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Childbirth

Share experiences and get support around labour, birth and recovery.

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Original poster

Who had a 3rd degree tear previously and what type of birth did you have after?

24 replies

DetectivePotato · 21/07/2010 21:03

I'm only 11 weeks with DC2 but I had a 3rd degree tear with DS, epsiotomy and tore. Forceps birth.

I was told the day after, subsequent children would be likely born by c section. At my follow up appointment I was told I had healed well and we would see when I had another one how my sense of urgency was when I needed to go to the toilet (not a wee).

Can I hear of your experiences of a 3rd degree tear and subsequent births? I would like to avoid a c section but I have been told that if I tear again, the damage will be much worse which I know can mean loss of bowel constrol all together. On the other hand, surely everything is a bit stretched now and a 2nd birth should be easier?

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fourbears · 21/07/2010 21:20

I had a 3rd degree tear when I had my DD (previous birth with DS was an episiotomy for a ventouse). I have no plans for another baby but was told at a check up 6 weeks after the birth that I would need an elective episiotomy with number 3.

Maybe that could be a possibility for you? I suppose it depends on individual cases but it might be worth asking if it could work.

Hope that helps a bit. Congratulations on your pregnancy!

NotAgainIHope · 21/07/2010 21:24

Hi DP,
I had a third degree tear with DS and had been given the same advice as you regarding subsequent CS births.
However I was told that I should not rule out a vaginal birth. Luckily I live near a very good midwife led unit which I was under for my antenatal care. They ultimately recomended that I have a vaginal birth. I ended up having DD in the local Royal Infirmary and had two wonderful experienced midwives who put my mind at rest by explaining the different methods of birth which would minimise the risk of tearing again.

I had a very active birth and ended up being cut and I didn't feel a thing. The stitches were fine and healed so much better than the tear did last time.

I hope this helps you to feel a little more relaxed about your options.

I must admit I got very wound up about it but the more I heard about sections the more i wanted a vaginal birth.

Good luck whatever you decide.

Original poster

DetectivePotato · 21/07/2010 21:24

Thank you.

They did say if I try for a natural birth I will automatically have an episiotomy so that should help.

My midwife at my booking in said it also depends on how they cut me last time. Apparently they can do it horizontal or vertical. No idea which one is better or which one I had.

OP posts:

NotAgainIHope · 21/07/2010 21:25

Ah I meant episiotomy not 'cut'

Original poster

DetectivePotato · 22/07/2010 09:24

Thats ok, its the same thing.

OP posts:

SiriusStar · 22/07/2010 09:39

Episiotomy then 3rd degree tear with ds.
I asked for a cs as they couldn't guarantee it wouldn't happen again and be worse. I couldn't face prospect of being bowel incontinent and knew I would panic and not be relaxed if I had a vaginal delivery again. I know what I am like and I think I would have freaked out the closer I got to the pushing point that it wouldn't be a good thing for me.
I knew the risks of either and weighed it up. I spoke to my consultant and he agreed cs best thing for me.
I do know of others who have had vaginal births after tears that went ok.
It makes me a bit cross when they say that with deliveries after having a tear, that there are ways to deliver that are less risky or better ways to "cut". Why didn't they do that he first time then so we didn't tear in the first place? GGRrr.

Original poster

DetectivePotato · 22/07/2010 09:45

My thoughts too, although DS's heart rate had disappeared and it was all done in a bit of a hurry. The only reason I can think of for not cutting the 'better' way.

Thanks for sharing your experience. I only know 1 mum who has been through the same thing and she had a c section second time too.

Anyone else care to share?

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NotAgainIHope · 22/07/2010 09:45

I know exactly what you mean. In my case I was told by the second lot of midwives that the first birth I had was obviously led by an inexperienced midwife due to the way that I was encouraged to give birth (ie on a birthing stool and other things) and thats why I had a third degree tear...

ealey · 22/07/2010 12:59

Hi there. I had a 3rd degree tear with my first, and recently had my second by elcs. I did a lot of research into this, and the general rule seemed to be that if you have no symptoms then you could attempt another VB whereas if you were experiencing any persistent bladder/bowel problems then elcs would probably be the best option. I didn't have symptoms, but my first birth was so traumatic I couldn't contemplate another VB. I was really pleased with this option, and just wanted to say that if you are advised down this route then please don't be scared about it. Mine was a really positive experience and I recovered very quickly. All the best with your decision.

LittleSilver · 22/07/2010 19:30

I am really confused by the posters saying here that they had/would have an "automatic" episiotomy.

I had a 3rd deg tear with DD1. Very anxious about DD2's birth (continence issues like OP) was very much pressured into choosing CS. I chose to disregard this advice and went on to have a very minor 1st deg tear (which they only sutured because of my history).

DD3 grazes only.

I did ask about an elective epis and was told they would definitely NOT do this because of these RCOG guidelines

So I'm really interested as to why it is being suggested, can anyone think of why?

I also see a colorectal surgeon (really recommend this if bowel probs)

I would also just comment that my CR surgeon told me that I shouldn't just be considering the likelihood of a tear. He said that the pregnancy itself, NOT just the labour affects the pelvic floor and impacts it. And I don't think that's considered enough.

I am not someone with any medical training, but OP it's worth doing some research as to what is best for you, do have a look at the RCOG guidelines. I chose not to have a CS and it initally looks like the right choice for me in that I never tore that badly again. But will I be paying for it post-menopause? Maybe. But am pg with DC4 and will be declining a CS again. It's a very personal choice.

Good luck with making the best choice for you, I know how stressful it can be.

pigleychez · 22/07/2010 20:28

I had a 3rd degree tear and Episiotomy after a forceps with DD1. (back to back)

Ive recently had DD2 (9 weeks).

Not once during my pregnancy did anyone even mention a C section this time round. No mention of incontience or anything so had a virginal birth.
It ended in Forceps again as DD2 was back to back as well! so another Episiotomy but in a different place. Must be like a patchwork quilt down there now

All seems fine now, and not wetting myself . I found I healed alot quicker this time too.

ClimberChick · 22/07/2010 20:34

Interesting, I had a third degree as well, but no-one has mentioned anything about effects oon subsequent births. In fact they didn't really say anything at all, except I had just lots of sympathy from MW/HV when I mentioned about the tear, but no mention as to why. I feel like there's a secret that no-one has filled me in on.

Though I am at least a few years away from having another one.

Original poster

DetectivePotato · 22/07/2010 20:36

Thank you for your story LittleSilver and that link.

It is interesting. I had an episiotomy and still tore, I never thought about that fact that having a future episiotomy doesn't guarantee not tearing again. I will speak to the consultant later on and see what they say, whilst looking it up too.

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Original poster

DetectivePotato · 22/07/2010 20:37

See that seems to strange when they were talking to me about it the morning after I had DS. The next one was the last thing on my mind, and my local hospital is known for being very poor and one of the worst rating in the country.

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toccatanfudge · 22/07/2010 20:39

I had a 4th degree tear (on top of the episiotomy ) with DS2

DS3 I had 4 stiches afterwards!

Original poster

DetectivePotato · 22/07/2010 20:41

OWW!

But reassuring to know! Out of interest, people who have had bad tears, what was the weight of your babies?

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toccatanfudge · 22/07/2010 20:43

DS2 was 7lb 11oz (but he was dragged out with ventouse)

DS2 was 7lb 5oz (or was it 6?? I get confused these days between DS1 and 3).

Not huge compared to many - but pretty big for petite me

deemented · 22/07/2010 20:44

I had a 3rd degree tear (dd was 10lb 2oz), and had a normal vaginal birth with ds six months ago - had a 2nd degree tear with him, but it was fine, absolutely no problems with it.

Ironically, today i recieved a letter for me to have a check done on the tear that i had - bit late, methinks!

BaronConker · 22/07/2010 20:51

Hello,
I had episiotomy with ventouse for DS1, stitches got infected straight after and then again at 4 months postnatal but eventually healed.

DS2 - had episiotomy which extended and resulted in 3rd degree tear, had to have spinal block after the birth and be stitched in surgery. No infection this time thanks to IV antibiotics and stitching was so lovely and neat it healed brilliantly, much better than first time round.

BUT felt very, very scared as my third pregnancy progressed. Saw a senior registrar (I asked for a consultant but didn't get one) to discuss birth options, said I wanted to try for vaginal delivery and had it put on my notes that I wanted an episiotomy early in 2nd stage (pushing) to avoid tear and a senior midwife present throughout second stage. When I got to hospital at 8cm dilated, senior midwife was sent for, and she was fantastic. Talked me through the pushing very gently, lots of 'push, push, push, STOP. push, push, STOP,' as she eased the baby's head out. Had an episiotomy, but no tearing and only a couple of stitches. It was brilliant and really exorcised all my horrible memories of the second birth.

Best of luck, no reason you can't do it if you have healed well, I managed it with two lots of scar tissue and can honestly say that I do NOT look like a patchwork quilt and would never know I'm a survivor of 3 episiotomies and a 3rd degree tear!

LittleSilver · 22/07/2010 21:01

DD1 7lb 14
DD2 6lb 13
DD3 7lb

So none of them porkers . Though am extremely grateful that none of had hot DD1's dizzying weight.

MonkeyChicken · 22/07/2010 21:02

I'm 37+1 pregnant with DC2. Had a 3rd degree tear with DD1 due to forceps (no episotomy they just let me tear). I haven't suffered incontinence problems but couldn't walk without discomfort for at least 4 months after DD was born! With this pregnancy no one has suggested C section or incontience etc. In fact they've mostly said "oh dear you had a nasty tear last time hopefully that won't happen this time." I have a friend who had a 3 degree with her first and didn't tear at all with her next two children.

Original poster

DetectivePotato · 23/07/2010 09:44

Ok thanks. I am feeling slightly more reassured that it doesn't mean an automatic c section.

OP posts:

napa · 23/07/2010 12:59

I had a third degree tear with DD who is now 6. Normal delivery, episiotomy, DD weighed 6lbs 11. Have had no problems since and tear healed well. Decided to go for a normal delivery this time. Did perineal massage from 34 weeks and had a water birth. Had a second degree tear and DS weighed lbs. Absolutely no problems at all. DS is now 3 months old and am so pleased that I did not go for an elective CS.

To second what another poster said... RCOG do not support elective episiotomy and do not recommend a CS for women with no complications from the tear.

Though I am a HCP and have seen women have a third degree first time and fourth degree the second, as well as women who had third degree the first time and nothing the second so it is an individual decision. Good luck with whatever you decide.

Original poster

DetectivePotato · 23/07/2010 19:35

Thanks. I was thinking about a water birth too as I have heard it softens things up. Only one birthing pool though so it would all depend on the day.

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