to be pissed off at hearing how "third and fourth degree tears" are rare by people on here, mainly doulas.

[ebd]

I had a third degree tear with my second ds and have since found out that third/fourth degree tears are actually more common than people realise. I know 5 people in real life who suffered serious tearing (out of an antenatal class of 14)and my midwife and health visitor tell me they see women with these type of injuries on a regular basis. My consultant even specialise in repairing women who've experienced this. So when I read on childbirth threads that third/fourth degree tears are "not very common" it gets my blood boiling. It is common for posters with no medical experience to make this sweeping statment and although I will get flamed for saying this, it is mainly doulas who quote this to women worried about tearing or women who have had a third degree tear and are worried about it happening again. There is one poster who is a doula who just quotes the "it's very rare" line all the time". It really pisses me off. I wish these type of tears were rare but they're not. One consultant gynae friend told me that often hospitals will "massage" the figures and say a woman has had a second degree tear rather than a third as if lots of third degree tears are reported, doctors can be investigated. I know mumsnet has a disclaimer that they haven't checked the medical qualifications of anyone posting, but I think posters with no medical knowledge shouldn't be spouting claims which are factually incorrect.

I'm reading this thread, and consider myself to be reasonably intelligent, but EBD, can you please explain to me why it would be better if we scared the life out of pregnant women by telling them that most people tear really badly most of the time?

The idea of someone feeling 'marginalised' because of this is ridiculous!! Speaking as someone who has suffered a 3rd degree tear, I can't say it worries me that I can't compare my fanjo with too many others.

Depending on who you talk to, these tears are described as rare, uncommon, never happening.

Hazey, don't think that's usually the case. I had a third degree tear stitched up by the midwife.

Of course, had she actually been around while I was in labour, rather than having to deal with seven women on her own, I might not have torn in the first place...

When I had dd2 I went through my notes at length with a MW, because of fears about tearing again, I'm sure the statistics of recurrence were something like 4% of women who had 3rd degree tears had subsequent bad tearing.

It would have helped me before I gave birth to know that it is possible to tear badly in childbirth and that there are things you can do to avoid severe tearing. Knowledge is power. Instead I had no idea. If I had known that trying to push out a 10 pound baby for 6 hours with nothing happening was a bad thing, I could have insisted on a c-section.
Also, as i have said about 3 times, its not about scaring first time mothers its about not telling women who've experience this type of tearing that its rare. However, I must admit that I have told my pregnant friends (without putting the fear of god into them) that they should avoid forceps. Unfortunately, one friend had no choice, had a forceps delivery and fourth degree tear.

sorry, I didn't realise that about sphincter injury. It took 2 hours for me to be stitched up in theatre with a spinal, I can't imagine it being done by a mw, that's awful. I think I was very lucky.

Not something I've experienced myself...

But 10% or even 4% can't be described as rare. 1 in 10, or 2 in 50, that's a tangible risk.

I also think that the idea that women need to be protected in some way from knowing the possible bad outcomes as well as the good, is all too prevalent in childbirth, BF etc.

Women should be given the facts and statistics so they know. If there is a 4% or 10% possibility that a vaginal birth will result in a serious tear then why not mention it. It is patronising and unfair to do otherwise.

I've worked in a Mat Unit about 1.5 years, and have only ever heard of 2 fourth degree tears, but heaps of third degrees.
(I only work PT though, so obv more than 2 in that time.)
I would rather not have known as a primey the very worst that could happen to my lovely perineum. (Epis and 1st, as it happened.)

Message withdrawn

People talk about it all being natural, and how everything would be better if we were in the good old days where girls would have seen women giving birth and so would be better prepared etc.

And yet aren't prepared to talk about the bad as well as the good, which if you had witnessed births a la the good old days, you would certainly know about.

I will make damn sure my daughter knows all the facts, without scaring her, if she ever gets pregnant. I couldn't bear her to suffer like I did after giving birth. I'll even be in the delivery room, if she'll have me! I do not see how the ignorance is bliss line which is often trotted out to pregnant women will help. A couple of friends who have given birth and had tearing are actually quite angry at me for not warning them more about the risks. It's a shame midwives and ante-natal classes don't promote a more realistic picture. If for example you were having heart surgery you'd surely want to know the risks so you could be prepared, make an informed decision etc so why should giving birth be any different?

Christ. I've just been and had a read of that thread. I had no idea. I'm glad I didn't because it would have frightened me silly. I had a forceps delivery and an epi but have had no problems.

I can see your point OP now. Perhaps its not so much a conspiracy of silence as an issue of total neglect of the problem by the medical establishment because its not something people will shout about. Dreadful.

not really to do with anything, But i tore upwards. If you can imagine. had reconstructive surgery but consultant couldn;t do anything about that tear cos apparently the scarring would be worse. So am figure of 0 instead of 8. Hmm. Didn't have MN at that time. would have loved to been able to ask about it.

I am sympathetic ebd to what you are saying. I think your post is being interpreted as an attempt to put another bad spin on childbirth. I'm sympathetic to people's concerns about that too. We all know that people can have wildly differing experiences of childbirth - some fantastic and some diabolical. The more negative outcomes can be a result of negligence, poor support, or plain bad luck - the positive can be a result of inner confidence, great support or simply good luck.

I know what you mean when you bristle at the well meaning and reassuring phrase "but, remember this is rare". If you've gone through the "rare" experience it's hard not to interpret that becalming phrase as almost "forget about that, it probably won't happen to YOU" - and the truth of the matter is that that IS more often the case. BUT it is going to happen to someone and the "rareness" of this can be quite subjective.

I always struggled with statistical probability. The fact that a 1 in 200-300 chance of uterine rupture during a VBAC was deemed to be "small" (allied, of course to the fact that it might not be a true rupture just a bit of dehisence (sp?)). To me that was NEVER small but I went for it anyway. However, when I was looking at vaccinating my child and viewing the statistics of possible vaccine damage that was 1 in tens of thousands I became uneasy about taking THAT "much" of a risk.

You've had a shit experience ebd - I don't think you are trying to sabotage everyone else's chance of having a good labour by mentioning this unease that you feel. I think there should be a little more sympathy for you on this thread but I also understand that people don't want every would-be Mum being paralysed with fear over this potential problem. Afterall fear can stall a labour, which leads to intervention, which can lead to injury etc. etc...

I guess it's all about women being able to be frank about their experiences. I imagine that you feel marginalised when it feels like people are trying to quickly shoo you off onto your own birth trauma board. And I can also imagine your anger when you hear the "doulas" and others on this board bigging up all the positives of childbirth (but what else would you expect them to do - everyone knows (I think?) that many are not medically qualified - it's more about the emotional support that makes all the difference to the birth surely?

I know people aren't deliberately dismissing what you have gone through in a callous way but I am sure it can sometimes come across to you in this way.

I hope you are recovering well and that you will be able to leave the childbirth boards alone soon! I am glad that I have eventually reached the point where I choose to ignore them. It took a while believe me. And I am a happier person for it.

never heard of anyone that has suffered from one

and I go to an nct group

and have alot of friends who have had more than two children

mayeb the midwifes in your area are really shite
because I do believe that the midwife plays a big part in a good delivery

I get what you are saying. I had a 3rd degree and don't know anyone else who did so I'd guess it is rare, but I tore because I freaked out and pushed at the wrong time, I wish I had been prepped more about the pushing stage and the potential risks, at the time I thought it was great I got him out so quickly, until I realised that's why I tore so badly. Next time I'll go much more prepared and do my fucking best not to tear like last time, so I'd say YANBU!

Agree with Hedge - my 1st experience included a "bad" 3rd degree tear; but it was taken very seriously, fixed in theatre under spinal, and I had a follow up with a uro-gynae consultant 6 weeks later.

Here in Oz, the consultant sees the tear alone as a reason to have a c-section next time, whereas to me it paled compared to most of the rest of my labour experience, and I don't remember it being impt (but they DID do an amazing job of stitching me up ).....

I think you have had some callous remarks here, and I think there has to be a middle ground between 1st timers knowing everything that's on the sphincter thread, and knowing enough to know that it's a possibility, and that by remaining calm and having an idea what to expect, they might be able to by pass some of this.

Although you can't really bypass the lochia!

It would all be far less terrifying if it was presented as just part of the deal, rather than left to new mums-to-be to find out via individuals scarey experiences on here.

Oh, and btw, my understanding is that a 3rd degree tear should always be dealt with seriously, as mine was. 30 years ago it was given to students to do as practice!

Apologies for sp. and punc.....

I'll stick my neck out here and answer as I am a doula. (Not the one mentioned) I think it is important to remember that all kinds of things can happen in childbirth, and when bad things happen to you it doesn't matter whether they are rare, common or you are the only person it has ever happened to. It just bites that it happens to you.
If a mother goes into labour terrified and convinced that she is going to tear it may have some bearing on her birth. I'm not saying that mothers shouldn't be well-informed, but perhaps being given realistic figures on tearing (and what can be done to HELP prevent serious tearing) would be more useful?

May i just point out that in bruxeur's link it doesn't say that 9% of women giving bith have a 3rd or 4th degree tear. It says that 9% of women who tear have a 3rd or 4th degree tear.

ebd I have a lot of sympathy with what you are saying and feel your anger has been misinterpreted. But then I'm someone with 3rd degree tear which wasn't picked up on at the time

I don't think she's saying scare first timers witless! But when the question is asked we need to be as open and honest as possible.

Wallace - Yes, indeed, RCOG link says 90% of all women tear during childbirth and out of those, 9% have 3rd or 4th degree tears.

Therefore, risk of 3rd or 4th degree tear for any woman is 0.90.09= 8%*

Still an important enough risk that it shouldn't be dismissed as "oh but it's very rare", imo.

YANBU, by the way. I understand where you are coming from.

It is unbelievably patronising to equate 'informing pregnant women about risks' to 'scaring them'. We are talking about adults, not children. Women should have access to serious and correct information so they can minimise risks and choose a birth that is right for themselves.