Sore perineal massage following bad tear...

[NeedlesCuties]

I've posted before about the 2nd degree tear I sustained during 1st labour, now I'm 33 weeks with DC2 it's really coming back to me and I'm getting worried.

Basically: I had a 2nd degree tear with DS following pushing when I didn't feel a need to push during labour. Took them 2-3 hours to stitch me up, pain relief injection they gave me didn't work so I felt every stitch. Got an infection, led to granulation scar tissue which took around 7 months post-birth to heal.

DS is now 2.5 years old and ever since he was born I can still feel a nip of pain if I sit awkwardly or sometimes (very rarely) during sex.

I'd put it to the back of my mind, but now it's starting to worry me. Last night tried to do perineal massage in prep for DC2 being born next month. It was painful :( Made me panic that if having a finger rubbed over the area now results in pain then what will it be like in labour & possible re-tearing??

Had spoken to a hospital doctor at 31 weeks pregnant and she was dozy and no help. Waved my concerns off by telling me that as it was my 2nd time I'd be 'well-stretched' and unlikely to tear. When I asked her facts and figures for this she couldn't and she also couldn't tell me any methods the staff would use to help prevent me tearing.

Would love a ELCS if possible as I really think this fear is creating a mental block in my mind. I'm worried about a CS due to reading about risks and also how I'd manage a toddler and a newborn with little support. But it's all swings and roundabouts as both CS and VB are laden with pros and cons.

I won't be seeing a MW or Dr till I'm 37 weeks pregnant and I'd love to ask for a CS, but don't know what the protocol for 'requesting' it is and for stating my case.

Sorry this has descended into an essay, but didn't want to drip-feed.

If anyone has any tips then that'd be good, or if anyone can tell me that it's normal for perineal massage to hurt 2nd time round then tell me that too.

OP

If I were you I would go back to doctor or community MW NOW, and tell them your fears and concerns, and how its affecting you.

Dont listen to dozy doctor. ingore her and find someone else to ask that you trust. Tell your docotor or MW about that doctor and say its not good enough, you want some answers as far as they can give you..

As soon as I had my first MW meeting at 8 weeks I told her of my concerns with new baby/labour and i was refered to a consutlant.

I am aware lots of consultants also dont care much about what happens to you below BUT again if you are refered and get a dogy one, ask for a second opionion.

So I would start now and make it urgent - and get information, proper information that can make you feel happy either way with whatever you go for.

Thanks.

My DH is a doctor who did a bit of training in area of obs & gynae (but is in a different speciality now) and he was aghast at how dozy the Dr we saw that day was. He said he supports my choice to have a CS, but we both know they aren't given out willy-nilly.

I have a feeling I should ring my community MW and speak to her about my worries. She is a total gem, really old-school and knows her facts. The best thing about her is that she is the community MW I had during my pregnancy with DS and she was the one who saw me at home for 10 days following his birth and did all the checks of my wound/stitches etc.

Just feel bad about pestering her or being passed off again, which is how I felt at hospital.

Is hard to know what to do for the best!

Needles Im probably no help as I'm pregnant with my first so havent been through this. I'm booked for an ELCS though due to tokophobia.

Just wanted to say, please please go and see someone as a matter of urgency. Pleased that you said you have a great community MW- if I was you I'd contact her right away. Get a referral to a consultant, would your husband be able to come along and back you up?

Wishing you luck xx

please dont feel like you are pestering her - you are pregnant and dont need any stress....anyone who is sensible will realise that and help you. make the call!!!

Thanks again. I think I'd been in denial since DS was born and just thanked God that the wound finally healed after 7 months.

Just the fact that the perineal massage hurt last night made all my fear flood back to me :( Sex life has been fine since DS was born, but I always made sure DH was gentle and left that particular spot of scar tissue alone.

The appt I mentioned in my OP (at 31 weeks preg) was meant to be with a Consultant, but ended up being a nice-but-dim Dr who asked my DH for advice at times!!!

Yes, I could arrange another appt and DH could come with me to advocate if needed.

I also have Group B Strep, which is another complication and thing adding to my stress, but I've been reading up lots about CS's and GBS and there doesn't seem to be much impact.

I just feel a bit of a fraud as it was only a 2nd degree tear... but the doctors I saw afterwards all said that the granulation scar tissue was bad and that 'some people' are just prone to developing that issue in their vulva area. It's a bit like a keloid scar, although I'm not black (which seems to be a risk factor for keloids) and I don't have keloid scars anywhere else on my body.

Sorry, this is also a long post! Thanks for reading!

Hi
I had a third degree tear but healed ok. I'm now 18wks with dc2 and have insisted on seeing a consultant (not the registrar) to ask all my questions. He reckoned my chances of tearing again are double, but still only 6-10%

I left the meeting feeling much calmer and ready to give birth again.

I'd def recommend asking your mw to get you a meeting with a good consultant

Thanks soandso I'm meeting with her in fortnight, will ask her then.

Trying to stay calm too... reading the stats your Consultant told you is reassuring.

All the best for your pregnancy and birth

Just wanted to say, I had a really sore 2nd deg tear first time. Took about 10 months for sex to not be painful.
Just gave birth to dc2 9 days ago. I had a water birth with gas and air. The gas and air helped me breathe through the pushing and I managed to deliver with no tear. Dc2 was a pound and a half heavier than dc1 too. I didn't do any perineal massage, there's no evidence it has any effect in second and subsequent deliveries.

That's great thing1
Always encouraging to hear

Hi Needles!
I have done perineal massage with all DC. But when I started this time-at about 34 weeks, I got very worried. It hurt, nothing seemed to want to stretch, everything felt tight and sore.
My biggest fear in pregnancy is having stitches "down there", and I got extremely worried that I was going to tear etc.
However, I have stuck with the massage, and now at 39 weeks I can really feel the difference. Everything feels so much more supple, and stretches with no stinging.
I never had a tear or stitches before, so to be fair I don't have the scar tissue that you have. But I would keep going with the massage, it can only help! And remember that breathing, and controlling the exit of the baby are just as important in preventing tears.
I do think you should see about getting another app with Dr if you feel it would help though.

Thanks woops I have appt with hospital Consultant booked for tomorrow morning (will be 37+4).

My community midwife suggested I request an elective episiotomy, but the more I read about that the less I wanted it. Having an epis = definite need for stitches and a definite wound with potential for this to tear.

I'm trying to go by the logic (and prayer) that just because I tore with DS it doesn't mean I'll tear this time.