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.

Same here, Kat - tore because I pushed too soon. Am still quite angry about that because the midwife wasn't there to guide me. I felt the urge to push and did. Midwife only turned up when dh pressed the alarm.

imho:

+20% = reasonably common event.
8% = rare event.
2% = very rare.
0.1% = extremely rare.

So, YABU to op.
I'm more bothered when somebody says something is "common" and it obviously isn't -- like in a thread not long back people were saying that cot death in a 2yo was a "common" event. It's a horrendously sad event that can happen to some very unlucky children, but it's not ruddy "common".

Actually, I'm gonna take that back, slightly . OP is valid to say it's more common than people think, and no one should feel ashamed about it happening to them. But it's still relatively rare, it is definitely "not very common".

Your personal perception of these percentages notwithstanding, 8% is by no means "rare" - a term used to describe the tails of the statistical curve, at about 1-2%. Not 8%, which is way into the middle.

I was very angry, after my mismanaged labour, that I hadn't been informed about tearing.

I can't believe how naieve I was. my labour was such a let down. I think op, you are like me in that you are really fucked off that it gets swept under the carpet, and all those anti natal things were a pile of tush.

I too, will make sure my dd is more informed, so she doesn't end up with post traumatic stress.

If you put the statistics into more managable language - one woman in every 10-12 women will have a 3rd degree tear or worse, I'd say that was worth mentioning.

if I've worked it out OK.

pirate cat - exactly.

I've stopped being able to spell - is it a pg. thing maybe? sorry all.

ebd, I am in total agreement with you.

The key statistic for me in deciding whether to go VBAC or elective was the risk of a 3rd/4th degree tear. The senior midwife had stats for almost every other risk I asked for but for this one, she fudged. And said in her long career, she has seen 1 or 2!

1 or 2!!! She was taking me for a fool. 50% of mothers I now who gave birth the first time had very bad tears. On mn itself, you routinely read eyewatering stories. If she has said the risk was 8%, I would have believed her. 8% is not rare by any stretch of imagination or even uncommon.

Seeing that I was not going to get a straight answer out of her, I opted for an elective. And never regretted that decision, particularly in hindsight.

8%, if it is a true figure, is utterly shameful. The NHS have every reason to cover up. It is a direct consequence of overcrowded, understaffed, mismanaged labour wards. The more women know the true figure, the more likely they are to request electives. It would be a snowball effect. So rather than give the true figure or deal with the appalling state of our maternity wards, they hide it.

Truly shocking.

I do believe the only way to give birth safely in an NHS hospital with minimal risk to my perineum is to go elective. And I did.

in my very limited experience (as a mother rather than a MW) i understood that 3rd or 4th degree tears were uncommon but not unheard of.

i personally had a 2nd degree tear as they hauled DS1 out but would have gladly had a 4th degree one as they managed to protect me but fractured his skull in the process. Am not sure i will ever properly come to terms with that guilt (although i cant really criticize the hospital as he's alive)

I hope that my posts haven't been dismissive. I do think that it is important for women to be better informed ante natally, my nhs classes were appalling especially as regards, 'if things don't got plan during birth or breastfeeding' (teachers response, was not to be so negative). However I was terrified of tearing, because my mum had gone into great detail about how badly she had torn with me, and what a nightmare labour was. I read up on tearing, and as a consequence did perineal massage, was upright and moving around for a lot of labour, and did lots of breathing preparation. It all went out of the window when after 3 days of labour and several hours of pushing I couldn't get dd out had to whizz off to the labour ward for ventouse and ended up with a 3rd degree tear. I didn't realise how lucky I was to have had the surgical care I had, as I have had no problems since, and had dd2 14 months later with a minor tear (although ironically the stitches were much more painful during stitching and for ages afterwards).

So whilst I think it is important to be aware of this stuff, i do think that it can be counterproductive (eg being so terrified of tearing again that you may choose a caesarian, especially as that is what a lot of consultants push for, when there is a very small chance of tearing again so badly).

It was never my intention to scare any first-timers which is why I didn't post this on an antenatal thread,conception or childbirth thread. I just find it very very frustrating that when someone plucks up the courage to start a thread/contribute to a thread about tearing in childbirth, someone comes along and trots out the "it is rare" line which can do more harm than good. I posted about my tear and the problems I was experiencing with it in childbirth and had some really good advice, but then another mumsnetter came along with the "this is rare" line and made me feel as if I was being a nuisance and shouldn't have dared contradict the "birth is fantastic and mainly problem free" picture that is often painted in real life. At the time I thought about saying something directly to the poster concerned but didn't want the thread to turn into an argument or scare other women reading it. I understand that for women who have never had a tear they will probably be unaware that some women do suffer very badly with tearing. However, I'd prefer if if these women didn't just trot out the "but this is rare" line, especially when there are so many unlucky women on here who have suffered.

I don't blame the OP for posting this actually. I am one of the statistics, I had a third degree tear when I had my DS. Not pleasant at all. I did search on here for advice after it happened but really, struggled to find anyone that was going through the same thing. Everything is fine down there now, but at the time, it was hell. wondered if i'd ever be normal again. thankfully things are ok now.

YANBU. I wish more was said of third and fourth degree tears online, people just are not aware of it. I was really annoyed to read books on birth and hardly a thing was mentioned on these tears, which really gets to me. It's not any less/more traumatic than anything else that goes wrong in childbirth, it should be focused on like every other aspect.

Sorry for ranting, but this is one topic that I feel very strongly about too.

I was also not informed of the reasons why I tore. I would have liked some answers, and I would have liked someone to tell me how to manage it better next time (i.e. better guidance of when to push at the right time!). But no one explained all this to me at the time, which I feel quite angry about now (nearly 2 years later). I would have liked details of why I tore so badly. No one talked about it. Why not. It's important to me. I know alot of women don't really care, and just want to move on, but for me I wanted the closure. It has sort of put me off having any more kids really.

ebd, I don't think you are scaring anyone at all, or have any intention of scaring anyone. I just think like myself, you want all that information out there, so people can choose to read it at their own leisure, so they can walk into this childbirth stuff with a more realistic view (sorry folks, but childbirth isn't always plain sailing - we must just be the unlucky f**kers!).
It also grates me when people parade how fantastic childbirth is and how they want to repeat it several times as it's so great. they don't realise how inadequate that makes others who have had some really unfortunate times during childbirth with tearing.

Where I gave birth I was told that every 3rd degree tear had a formal investigation into why it happened. I did understand what could happen because of NCT classes, we had a session just on this where the men were told to go to the pub.

I had a bad tear and had problems having sex for a while afterwards, I wasn't told anything aboout the impleications of the tear, and I think I should have been.

I would think it is fair to describe it as rare but not unheard of.

moomaa that's quite interesting. if I ever do decide to go ahead and ttc no2, then I will definately be having words with MW on wht happened with the first birth. and ask plenty questions. would hate to tear like that again! would like answers to why it all happened like it did last time.

that would mean a lot of sacked MWs then, if we had to go by that theory...would love to see how short staffed the hospital would be then since it seems to have happened to loads of us on here (from this thread alone!).

moomaa why the fuck were the men told to go to the pub?!

NO not fair to describe it as rare, when it's happening to 1 in 12 women!!!

Otherwise, I think we're all saying the same thing :-)

I have had 2 children and know a lot of mothers (to the extent that I also know a fair amount about their births).

I had 2nd degree tear both times. Stitches both times. First time needed restitching about 7 months later. Second time healed beautifully.

I have never met a mother who has had a 3rd or 4th degree tear. Note that I am NOT saying that it doesn't happen. Bloody obvious that it can and does given that the extent of the tearing has a name and there are personal testimonies on mumsnet to that effect.

But in my experience and my limited (like OP's) sample of responses from my circle of mother friends, it is relatively uncommon for 3rd or 4th degree tears to occur. I would say rare. Uncommon. Unusual. Unlucky.

FWIW with DS (my second) I did perineal massage and tried to push in a tear-unfriendly position. But still tore. Guess I'm just predisposed (and 2 previous tears/cuts don't help).

I don't get where the doula comment has come from?

I think 1 in 12 is rare. Well that;'s the way i'd interpret it.

If someone said 1 in 12 people are left handed, or blue eyed, or red headed, I'd say it was rare. Is a question of semantics though I suppose.

wish i had been lucky enough to just get a 2nd degree tear, would have meant no spinal, being completely out of it etc on pain killers. I couldn't enjoy my new baby because I was in too much pain, DH took more of an interest in him after the birth. I was too focused on what was happening to my nether regions (whether i was going to be doubly incontinent or not), and missed those precious moments...