Planning a vaginal delivery following a 3rd degree tear - how did you prepare?

[molejazz]

I'm currently 19 weeks with my 2nd baby, had a 3a tear with my first. I don't need to go for a ELC as I've healed well, but am starting to worry a bit about my chances of tearing again (seems to be about 4-5% of women do?), and was just wondering how others have approached this?

Things I'm thinking about are: not gaining too much weight (hmmm... hoping for a smaller babe than my 9lb pounder), 2nd stage in water but getting out for delivery, delivering lying down on my side, and perineal massage. Anything else that you think helped?

No, not done it yet, I had a third degree tear too, and am 33 weeks with numbers 2&3. As I'd have to have an epidural, monitoring, syntocinon up after twin 1 born, I've elected ELCS as that all screams 're-tear' to me. However, if i go into spontaneous labour before my date I want to know whether to go for it and try twin vb- so I'm no help but will watch your thread OP!

To be honest I just hoped for the best. The tear healed really well first time around and I didn't have any lasting effects.

For my second birth after an attempt with a ventouse and then a McRoberts manouvre (sp?) when DS2's shoulder got stuck, I ended up with a smallish tear which healed well and again, no lasting effects and everything is absolutely fine a couple of years on. I remember the Dr telling me about how the stitches really weren't a big deal (attempt at being comforting I think) and then remembering himself and expressing some sympathy for my poor fanjo.

I had a 3a tear with dc1, I had done perineal massage and gave birth semi reclined on my back.

I had dc2 2 weeks ago, did perineal massage again, gave birth kneeling up, didn't actively push, my contractions pushed baby out and I got another 3a tear! But, it's healed nicely again (so far) and my pelvic floor feels alot better this time around.

Possibly not helpful, but if you do get another tear it is more than likely it will heal well again.

Had bad tear with DC1 and the next three just popped out! couldn't have been more different. Not sure there is an awful lot you can do - it seems to be one of those things that happens or it doesn't IYSWIM.

I had a 3a tear, and have done no special preparation this time (35w) I've had no ongoing issues from it though.

The Supervisor of Midwives I have seen about other things has said that I'm no more likely to tear again than anyone else, so it makes no difference really. If you think about it, if 4-5% of women do, then that means that 95-96% of women don't, and to me, they're bloody good odds!

This baby is predicted to be a fair bit bigger - up to 10lb, but I am still planning a home water birth and to be honest, if I tear again, I tear again. The tear was caused by an episiotomy extending, and that was given for a forceps delivery, so by planning to be at home, I suppose that's the preparation I am doing to prevent it happening again as there'll be no induction, epidural, forceps or registrar forgetting to tell me to stop pushing!

Your weight gain in pregnancy has no bearing on the baby's weight either, so even if you gain very little your baby will still be the same size as if you gained a fair bit (GD notwithstanding!)

Thanks all, it's actually really helpful. I don't know why I'm getting a bit hung up on birth preparation this early in the pregnancy , possibly because you're right and there not that much I can do really.

It took a while to deliver DS and he was in distress at the end so they just told me to push, no time for a slow and managed exit. No way of telling if that will happen again.