3 rd stage with a previous history of retained placenta reduces the risk of reoccurrance ? If so i would def. read more into it .
You should see your consultant re your 3rd degree tear,perhaps ask to see the consultant in your hosp who specialises in this department.All the consultants have differrent " interests " or specialiies that they tend to deal with on top of the routine stuff.
He will look at the whole pic and may suggest an elective episiotomy this time ??
I faced a similar decision and all was well next time around,but for me that was a personal choice.I really wanted to avoid having a section .
I still tore but not badly.

[Chattyhan]

I've got a friend who is making a simular decision at the moment. Her son was a forceps delivery after a very long labour who got stuck and she hemoraged (spelling) twice. She has received lots of support from her midwife. They listened to her notes from the labour via a special phone service and had a meeting with a consultant to discuss what went wrong and concluded it was a series of circumstances which led to the problem and nothing essentially wrong with her. She has been advised that she will have more attention in this next labour and will not be left to labour for so long. Any sign of a problem and she will have an emergency cesarean but it has made her more reassured and happy to try for a VB. She has also been advised that they won't let her go overdue and that she will have a sweep 1 week before due date and will be induced on her due date if neccessary.

I know it's not quite the same as you but thought it may help suggest ways you could go from here.

[fakeblonde]

Just read your bit about having a heart shaped womb.Its usually pear shaped so you MAY have what is known as a bicornate uterus in which case your likelyhood of retained placenta along with shape of womb is increased.

[FLIER]

Ask to see your consultant asap to talk through everything. You need to have as positive an atttiude to your birth as possible and to do this you need to be clued up.

I had retained placenta with my first and had to get a spinal, had 2nd degree tear also.
My 2nd birth I spoke to consultant who told me chances were that placenta would be retained again so I would be hooked up to drip and monitored, which I didn't want as wanted as natural as possible and on all fours if poss, due to spd.
In the end I gave birth on the bathroom floor, baby was perfect but placenta had to be delivered at hospital.
I bought the Gentle Birth Metod by Dr Gowri Motha - this teaches some visualisation tecniques which may help prepare you mentally and physically.

sorry for the long msg!
Hope you get the answers and help you need from your consultant/midwives.

[VoodooMama]

thankyou for your experiences/thoughts people,

fakeblonde...I had a 3rd deg. tear and an episiotomy, it was 2nd deg. after labour, then they made it third degree operating to remove the placenta,
I am seeing my consultant on weds. 9th for a big chat, i will see what he reckons but at the mo I am 70 Cs 30 Vb
the downsides of a cs are weighed out by
not affecting my poor scarred bits
not being as utterly exhausting as vb (?) I think
less pain (?) i think
my recovery was over 6 weeks last time as I had 2 d&cs 10 days apart, in the second one they totally unstitched my lovely nearly-healed stitches and re-stitched me,
because of the heatwave and heavy towels I had to wear I got the most godawful case of external thrush which lasted about 3 weeks,
the more I am remembering this the more I think cs, cs,c s!!!!!