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 to feel like apologizing for being a midwife and I'm horrified at the appaling care some of you have experienced.
I wholeheartedly agree that women should be given complete unbiased information on all aspects of childbirth (which sadly isn't the case for the majority of pregnant women) which leads me to comment (at the risk of being ranted at) that an elective C/S isn't always the answer next time round (as seems to be the general feeling on this thread) I have known women have great experiences yes with elective C/S following 3rd/4th degree tears but also lots that have worse experiences, ie with bad wound infections and other C/S complications.
I guess what I'm trying to say is find out all you can, think carefully and then make the choice that feels right for you (not what others think you should do.)

Sorry for long winded post.

I agree mummycarotcake. I chose not to have CS second time and I am glad. Even tho, I had 2nd tear I was driving and out and about in couple days. I think most MW do a fantastic job. There are some shites tho' as in all proffesions. It's up to individual MTB and what they feel happy with.

diddy1 - thanks for sympathy...

I want to quickly point out the the worst experience of my life (let alone of my labours) was DC2 (born at 35 weeks) being taken away to SCBU immediately, without me even seeing him. The emotional trauma of that was so much worse than any physical pain I've ever been through. Because of that, when I needed to be induced/sectioned for premature rupture of membranes at 35 weeks with DC3, I chose not to have a section. Despite saying before that I would always opt for a cs rather than another induction, because of the risk of another episiotomy, I read up and realised that my baby would need less special care if I delivered vaginally. Indeed, she needed none (!), and I had an excellent midwife and easy delivery.

Shortly after, my sister was terribly, terribly ill (on a life support machine for 24 hours) following a cs, and it has scared me off them for life! So I know mummycarrotcake is talking a lot of sense. (My placenta is low this time and I'm terrified it case it doesn't move up....)

oh Hedgiemum... your poor sister, no wonder your terrified. Try and think positively, crossing everything for you and hoping all will go well.

It seems to me that the real problem is not how common or uncommon a third degree tear is, but that so many of you have experienced really appalling maternity care. The original poster sounds really angry (understandably) about the care and information she received.

If a third degree tear occurs despite everyone's best efforts and is managed well afterwards it is not neccessarily particularly traumatic, from my experience

I had a third degree tear with my first baby, but it was pretty much inevitable (as opposed to caused by poor care. I had a forceps delivery, but it was either that or an emergency section, I think the forceps + third degree tear were better for me
I felt it was all managed well, I was stitched well in theatres by an experienced registrar, had good pain relief and a good recovery afterwards. No issues with incontinence. Follow up with consultant obstetrician and specialist physio. Offered c-section for second baby if I wanted, chose a vaginal birth which was fine.

I didn't know much about tears prior to giving birth, but I don't really think it would have been particularly helpful to have know more. I don't know anyone else who has had a third degree tear, but I can't say I feel marginalised and isolated and I'm perfectly happy discussing my perineum with random strangers. I think this is because it was all managed well, and was the best birth possible in the circumstances.

ebd, would birth trauma counselling perhaps be useful? Have you complained to the hospital where you gave birth?

Lenin - Nooooo. Sorry, I phrased that badly.

I have read through this thread tonight and realised for the first time what happened to me when my DD2 was born - 36 years ago. I do not want to recall all that went wrong, I have tried to forget about it suffice to say that a student Doctor took over an hour to stitch me up (a small tear they said). It was not painful, I was totally numb but they gave me gas & air to stop me shaking uncontrollably. First bowel movement after birth I though I had burst the stiches but Sister said the Doctor had not cut off the ends of the thread - simply tucked them in side me. At my post natal appointment 6 weeks later my lovely GP was so angry and demanded to know who had sewn me up 'like that'. He had my notes from the hospital which did not mention a tear. He was unable to examine me internally then but was later able to determine that there was stitching in the back passage too and further that I had been 'packed' to stop bleeding during stitching and some packing was still inside. I was so ill I had to give up breast feeding and have massive doses of antibiotics, got thrush, discharge. TMI I know. I believe my GP made a formal complaint.

On the plus side my DH felt that I had been returned to the tightness of a virgin and although my bits do have an unusual (dare I say rare?) appearance they functioned very well after a few months.

What I meant to say, before I got carried away with detail of my own experience, is that the OP is correct there is a conspiracy of silence going on here. I did not tell my friends or my DD's about my experience when they were pregnant because a) I did not want to frighten them and b) it is very rare so would probably not happen to them. If tears are indeed very common but routinely hidden or down played then women will continue to suffer. We need to speak up and demand that statistics are honestly recorded so that research into causes can take place and practice be amended accordingly.

Lenin - I've had 3 c-sections. The two electives were much more natural than my VBAC with DS2.

I think I lost the original AIBU along the way...but i would agree about the conspiracy of silence.

I had a 4th degree tear with my first child. Repaired immediately in theatre and a colostomy was performed as the tear was so serious. My poor husband paced the floors of the hospital for 4 hours wondering if he'd ever see me again as he was terrified about the general anaesthetic. Poor DS1 was crying for food by the end, sob.

I was well supported by the hospital and had a brilliant colorectal surgeon who arranged physio for me.

I had the colostomy for 2 years in the end. I'm 'ok' now but it's almost inevitable I will have serious continence issues later in life.

I had private medical insurance which covered me for an elective section with DS2, although the NHS said right from the start that they would support an elective for any further children.

In my worst nightmares I never dreamt I would come out of childbirth with a colostomy bag.

Yes my first c-section was under GA after a long and horrid labour. Elective is sooooo nice. We had Shchubert's Impromptus and lovely room full of cheery staff and everything.

women should be informed of the risks.
i also had a 4th degree tear and not know such a thinng was possible until getting rushed down to the operating theater i would have certainly prefered to know it was at least a possability before hand

forwarned is forearmed imo
and only when you know the facts can you make informed choices and descions

yanbu op.
i agree.

omg
i have just read the thread and am absolutely horrified at whatsomeof you have gone through

I countmyseldf to be extremely lucky indeed

I haven't read the whole thread, but I had a third degree tear. It was beautifully stitched by a lovely young female registrar in the delivery room (there was talk of taking me to theatre under a spinal, but I pointed out that I had managed to avoid an epidural, I certainly wasn't having one now the baby was out!) and was perfectly healed within about four weeks. Was a bit tender to start with but had forgotten all about it by the time the locia stopped.

The shocker was not the care of the maternity ward, which was quite good (they made sure I had fybrogel, antibiotics and anti inflammatories and sent me home with loads too) but the 6 week check. First I was asked by a student doctor when my baby was due - I pointed at him in his infant carrier. He said, "I think I'm in the wrong room." Then a female gynae came in, who asked me if I was ok and that was it. I asked if she was going to examine me and she seemed very reluctant to do so (surely if you specialise in gynae, a certain amount of looking at women's bits is inevitable?) but eventually agreed when I pointed out that I had no actual idea whether everything was as it should be or not, and that was it. useless.

georgimama- I also had a female gynae who was reluctant to examine me at my 6 weej check, after my third degree tear. I hated having to practically beg her to take a look... But was desperate for some reassurance that things were OK or otherwise. I found the midwives in the postnatal ward didn't want to examine me either. Eventually I managed to persuade one of the midwives to check my stitches but it was obvious she really really didn't want to do it. I know they must get sick of looking at fanjos but still...

Why should midwives/gynaes be reluctant to look at healing stitches? Seems unprofessional and rather poor post-natal care. I am really sorry for what women with bad tears have to endure.

Here here to hazeyjane. Same happened to me and am quite anxious for the baby i've got cooking now to be born in May and how it will b born(cesarian?Rip down same 3rd degree line? Selective episiotomy to prevent re-occurence of former 3rd degree?. My episiotomy was very painful with 1st child and healed badly was going to be sent for resew but got pregnant so they said they'd wait till after the birth during which I got the 3rd degree and permanent damage to my no.2 muscles, not to mention no.1s.

I had a 3rd degree tear. We only realised when the midwife tried to stitch me up and "couldn't find the end of it"!!! I ended up in theatre having an epidural and being stitched back together. My point is that I was stoned off my tits on gas and air and loving every minute of it so frankly I didn't twig what had happened until hours afterwards. A lot of what people talk about is their own personal experience. Never let the facts get in the way of a story. If you don't like the fact that someone hasn't experienced lots of tears like this and shares that then either tell them or go somewhere else for your support. No point getting steamed up about it mate. Life's too short.

I had a third degree tear which was recorded as 2nd degree tear in my notes and I was told at time that it was 2nd degree. It was about three years before I realised that it had been third degree. They called for consultant to stitch me as midwives said it was too complicated a tear for them to risk it, and he said at the time he was having difficulty getting stitches in so deep into back passage. I didn't have GA. I didn't have any pain relief during birth but had gas & air during stitches which took a/c DH about three hours - twice as long as the labour! - seemed like eternity to me! I only realised how bad it had been a while back when I got a vaginal prolapse (uterus and rectum) and the physio found that my pelvic floor muscles only function slightly on one side, and not at all on the other, even after electrical stim 3 times a day for 6 months. Eventually she had to conclude that some of the nerves to my pelvic floor muscles had been shredded along with everything else and there's no way to bring them back...

And this was recorded as a 2nd degree tear as far as the hospital's records go.

I can't help but agree with the conspiracy of silence theory.

OLD THREAD!!!!