To ask for experiences giving birth after a bad tear?

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I had a grade 3c tear with first baby. I recovered well but am left with some permanent damage. I am now pregnant again, and wondering whether to go for caesarean or vaginal birth. There will be a 2 year gap between the two and I'm 38.
Obviously I don't want to make things worse down there and end up with incontinence or sexual problems. I think I was really lucky to recover as well as I have following the first.
I don't really fancy a caesarean (being a bit squeamish) but I know if I go for another VB I will have a 5% chance of another bad tear and if that happens there's a chance of worse damage. (I have been told I can choose ELCS if I want).
Has anyone else had a second vaginal delivery after a bad tear and what were your experiences?

I had a 3b and every professional I asked said it was my choice. I asked their personal opinion and they said c-section. I went for the c-section and it was the best decision I made. I appreciate it’s a major op and some people have a more difficult time recovering than I did. My experience was positive though and the best thing is everyone expects you to rest and recover whereas with a big tear you’re expected to get on with it more! I think the chance of recurrence is higher than 5% but maybe check.

3B here. I have also been told that I'd have a choice with subsequent births - but like you, I'm really unsure what's for the best. At my last sign off, I was told that I had healed well and should feel confident to opt for a vaginal delivery in the future. But at the time, the doctor who actually delivered my baby and had to sew up the damage said "next time, definitely go for elective c-section". I'm probably leaning more towards a reluctant ELCS, as at least you can plan for that - which seems more important when you already have one child.

Sorry - that's not much help. I'm interested to hear what others say!

I don't think this is helpful exactly, but I know a few people who had third degree tears and all of them opted to have elective sections for subsequent births. It might be difficult to find stories because I get the impression the vast majority have sections afterwards.

3rd degree tear here - baby no breath g dragged out quick so grateful. Birth 2 years later one stitch. They really seemed to take it into account and managed my birth differently they said-11 years ago bit hazy on what! Such a different recovery the second time though I healed well from the first. I was offered c section elective but said no. They said they d do an emergency rathe ethan 'drag out' another which I consented to. I was really fearful of not being able to drive and the longer stay in hospital. Difference between 8 hours and 2/3 days at the time so was keen to avoid
c section. So I guess what I'm saying is it isn't a given you ll have another tear but your wider situation/feelings might mean you make a different diecsion x

I don’t know what constitutes bad. I had to have 10 stitches after DS1. The others were born quickly and without incident at home, no repeat of the tearing. Not sure if that helps at all, but I hope it goes well for you.

Also interested to hear experiences. Dh and I have just decided to try for dc2. I had a 3a with our first and I've just bought this topic up with dh who breathed a sigh of relief and said "thank god you've said that, I would be so worried of you having another vaginal birth, I saw the tear the first time!". If I were to tear again, chances are if would be more than a 3a and there isn't much more to go before its really dangerous and requires major surgery.
As much as I would like to have a VB, I think I will be opting for c section following conversation with dh. I also remember the midwife telling me to have a c section next time.

Personally I was lucky and I've never had 3rd degree tear but I know someone who did after a forceps birth

What she decided was that the tear was likely due to the forceps so she went for a normal birth but that if forceps were indicated then she would go for a section (obstetrician was happy to agree with her plan) - she had a normal birth with a small tear which didn't cause any problems (can't remember if she said she didn't need stitches at all or if it just just one)
She also said she wasn't being induced either - so if she went over she was going to have a section , but went into labour the day before her booked section - she said the two births were night and day to each other and was glad she had a normal birth - however other women will say they were glad they had a section. listen to what your gut is saying.

First birth had a 3b Tear second birth 2nd degree tear. 2 months post birth and everything is back to normal and no issues.

I had a 3b and some other complications. Had an ELCS the next time - it was so much easier in every way! Delivery, recovery, everything. I'd do it again any day of the week.

I had a 3b tear. I healed well, both in terms of immediate recovery and tests they did about 8m later. Different professionals had different views. I chose to have a VB. They had this special bundle and advice for the midwife second time round e.g. advised she pushed against the perineum when I was giving birth (I think, not explaining well) and having special scissors available so they could do a (better) episiotomy if necessary.

I gave birth in the birth centre (within the hospital). I had some minor tearing and was home 10 hours later. My friend had a similar experience.

It's a tricky decision to make. Have you had/been offered tests about how wellnyou have healed?

To the PP saying they thought it was higher than 5%, I read your risk is 7% if previous 3rd or 4th degree tear, so possibly 5% for 3rd degree? (In comparison to 2% with no prior tear). I decided in my case I was happy to take that risk. However you talk about permanent damage, so you may feel differently. I also felt that at the end of the day I could deal with it happening again.

I had a 3a tear, and a PPH. I didn't go for a C-section for DS2. Mine was 'only just' a 3rd degree tear, and I didn't want a c-section. Midwife and Dr both said I'd be fine to give birth again, and wrote me a special birth plan with 2 midwives and a drip on standby.

DS2s birth was a really good, though quick experience (1.45h labour). Had a 2nd degree tear, got stitched up by the midwife and then was allowed to go home at bedtime. I was pretty much back to normal the next day.

I’ve put this on a few threads recently so you might have already read it! I had a 3b tear with my first when he got stuck with a shoulder dystocia during his waterbirth (I was 33). Second was due three years and two days after the first’s birthday and I asked for a section and was booked for 39+6. However, I went into labour at 38+6 in the middle of the night and when I got to the hospital, the surgical team were already doing an emergency. I progressed so quickly that I had given birth vaginally an hour after arriving. I had only a couple of stitches and was home before he was twelve hours old. First baby was 7lb 4oz, second was 8lb 9oz. I was driving the next day! The midwife offered to be much more hands on at the point of birth with the second and I think that made a difference. The first was a waterbirth so no intervention until they realised he was stuck.

Thanks for replying. Interesting to read other views and experiences. I had a very medicalised birth last time, had to lie on my back throughout, and ended up with ventouse, so I kind of think if I could have a more natural birth things would probably go better. On the other hand I don't have very stretchy skin and am also an older mother, so who knows.
I would be ok with the risk of another tear, as long as it didn't cause more severe permanent damage! C section is not without risk either although not to the same area of course! Leaning more towards what @iolaus mentioned, having a c section rather than an induction or if any other complications develop.

@BendingSpoons no haven't been offered any tests. What sort of test do you mean? I have had physio but no one has done a pr exam to check things have healed properly. From the outside I think things look ok according to physio.

I had a stage 3 tear with my middle son, Was awful I literally shit myself for a month after giving birth, I had a stage two tear with my third which was easily managed in comparison with painkillers and was fine after two weeks.

This happened to me. Def have the section. I had two sections after my first birth and don’t regret them for a moment. It was so calm, I was in hospital less than 48hrs (was in 6 days with my vaginal birth) and felt like I really enjoyed my baby. I was scared and unsure what to do but the section was def the right choice. You don’t want to end up with a lifetime of continence issues.

3rd degree tear on my first, was in physio for months. My mw told me that I should have a vaginal birth when pregnant 2 years later. On my appointment the day after my due date I told the mw covering how nervous I was and she booked me in to see the consultant as she believed that I should have a c section. I went into labour 2 days later and number 2 was born in less than anhur of me getting to hospital. No tears and he seemed to right any damage my first had done! Number 3 came 17 months later and another vaginal delivery. No stitches again

DC1 was forceps, episiotomy and tore internally up to my cervix, an hour being stitched up afterwards and a prolapse diagnosed 6 weeks later.

DC2 (2.5 years later) gas & air in the pool, not even a graze. I had the prolapse surgically corrected after DC2 when our family was a complete and not had any further issues.

I had a 3C tear, water birth. Took months to recover and I still have some issues tbh. Opted for CS for the next and don't regret it. I'm squeamish too and the CS was quite weird and unpleasant, but recovery was so much better.

How many years down the line are the people who had multiple vaginal births with at least one severe tear? Because my concern would not just be in relation to symptomatic injury post partum, it would also be about the microdamage etc that could contribute to POP, incontinence etc many years down the line. Even without severe tearing the risks of POP/ UI etc are significantly increased by vaginal birth earlier in life and that risk significantly increased again for a second vaginal birth. I would imagine, but I don't know the research, that the evidence is particularly stark if you only consider women who have had 3+ degree tears in one or more of their births? Something to discuss with consultant maybe.

My DC2 is only 12 weeks. I might have made a different decision if I were older but I was 28 and 32 and in otherwise good health so I figured my body was still relatively "springy" (highly technical term!) and I'd have time for it to go back to normal/exercise before I started having anything age related to deal with.

I had Avery had tear to with my first. I gave birth naturally to a 9 pound baby with a huge head 2 years later and had no problems. Healed perfectly and no lasting damage.

I had a 3rd degree tear with my first and was advised against having elective C section with my second. I ended up having episiotomy and emergency forceps delivery which was brutal. I had to hang on to the bed to avoid being pulled down. Pain and bruising for weeks but they did a very good repair job and I've never suffered incontinence or any other problems. Next births were straightforward with minimal stitches. Seem to remember a midwife telling me it's easier to heal from a tear than a cut. Personally I found the tear less painful but could be because forceps were used the second time. I can't believe they still use forceps.

3b year here. I asked for an elective section and it was the most stress free experience imaginable. Recovery was easier and less painful than recovering from a tear. I was also terrified of damaging my pelvic floor even more than it had been already.

@MeadowHay has also raised a good point, in that pelvic floor damage sometimes only makes itself known much later in life.

I had a bad tear, episiotomy and extensive stitching with my first DC - totally natural birth, but he was HUGE. I will never be the same down there, but it's functional!

It didn't occur to me to ask for a Caesarean with DC2, and no one suggested it. DC2 arrived much quicker and more easily even though she was also pretty large. Minor tearing but no stitches.

I think DC1 paved the way :)