Considering a home birth after previous 3rd degree tear - am I crazy?

[MrsJLS85]

2 years ago I gave birth to DD in hospital, forceps were required, and I had an awful 3rd degree tear (through to my back passage) which luckily has healed well and I have no incontinence issues.
I am pregnant again, due in the summer, and considering a home birth. I am convinced the reason for my bad tear before is because baby was back-to-back, and I gave birth lying down on a bed with feet in stirrups. I am hoping a homebirth would reduce that risk by allowing me to be active, and labour/birth in a more upright position.

I would love to hear any stories/opinions you may have based on any other experiences.

I can't talk about third degree as I had a straightforward episotomy.

But I had forceps, back to back baby for first birth. I didn't progress and got more disheartened with repeat internals showing no progress. No help offered other than 'stay upright' and gas and air. Then the dreaded drip and an epidural from hell.

Second birth no way was I setting foot in a hospital unless I became high risk for some reason. When I went into labour at first it felt like it was going the same way. The back pain was the same. The difference was being at home. Being able to contort myself into funny positions recommended by Spinning Babies (with help of DH and my doula). Being able to say 'sod this, I'm getting in the pool for a rest'. I felt DD2 change position and all was plain sailing from there on in. I bloody loved my home birth.

Thanks amanda, great to hear that your second birth went so well

The risk of having another third degree tear is about 5%, in the event of that happening you could be transferred for suturing. The risk may be smaller if you have it at home as you would obviously not have an instrumental delivery there! I don't think you are at all crazy to consider it!

It sounds like a sensible plan to me. By staying at home you are significantly lowering your risk of intervention and therefore probably also your risk of a serious tear. If you sustain a bad tear you transfer in for suturing, which is at most a bit annoying. Book for a homebirth and you can still change your mind at any point.

i had a third degree tear with my first DC (a failed home birth), and i had also planned a home birth for DC2 - for the reasons you give - that i felt i would be more relaxed in my home environment, there would be no intervention, i could labour / birth in water if i wanted, or to move about, choose positions for delivery. however DC2 was breech and i ended up with a CS. i am now pg with DC3 and have been told catergorically that there will be no home birth, and i feel sad about this and i'm wondering whether to challenge this decision and opt for one anyway.

i would say book your home birth - you can always change your mind at any point!

I had a bad third degree tear with ds1, after a venteuse delivery. Ds2 was born three years and to be honest, shot out like a bar of soap - totally different experience. Personally, I didn't want a home delivery - had a very nice midwife led unit, with more comforts than home - but it wouldn't have been a problem if I had.

I had a home birth 3 weeks ago after a crash section with DC1. It was great. Just posted about it in the other thread about home birth hints & tips.

I cant see what the issue is, if you've decided to have another vb then hb wont increase your risk of tearing. (although not an expert) If it happens then surely you just go in for suturing, much as you would go to theatre in hospital.

A couple of thoughts - if you book a home birth it is easy to change your mind and go to hospital, but not so easy the other way round.

I had a home birth with a back to back labour. He turned 3/4 round during the labour so it was very long. There is no way I would have been able to labour naturally for so long in the right position (on knees) had I not been in my birth pool at home. (I.e. I believe that had I been in hospital, my risk of intervention / CS would have been higher).

Water is an amazing pain reliever, helps greatly with getting in the right position and especially with helping your skin to stretch, so reducing the risk of tearing. I recommend it whether or not you go to hospital or stay at home, and whether or not you actually want to give birth in the water.

I had a home birth and still ended up having an episiotomy, and had to give birth lying on my back with my legs in the air (and god, did that hurt my back, but it was the only position in which DD was moving!)

what I'm saying is that you can't necessarily avoid interventions, but they did give me a lot longer and a lot more space and time until they decided that I had to agree to it. And they really did try everything first.

oh, and there is less risk of a baby being back-to-back if you're on your front - gravity pulls the heaviest part of the baby's body to the ground - the back is the bit with the heaviest bone structure, so it stands to reason if your back is towards the ground then your baby's back will be along it.

the daft thing is, hospitals know this.

The birthing ball also helps to make your baby lie front to back as well, as it pushes your body forward.
Spend as much time as you can on your hands and knees and that will also help.

I don't think you're mad to consider it at all. I could have written your post as it sounds as though our first experiences were almost identical (other than back to back bit).
I'm due in 5 weeks and going to try for a home birth. Eeeek! I'm hoping that I'll be more relaxed in my own home, feel more in control and this will all help. Fingers crossed.
My MW and consultant have been amazingly supportive throughout and supported my decision. I think if you have people on board this will help. But you're bound to have a wobble in the mean time. I read lots on here and a few homebirth sites which were on the whole really positive. Good luck with what you decide.

I had a third degree tear with DS1 as he was back to back and didn't turn. I didn't need forceps but he did deliver face up. No issues with the healing of the tear either. Three years later i had DS2 at home in under 2 hours. Slight tear along the old scar but no need for stitches. Like others have said, give it a try, you can always transfer in if needed. I really loved my homebirth and hope to repeat the experience this time. Good luck!

My friend had a home birth with her first that resulted in a 3rd degree tear, her 2nd was also born at home and the same happened again.

It hasn't put her off wanting her third to be born at home though and the chances of it happening to you a second time are slim.

I had a third degree tear with ds1 but didn't tear at all with ds2