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Birth after a 4 degree tear?

(17 Posts)
xbblx123 Thu 19-May-16 21:46:34

Hey people!

Just had my first midwife appointment I'm 9 weeks and my midwife said because of i had a 4 degree tear with my son 2 and half years ago, she said a consultant with discuss the possibility of having to have a C-section? But I really don't want to this is baby number 2

Mummyme87 Fri 20-May-16 08:10:21

You may be referred to urogynae who will discuss your recovery from tear, may offer an endoanal scan to assess muscle function. If any concerns they would advise for CS.
If you have no issues with bowel and bladder function and want a vaginal birth then that is what you have. Risks will be discussed with you. You need to take in to account lots of things like mode of birth last time, was it an instrumental and did you have an episiotomy.. Both risk factors for 3rd and 4th degree tears

laura909090 Fri 20-May-16 08:37:07

I'm in the same situation, 19 weeks pregnant after a 4th degree tear. My consultant did no scans, but straight away highly recommended c section this time. Even tho I've no damage from the tear and I recovered really quickly she has said that the rate of incontinence if I tear again is so high that she will never recommend a vaginal birth. She also said they can not repair scar tissue as well as they did the first time round, hence the risk of problems. I'm gutted to be honest.

xbblx123 Fri 20-May-16 08:50:43

Thanks for your help.. I really don't want to have a C-section, it did take me about 10 weeks to be totally recovered but I had low amniotic fluid too so probably didn't help, I guess I will have to wait and see what they say..

laura909090 Fri 20-May-16 09:02:47

I really don't want a c section but the consultant was so negative about trying for a vaginal birth. I know ultimately it's my choice but when she's asking whether you would want to go out with a changing bag for the new baby and a change bag for yourself it puts you off.
The consultant didn't even go into the risks and how likely a tear again is. Plus they said that the 4th degree bit of my tear was fairly mild, in that it was 100% 3rd degree with a small amount of 4th degree tear but a normal birth still isn't recommended. So hard knowing what to do isn't it.

Boosiehs Fri 20-May-16 09:06:36

You are brave women to want to go through that again with the serious risks to your health!

I had a v bad first birth and actively requested a c section for my second. Best decision ever. Really easy recovery, much quicker than first vaginal birth! Good luck with your choices, but a section really isn't bad. X

xbblx123 Fri 20-May-16 09:09:46

Yeah I understand I guess I will have to wait and see what they said when do you see the consultant? I suppose the most important thing is that's mother and baby are okay, I have a 2 and a half year old so need to be back on my feet asap after this one

Cakescakescakes Fri 20-May-16 09:13:43

I had a 3b tear (induced, horrific, needed surgical repair in theatre). I was offered the option of what to do with my second baby. I chose to try a normal delivery and had a fairly quick and straightforward labour with just gas and air (although it was another induction). The midwife did a small episiotomy to protect my previous scar tissue from tearing again. This healed up fine in a couple of weeks. Baby 2 was over 10lbs..... Weren't expecting that ha ha!

I agonised over it for ages though. The consultant said it was up to me. I was concerned about the long term damage but I also was worried about CS recovery with a toddler to look after and little family support. I was terrified of labour but a positive second experience really gave me closure over a truly horrendous first labour where I genuinely (and non flippantly) thought I was going to die as it was such a catalogue of nightmares.

Minkybinkyboo Fri 20-May-16 09:14:31

Take as much advice as you can. I had a 3rd degree tear with my first born and had an elective c-section 10 days ago with my second. I was really concerned about recovery with having a two year old at home but it's been a lot easier than I thought and certainly easier than last time.

MerryMarigold Fri 20-May-16 09:16:21

I had a third degree first time. Next time I wanted a planned c section. It was v lovely and if I ever had another child ib would go c section all the way. The recover was much much better for me. I had twin babies and a nearly 3yo but it was a lot better than the first time. I have a friend who had a third degree twice (with a 11 year gap). The second time there were major problems and she's had so much surgery/ pain etc as opposed to the c section which is relatively quick recovery. I personally wouldn't risk it unless there are v obvious reasons why you ended up there last time and the assurance that it would be entirely avoidable this time.

laura909090 Fri 20-May-16 09:24:53

See this is what's putting me off too. In my case there was no reason for my tear, no forceps etc and only a 7lb baby so I do wonder if it's more likely to happen again. Think we are decided on c section, but I'm dreading it because my recovery from the tear was so good and also because I'll have a 2 year old at home. As long as we both come out in one piece I'll be happy!

laura909090 Fri 20-May-16 09:27:13

Also in reply to your question, I saw the consultant around 12 weeks and am due to go back about 22 weeks to make my decision and put everything in place ready for if I have c section. I kind of figure that if I'm consultant led anyway I'm not going to be able to have the nice floaty midwife led water birth labour so may as well go with c section!

Equimum Fri 20-May-16 09:32:06

I had a 3c tear first time (no reason) and really wanted a vaginal birth second time round. My consultant was completely happy with this and everything went pretty smoothly (I did get a 2nd degree tear, but baby was 10lb and in superman position.

It's interesting hear that so many if you were advised to have c-sections. The lady in my BCt group who had a 4th degree tear first time (with no lasting issues) was offered a c-section, but advised to try to a vaginal birth ideas happy to do so. She didn't have a single stitch this time and both babies were big boys. Maybe different doctors have different vies in this?

xbblx123 Fri 20-May-16 09:57:17

See there's so many pros and cons of normally delivery and C-section, I'm really don't know what to do or think, I suppose it's something i will have to think about and discuss with consultant ect.. thank you anyone for your story's x

MissElizaBennettsBookmark Fri 20-May-16 11:13:27

Had forceps w huge cut for first birth. 2nd was emergency Caesarian - not my choice - but I found recovery a lot easier than my 1st birth, albeit got tired more easily.

MissElizaBennettsBookmark Fri 20-May-16 11:14:04

Whoops, posted too soon. Meant to say, good luck OP... flowers

OhtoblazeswithElvira Fri 20-May-16 11:30:01

Forceps and 4th degree tear with Dc1, repairs in theatre. Have recovered quite well considering all that but things are not and will never be 100% OK. Took me weeks to walk normally, be able to sit up / down / walk the stairs carrying baby etc.

I read up about this (mumsnet, NICE guidelines, BMA reports) and found that indeed the chances of incontinence are so high with a vaginal birth after 4th degree tear if you have symptoms (1 in 4 I think).

The consultant recommended a section without hesitation (the possibility had been laughed off by my midwife who "lost" my referral 3 times angry).

I had a lovely elective cs with dC2; was dischaged sooner; establishing BF was so much easier than the first time (baby wasn't bruised and angry, I could sit down!). I was able to walk, carry baby, move about from day 1. I took paracetamol for a few days - compare with a bread bin worth of medication I was given on discharge with DC1 (2 types of strong painkillers, antibiotics, movicol etc).

Do inform yourself so you can make the best decision for you. It's scary to go under the knife but for me it was the best decision due to the bad long-term prognosis incontinence-wise.

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