damage to pelvic floor muscles after first vb

[tutti76]

I had vountouse delivery and 2nd degree episiotomy with DS. I recovered quite well but I cannot say that my private parts are as tight as before pregnancy (even after millions of pf exercises!). I am now 30 weeks pregnant and considering my options, including home birth. My concern is not causing more trauma/stretching to my pelvic floor. At my last appointment with the mw, she said "don't worry, most of the stretching is done by the FIRST vb". Is that medically possible? I would have though every vb would put more pressure on your pelvic floor, stretching it again. If that was not true, why so many women have incontinence/prolapse issues after the second or third delivery?

Well I certainly was a bit looser after first,but my fandango was hanging out by 35 weeks with DS2! He was 10lbs 11oz when born naturally at 40 plus 10 following induction.
Carrying him about inside did all the damage. I was so bruised and swollen long before labour,I could hardly walk. Was about 2 weeks after birth before I regained full sensation down there,then realised I had a rectocoel prolapse. I was really upset.
But lots of pelvic floor exercises and pilates have resolved it. I have never wet myself thank god!
If I do have a third baby,I would consider some corrective surgery afterwards. Apparently they can fix it up really well with a small op now.

Oh dear! i'm 30 weeks pregnant and already experiencing what you described! I am seeing a consultant next week to discuss options, including ELCS. I appreciate this second pregnancy is already damaging my pelvic floor muscles but at least with an ELCS I may be able to avoid incontinence issues/prolapse.

Part of my reason for an elcs second time round was to prevent further pelvic floor muscle damage. I had high rotational forceps, episiotomy and a lot of tearing with DC1 - the episiotomy tore too. I have had incontinence issues since the birth which are ok at the moment but not perfect.

My physio said another vb would be another big stretch as the head is born which an elcs would avoid, though the unavoidable pregnancy hormones and weight have a big impact too. Depends perhaps on why you needed an assisted delivery first time round, I had a gut feeling I would need assistance again if I tried for another vb and I didn't want further incontinence issues. I have permanent weakness on the side which had the episiotomy and almost no sensation in the whole muscle making pf exercises very challenging.

There were obviously other pros and cons for elcs v.vb which may or may not be relevant for you!

have had 3 VB and then 1 late second stage emergency CS. I found that each vaginal delivery made things worse, while after the CS my pelvic floor was definitely not damaged(even tho I was pushing for a long time). I also found that I had urinary incontinence during my 2nd to 4th pregnancy, but this basically disappeared when baby born so don't freak out if you are experiencing this while pg.

Many thanks for your comments lovethesea and dreamingofflour. My gut feeling is that another vb is going to make things worse. i will push for a elcs next week. I am aware of the risks and the recovery times but I think long term is the best option for me. I had instrumental delivery after 24 hours labour with a 9lbs baby son in posterior position. I think they were rotational vontouse and then outlet forceps to get baby out. They are barbaric instruments. yes, they save lives but they also cause lot of damage to the mothers. I think I should have had a c-section instead.

Just to let you know that I had ds2 by elcs last March and it was a fantantic experience!! I would have another elcs any day! Baby is doing really well I feel that I recover phisically and emotionally quicker than with my "natural" birth. The scar is healing very well and the most important thing is that there are no incontinence issues. Thank you so much for your help and support.

I had a vb with dd2 after the same problems ad you with dd1. I had a good women's speciality physio after dd1 and after dd2 all is fine. What happened with dc1 is not necessarily set to be the same for dc2 so have a good think about it. I had dd2 at home in water and all was great so don't make the decision until you have done a lot of research. Talk to your consultant and he can refer to a physio to see how strong your pelvic floor is now.