3 deg tear with 1st means c-sec with 2nd baby?

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Hi

I really need some help as am desperate for a vaginal birth with baby no 2.

is there any mum out there who had a 3 or 4 degree tear with first baby and then had a better experience and did not tear as much with baby no 2?

I had a midline epis as well as forceps and epidural and have healed well and no pain and no incontinence issues - spinchter muscles tests are okay too

I am worried about the scar tissue inside and also the scar line from the fenton's procedure which was to bring both sides of the tear together neatly

if this scar tissue will tear with baby no 2

baby no 1 was 8 1/2 pounds and am wondering if baby no 2 will be larger?

i think I may have had a back to back labour but found out that it only took 3 contractions for the delivery by forceps so he was nearly out himself

I'm really curious to know if you can have a baby second time round and not tear as bad

help!

thanks

I tore with my first and had 3rd deg tear with second. Second one was back to back so was horrendous pushing her out. I knew I was tearing with every push. Midwife poured cool water on my bits while I pushed which I found very soothing.
If you've torn badly before the chances are you will again. Though if this one is not b to b it could be better.
I've heard that massaging the perinium with olive oil every day can help the skins elasticity and when it labour having long baths will soften it all up down there, which hopefully would lessen tearing.
What has your midwife said about it?

3rd deg tear with 1st. Followed by Fenton's after stupid midwife screwed up suturing.
1st deg tear with dd2
grazes dd3
dc4 yet to see.

Bear in mind my DDs have got smaller. I also have continence issues due to external sphincter defect. Was heavily pushed towards elCS which I declined both subsequent times. No regrets BUT continence has worsened. That was the right chouce for ME, am by no means saying it would be for everyone. Please don't think I am evangelical about it.

Can I really steer you though, towards considering your longer term future health-wise, and not just considering whether you will tear again. It's not just about that. Continence probs can get worse post-menopause, and I may well be kicking myself for not having a CS when I am 50.

That said, my physio said there was some evidence so suggest that it is NOT just childbirth that can trolley damage you, but the actual pregnancy itself. Sorry no refs for that. BUT I would have a look at

these RCOG guidelines

I would also consider the point that, in my experience, midwives do not see the long-term effects of perineal damage and can have a blinkered and limited view of what it can mean to us. Faecal incontinence ain't fun. They just don't seem to realise it's not just about will I tear again?

I would ask for a referral to what an ob/gyn/colorectal surgeon has to say and take professional advice for your specific situation. I wish you good luck in making the right choice for you.

Ooh, and there's a Raggedy Bits thread over on Health; very good.

I now refuse to let a midwife assess or repair my perinuem post-childbirth. I simply do not trust them to do the job properly. And before any mws jump on me, no one below SpReg/consultant assesses it either.

I had a 3rd degree tear, and saw the consultant for my follow-up check last week.

I was told that there is a chance of something over 10% that there would be a similar tear 2nd time around. If I got pregnant again they would be happy for a normal birth but that some women feel that the first birth was so traumatic that they prefer a c-section, and this could be discussed.

I had a 3rd degree tear with my first - failed ventouse and then forceps delivery with no episiotomy as 'there wasn't time to do one'.

I didn't get an option of a c-section with my second and never saw or spoke to a consultant.I never had any sphincter muscle tests or anything else either and I would say I suffer from 'urgency' when I need a poo (sorry if TMI).

Anyway, I had a vaginal birth with DD2, no forceps were needed and I only had a 2nd degree tear which was a relief after the pain of DD1's birth. I think that the chances of you needing forceps again are lower than with a first birth and forceps are a big factor in bad tears.

I think LittleSilver has a point though - it's important to think long-term. I wish I had been given the option of a c-section as it probably would have been better in the long-run with regards to continence.

I had a csec with my dt's, then a vbac, during which i had a 3rd degree tear. I then went on to have another vbac, with a 2nd degree tear.

I'm with you on this one Lables. I've just been for 12 week scan today and saw a consultant afterwards who reviewed 1st birth with me and then gave me options for this time round.

1st was ventouse with 3rd degree tear, 8lb 9oz DD. The info given today from the consultant was 5-10% chance of 3rd/4th degree tear this time round and if tear was of that level there's a 20-25% chance of permenent urine and/or feacal incontinence. So I'm co confused now as to what's best for me and baby.

I really want to have a vaginal birth and feel gutted at the thought of a csection but then I know I would not cope at all well being faced with incontinence problems for the rest of my life.

I also worry about establishing breast feeding after a csection as I think it can be difficult although I have no idea where I've got that bit of info from? I found bf with DD very difficult to establish and never did, managed 6 weeks then gave up and blamed that on the traumatic birth!

Basical I need a crystal ball!! But it's good to read the other posts.

No advice on the birth but I can say that feeding my DD after a planned cs was very very easy. Her big brother was an em cs and a nightmare to feed.

Bumping this.
Anyone else out there who has helpful experience in this situation?

I had a third degree tear with DC1 and was given the option of an ELCS with DC2. Doctors were very happy to let me choose and didn't put any pressure on. I initially chose a VB but other complications towards the end (SPD, high BP meant I needed to be induced and then DC2 was oblique so they thought induction would be risky) meant I ended up with an ELCS. The CS was a fantastic experience and I don't regret it at all. I recovered much more quickly from that than I did from my first labour. I was worried about BFing as well because I never did manage to feed DC1 but it was brilliant - DC2 latched on in the recovery room and feeding has been a cinch ever since (still can't quite believe it!).

I thought it would really upset to have had a CS rather than another VB but it was such a good experience that I don't mind at all.

I had 3rd degree tear with DD (extended epis, normal delivery 6lbs 11oz). Have had no continence issues so went for normal birth with DS, though consultant offered a CS. Had a lovely normal delivery in the birthing pool, second degree tear, 7lbs, healed fine so far (DS is 3 months old)..

I did perineal massage as that and using water for labour and delivery are recommended for avoiding perineal damage.

Good luck with whatever you decide

I didnt find that a C section made breastfeeding any harder.

I had to have a CS for other reasons, not just the third degree tear. I think it is difficult, on one hand you dont want a third degree tear again, but chances are it wouldnt be that bad, and on the other hand with a CS you guarentee that there will be no perineal tear, but will have a large abdominal scar with possible overhang and loss of sensation.

Its a shame that it isnt possible to have a crystal ball!

Pregnancy alone weakens the pelvic floor regardless of the type of delivery so pelvic floor exercises are really important.

I had a 3rd degree tear with DS1.

When I was pregnant with DS2 I requested a CS as I was worried about a vaginal birth causing permanent damage if it happened again.

In the event DS2 was born a month early, before my scheduled CS date, the birth was quite quick so there wasn't time for the CS. I did end up with a 2nd degree tear but this was nothing like as bad as the 3rd.

Looking back I am glad i didn't need the CS the birth was a far far better experience than with DS1. But obviously before the birth I didn't know that it would turn out ok.

I had bad tear (but not quite 3rd) with dd. THen had fenton's when she was 7 months because the stitching not good - too tight.

Had smaller tear with ds1 (fixed fine).

Tiny graze with ds2 - borderline whether actually needed stitches or not.

Great to read your posts. I'm going to go and chat it through with midwife in a few weeks and then if still struggling I might ask to see the consultant again... they'll love me! Thanks for your feedback re the breast feeding.

I'm trying really hard to get back into my pelvic floor exercises I was brilliant for about 7 months after DD's arrival but then seemed to give up on them without knowing.

I had a traumatic birth resulting in a 3rd degree tear first time around. I agonized over what to do second time, and went for the ELCS in the end. I was very happy with the whole thing - the recovery was much easier for me than after the tear, and establishing BF was also easier than after a traumatic birth. We're still exclusively BF 3 months down the line, and feel completely back to normal.

If you've had no symptoms from the tear, and your gut instinct is that you still want a VB, then I think that the weight of evidence is probably on your side. Good luck with your decision, it's such a hard one to make.

I'm having the same dilema at the moment.

I had a 3rd degree tear and have had a sense of urgency ever since. DS is 2.6. I am 14 weeks pregnant and will be seeing a consultant around 20 weeks. I was told the day after I had DS that they would probably recommend a c section with any subsequent pregnancies.

I am keen to avoid a c section but I was lucky and healed well. The thought of being incontinent scares the hell out of me and I just not sure if I want to take that risk. I keep thinking that 6 weeks worth of recovery from a c section would surely be better than a lifetime of incontinence issues, but then you can't say that there will be any. I need that crystal ball too!

I'm also in the same position as you and it's a very difficult decision. I have read the RCOG guidelines which are a good source of info rather than just listening to one MWs and one consultants opinion.

I don't get to see my consultant until 36 weeks which I have said is way too late but they won't see me any sooner even though I have requested it.

everythingiseverything can you use the Aquaflex cones when you are still pregnant?

3rd degree tear and episiotomy with dd. She was back to back and came out with her arm over her head in the style of superman! Repaired by a wonderful registrar in theatre and had great aftercare. When pg with my second I met with an obstetrician who gave me all options based on my recovery and I really wanted a vaginal birth again. Scans showed he was bigger than dd (5lb 8oz) but mw and ob were happy with my decision.
Ds was a wonderful birth, no pain relief and only a 2nd degree tear.
I think what helped was me feeling in control. I was abe to talk through my fears with ob and my truly wonderful mw whom I saw throughout my pregnancy and who delivered ds. At the beginning of my second pregnancy I was convinced a cs was the only way forward. Please talk it through with your mw and good luck with whatever you decide!

Hi labels,
I too had an extended 3rd degree tear, plus severe cervical and lateral vaginal wall lacerations (bit of a mess basically) following a forceps delivery of DD1 after a loooong labour. But, similarly to you, it seems, I had no major problems afterwards and was OK'd for a vaginal birth by my consultant second time 'round (although offered a CS if I wanted).

I fought hard for a water birth in thr MW led birth centre with DD2, as I figured it would make me less likely to tear the fewer interventions I had. I was a bit of a battle because at the hospital I was at and 3rd degree tear automatically means labour ward, but I researched it, gave them my reasons and GOT IT WRITTEN IN BIG LETTERS ON MY NOTES. That's VERY important.

Duly had lovely water birth with DD2 who was much the same size as DD1 (9lbs 8ox vs. 9lbs 2oz). Had second degree tear (she came out quite fast in the end and was sizeable) but nothing like as bad as no.1. Far less pain afterwards, much faster healing, and so far so good (but only time will tell, I suppose).

Look and think hard about what happened last time, and, if you decide to go for a VB again, think about what might help reduce the chances of another bad tear - I decided water was key, and I believe it was, for me.

I do also hope that you find your second birth an emotionally healing experience. I was quite traumatised by DD1s birth, and having such a lovely birth with DD2 really has helped.

Best of luck,
db
xx

Had to have a c-section with first, after being in/out of labour for several days. The scar (which is a neat cut, so heals more easily), was painful for the first few hours, and a bit uncomfortable for the first week, then fine. I had some help dealing with the baby for the first few days - after that I was ok, and I could always lift her.
Personally, I wouldn't even consider not having c-section second time round. I'm lucky(!) that I would have to have one due to complications with first child.
So what I'm saying is that c-section can be better than other options.
If you don't want it, then obviously you should argue your case. But you may find it a good thing - so don't stress about it if it is offered to you.
Best of luck.

Go for CS. Neat little scar on your tummy, easy to keep clean and will have no effect on your sex life and continence. Baby will be out in a minute, without being prodded by forceps and the like.

I had huge mediolateral episiotomy that was torturously painful for a very long time. Come second pregnancy, dr said there was 50% chance of another big episiotomy because scar tissue doesn't stretch like normal tissue. I had an elective CS instead.

I didn't even take paracetamol from third day onwards and got to enjoy the first days of DS. Breastfeeding was no problem. In was up the first night and was totally fine in day 3.

Cote, it's great that you had a really positive experience of elCS. Not everyone will have that experience though, elective or not.