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subsequant pregnancys after 4th degree tear ...what did you do cs or vaginal birth

(26 Posts)
kittenbaby Sun 12-Aug-07 20:11:47

hi girls im still struggling to get over my repair op for fourth degree tears in childbirth.
dd will be 7 weeks on wed
for the first three weeks i didnt feel like i was getting better at all
really would be interested to hear from anyone thats had this and if and how they had anymore children


i did so well during the labour and giving birth
only had gas and air during the labour and nothing at the pushing stage
apart from the fact i was in the water
thought everything had gone so well
after dd was born i delivered the plactena naturally after nearly and hour while bf dd
and i thought thats it ive done it!

then when i was examined the mw said we need to get someone more senior to look at you the look of horror on her face im not sure ill forget
then a sister examined me then a doctor then a surgeon they said i had 4th degree tears
i never knew anything like that existed and that id have to have a spinal tap and a repair operation
i was crying my eyes out even though when i was in labour and giving birth i was pretty silent and just got on with it
i found the examinations far far far worse than the labour and birth
thats was the worse bit
never knew natrual childbirth could do this to you
ive been reserching 4th degree tears on the net to see how long its gonna take me to get over it and to see if i can get any tips
and it doesnt sounds good
it seems as if 4th degree tears are v v uncommon and i just cant understand how this has happened to me
like if i had had an epidural or even pethidine and had lost the urge to push and had to had forceps or vontouse and that had caused it then i could understand why it happened
or if dd got stuck and they had to rush her out , or if she came out the wrong way round
or if i pushed before i was 10cm or baby was really big [dd was 8 4 and a half] i could understand it obv im glad those things didnt happen but then id understand what happened

but i only had gas and air
was on all fours
was in the water
only pushed when i was told to do so
i just cant understand it
there seems no reason for this to of happened
so does this make it even more likly to happen again as there is NOTHING i could do differently next time

been thinking about if id ever have another baby in the future
and wondered what your experiences where? esp regarding cs or vb

ginnypotter Sun 12-Aug-07 20:28:57

oh you poor thing. i had a 4th degree tear after having ds but he was a long labour, epidural, and forceps delivery so i understand why it happened. it took about 6 months for me to feel 'fine' again down there and i still get the odd twinge in the scar 3.4 yrs on, although it's no longer painful.
with regards why it happened to you - i think you are more likely to get big tears when you have a water birth as midwifes can't examine you as easily, and so can't control the pushing/panting bit when the head emerges. so that might be part of the reason why it happened to you, also i think more common to tear on first delivery.
as for your other question - i did have another baby, dd was born 7 months ago, by an elective caesarean section. i asked for a caesarean because of the trauma i sustained during my first birth, and the consultants agreed no problem, some even reccommend it. the caesarean was fine, painful afterwards, but by 2 weeks i was feeling ok - much quicker than after my vaginal delivery.
i'm so sorry you are in pain. have you thought about hiring a valley cushion? they're fantastic i had mine for weeks after i had my ds. most nct branches hire them out. try not to worry about future pregnancies - i was convinced i would never have another baby after my experience with ds, but by the time he was 18 months i was happy to try and go for baby number 2.
i really hope you feel better soon, you're not alone sweetie

ginnypotter Sun 12-Aug-07 20:30:02

and congratulations on you baby girl
you sound like you did so well during the labour - well done you!

ginnypotter Sun 12-Aug-07 20:30:40

your baby girl even

expatinscotland Sun 12-Aug-07 20:31:35

You may benefit from contacting a birth trauma assocation.

You poor thing!

As for subsequent births, honestly, speak to a consultant or two before deciding.

There have been several women on here who had 4th degree tears who needed csections subsequently because of faecal incontinence.

MerlinsBeard Sun 12-Aug-07 20:34:40

sorry, had postedin your post in feeding to say i thought u may be better posting here. didn't know you had already!

chipkid Sun 12-Aug-07 20:39:14

I had a third degree tear. It was caused by the shoulder delivery!

I was advised against another natural birth by two very senior consultants who only had to mention the risk of double incontenence should a further tear of that nature occur to convince me!

But I am a lawyer as is my husband so there may have been an element of over caution. You need to get proper advice which will no doubt turn on how well you have healed etc.

congratulations on your baby girl-try not to let it spoil this special time xx

Bluestocking Sun 12-Aug-07 20:42:02

Congratulations on your daughter, and I'm so sorry to hear what happened. I can really empathise with your feeling of "why, why, why?". You didn't do anything wrong, and it's important that you can get to a point where you can allow yourself to realise that and forgive yourself. But it only happened seven weeks ago and you will still be feeling very raw, emotionally and physically, as well as experiencing the turmoil of having a newborn in your life. My birth experience was very different to yours but I too ended up with a fourth degree tear; I wrote about it on this thread. I would really recommend contacting your hospital's PALS unit - it is so helpful and healing to talk through what happened, and I found that the process enabled me to put the experience behind me. I haven't gone on to have more children, but I wasn't planning to. The obstetrician told me that if I ever did, I would have to have a planned C-section, but to be honest I was delighted to hear it - one vaginal birth was quite enough for me! But I have heard of people who've had bad tears going on to have subsequent vaginal births so don't write it off as a possibility.

CharleeWeasley Sun 12-Aug-07 20:43:35

I had a 4th degree tear with ds1 due to hm holding both his hands over his ears! But i with ds2 i explained this to the midwife delivering him and she ehem 'held me open' during the autcual delivery and i got a tiny scratch and that was it. But its best to talk to your dr in charge in the even of another baby.

Congrats on your little girl.

kittenbaby Sun 12-Aug-07 21:24:38

thank you so much for your replies

ginny- did you have to see anyone like a gyne to have your repair looked at? its good to hear your experience that it took 6 months for u 2 heal i was starting to wonder if i ever heal

does anyone know how common 4th degree tears are ?one australian site ive been on said 0.8% chance of it happening

chipkid thanks 4 telling me ur story

expat thanks ive alreadybeen on there site

blue stocking
i think tbh id feel the risk of having colostomy bag would put me off taking th risk
how are you know do you have any problems still?
thanks for the thread

charlee how are you doing now ?

peanutbear Sun 12-Aug-07 21:33:15

I had this with ds1 I have had 2 more since both Vaginal delivery
ds2 I had stitches but not many DD nothing at all

but I get really scared when I have any kind of vaginal examination dont know why but I have developed a phobia about any health proffesional messing down there, They are really good about it though and give me G&A if I really need it

I think it takes a long time to recover from a 3 or 4 th degree tear

I had no strange things happen at the birth either to up my chances of having a tear

I was offered a CS if I really wanted one for future children but I think you have to make this desicion sometime in the future not when its all so close

Bluestocking Sun 12-Aug-07 21:35:22

Hi again KittenBaby, I am absolutely fine now - I just have a nice tidy scar as a mememto of the colostomy! Having a colostomy bag was a bit grim but knowing that it was only temporary was a big help.

incy Mon 13-Aug-07 12:07:34

You poor thing. I had the same experience with the birth of DS1 - like you I only used gas and air and found the actual labour fine - However, I can still remember the look of horror/panic on the midwifes face after examining me and was rushed into surgery for repair and had spinal block so I sympathise completely.

DS2 is now 2.5 months old and I had a C section second time around -like you, I had a big fear of it happening again.

Apparently the risk is very low of it happening again and I was completely healed but there is a risk of about 2% which was unacceptable for me as I was so traumatised.

As has already been suggested what about talking to the birth afterthoughts team at your local hospital. For what it is worth I was fine until I got pregnant second time round and then became very frightened - they will talk to you even years after a birth and try to help.

You will be referred to a consultant when pregnant again and they will talk you through your options and the risks associated with both types of birth (section and v).

My consultant was lovely and said it was totally my choice - if I had gone for a vg birth I would have asked for a midwife to be present at all times as they can perform an episiotomy if you look at risk of tearing. Personally I couldn't feel confident this would happen (my midwife left me with my husband first time as there was an emergency).

Whatever happens please don't let it put you off a second - my elective section was wonderful compared to the horror of my first birth and I wouldn't hesitate to have a third as my trauma of birth has now gone after such a nice experience.

kittenbaby Mon 13-Aug-07 15:53:07

hi
peanut im just the same i always found going for smears etc painful
but i could manage it

now i feel like i just cant do it
and im sure im gonna have to go for one soon dont you have to have one aftr the baby and its my 6-8 wk check up 2moro and im so so scared of being examined

blue stocking its great to hear how well you are now

incy
thanks for the support
how would you compare the recovery after the cs compared to the repair op?
it will b g8 to hear the views of someone thats experienced both

thanks so much to you all xx

kittenbaby Mon 13-Aug-07 15:57:04

also incy
is it routine that anyone thats had this would see a consultant
or would i have to ask to see one
tbh i think id prob go 4 a cs dont think i could go though that again

incy Mon 13-Aug-07 16:26:17

You should be referred automatically to a consultant in your next pregnancy - however, I did mention it at my booking in appointment with the midwife to make sure it was booked in after my 20 week scan.

At my hospital you saw the consultant at 20 weeks (after a scan) and then another appoitment at 34 weeks to make a decision as to the birth.

After my tear I had an appointment at 3 and 6 months (where they did a scan) to see if all had healed - it had and so I was given a choice as to my delivery by the consultant.

Personally I found recovery from an elective section much quicker than a 4th degree tear - the worst part of the CS op is the spinal block/colostomy bag but as we have already been through this once when they repaired the tear it was nothing new.

It did feel as if a horse had kicked my stomach for the first week after the op but I was fairly mobile and was signed off by my GP for driving after 2 weeks.

I know lots of people have strong opinions on having a CS - I know that the risks of a natural birth and tearing again are fairly low. However, I took the view that I couldn't face it all again and at the end of the day it should be totally my choice as I was the one who would suffer the long term damage and colostomy bag for life.

kittenbaby Mon 13-Aug-07 16:55:52

thanks for all this useful iinfo incy think the reason im thinking bout it is because its my 6 week check up 2moro
how long did it take you to feel better after the repair op
im really really scared of being examined

incy Mon 13-Aug-07 17:07:49

I really feel for you and you seem to be blaming yourself (what could I have done differently) - it is totally not your fault and you should not be left feeling like this - it might be worth discussing this with your GP at the 6 week check as hospitals do have after birth counsellers (ours is called birth afterthoughts).

At my 6 week check I just had to lie on my side and the GP had a look to check the healing progress - it was nothing internal just parted my cheeks and looked (sorry if TMI!!). I said before she did it that I was very worried and she was very gentle and nice. The same happened at my 3 month check up at the hospital and they quizzed me as to any difficulties (eg leakage). The 6 month check up was an anal scan which was not the nicest thing but they can check to see all is healed so worth it.After this I was discharged as no problems.

I would say it took up between 3-6 months to feel better and healed. I still felt very weak/worried for some months. As I said it only all hit me when I got pregnant again and I was terrified of birth a second time.

It is a very traumatic experience and personally I found it difficult to tell anyone what had happened as it was embarassing. I told people after I had number 2 (people were curious as to why the elective section) and I found people very kind and sympathetic.

kittenbaby Mon 13-Aug-07 17:22:17

thanks incy x
its not so much i blame myself though i do think was it something i did
more i just cant understand it
im scared to tell my gp how sore i feel but i guess i have to
but it may help me to talk to someone i guess help me get over all this
im in the process of writing a letter of complaint to the hospital for the hideous treament i recieved when admitted to labour ward
2 mw where so nasty to me
luckily the mw who delivered dd was great and the one that looked after me afterwards
and the surgeon and anisatist sp!
where all great but still needs bringing up in the hope of helpi ng other women in the future

incy Mon 13-Aug-07 17:30:44

Potentially the only person who could have done something was the midwife - if they had seen you were about to tear they may have been able to perform an episiotomy which would have been a controlled cut rather than a tear. There is nothing you could have done.

Certainly mention any pain to your GP they will have a look anyway and she will be able to ressure you.

Big hug.

kittenbaby Mon 13-Aug-07 17:43:34

thanks incy
ill post u on here 2moro to let you how i got on xx

kittenbaby Tue 14-Aug-07 17:09:26

hi incy

had my6-8 week check up with the gp today and baby saskia is fine and well yippie!!!
my gp said baby looks really healthy and well
gp said he thinks dd is gaining weight fine
dd is 7 weeks tomorrow
last week she gained a 8 and a half oz
and this week [well six days ] she gained 6 and a half oz
so she is gaining weight quite well
so bay is great

with me he said he had nevr seen anyone sustain a 4th degree tear the whole time he had been a gp and that it was v v rare
and he just thought i was just extremely unlucky as there seems no reason for it have happened
he was really sweet to me his a fab gp
he said as im going for a check up he felt they wouldnt really be much point stripping me off and examining me
he said that 4th degree tears take months to get over
which in a way made me feel a bit better oddly
i guess because at least its normal that i feel so sore still
feel a bit better about everything thing now
just got the hospital appointment to get through now, he said hs gonna chase it up today
dont know how im gonna go through with the hospital examination but i guess i have to

incy Tue 14-Aug-07 20:07:09

Glad to hear it all went well - it really does take quite a while to get over a tear both physically and psychologically so take it easy and enjoy your lovely baby x

kittenbaby Tue 14-Aug-07 21:05:04

thanks incy xx

Bluestocking Wed 15-Aug-07 20:16:07

Well done, KB, and well done baby Saskia - you grow, girl! Glad your GP appointment went well. Try not to stress out about the hospital appointment - I'm willing to bet that the people you see there will be really kind and gentle with you too. Everyone was really sweet to me when I was undergoing treatment, and there was no shortage of lovely nurses to hold DS (and coo over him in a very flattering way) while I was being examined. Be kind to yourself and enjoy this special time with Saskia.

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