Hernia and SPD and previous tear - C-Section or Vaginal?

[MelissaClaire]

I'd posted this on the pregnancy section, but just realised I should probably put it in this section - I also forgot to say that I have mild SPD too. As anyone any advice?

Has anyone had a hernia in their groin due to pregnancy? This is my second pregnany (30 weeks) and I have just been diagnosed with having an inguinal hernia (lump in my groin). My first birth was forceps with a bad third degree tear. I was really hoping for an active and as natural as possible birth this time - My logic was that as everything is so "loose" this time, labour would perhaps be easier? My midwife is speaking to the consultant about whether a c-section is now more desirable, and less risk (as I don't want a bad tear again or to make the hernia worst). Has anyone had a similar exprience or any advice? Thanks!

Er... the midwife is talking to the consultant? If I were you I'd be requesting an appointment so I could talk to the consutant.

I am under midwife led care, and was due to see the consultant again at 36 weeks. The midwife is speaking to my consultant this afternoon (he was involved with my daughters birth) and I will be seeing him in the next few weeks, but I wanted to get some other views as I suspect he will leave the end decision to me.

MC...I have been advised to have a elective section due to having a 3rd degree tear with my dd, and i am doing.

I also suffer with SPD but have just "got on with it" this time, as i know there is nothing they can really do anyway, you need to speak to consultant yourself asap and discuss your options, as what i am trying to say is i had JUST a 3rd degree tear and they are doing a section for me on that alone.

Good luck.

Thanks for your message. I think the consultant would be happy to do a section if that is what I prefer, but he was rather sitting on the fence before and leaving it to me - saying a straight forward vaginal would be best, but a elective c section would obviously be better than forceps again and the obvious problems from the tear.

It will be interesting to hear what he says now the hernia problem has arisen too.

Good luck to you too - when are you due?

I didn't mean to sound so harsh. Sorry. I typed that message very quickly. I just meant that I think it's best to get medical advice first hand. i.e. straight from the consultant and not through the midwife.

Thanks. I actually just spoke to the consultant who wants to wait until 36 weeks before making his mind up and advising whether he would prefer to go with a section - I'm also having a sizing scan then, and he says if he feels the baby is particularly big and with the hernia then he may prefer a section, but if not he still thinks he would prefer normal delivery.

So, I guess I just need to keep an open mind and plan for either!

Hi MC...I am due on 20th Aug but they want to do section at 39 weeks, i didn't see the consultant till i was 24 weeks and was told to think about what i wanted, i just decided to go with what ever the consultant advised and that is what i am doing (even though i am sh**ting myself lol!).

It would be very easy to go for vaginal delivery if there were guarantees there would be no tear, but the risk i think is too great .

Hope everything goes well for you, when are you due?

Hi MC,
I'm 36 weeks in with pg 2. I had dd in Jan 03 and had a bad 3rd degree tear and a retained placenta. I had very poor bowel control for the first few weeks after the birth and even now can't hold it or seem to have much advance warning that my bowels are full and ready to move though I've not been incontinent since about 12 weeks post natal (sorry if tmi!) My obs consultant referred me to a "bum surgeon" (colo rectal!) at 30 weeks.
His advice was that a section would give me a more predictable outcome than a second vaginal delivery which might go fine or might leave me faecally incontinent and in need of further surgery. I also run the risk of a retained placenta again so my choice was to have one op (albeit a major and scary one!) rather than risk needing more than one op as a consequence of a vaginal birth.
My section is booked for 30th June.
Best of luck with this. Dunno if there's any other info I can share but do let me know if there is!

Thanks so much for the responses. I am due August 11. Since my tear, I haven't actually suffered with any severe incontinence, although when I have to go, I have to go.

I too am terrified about the risk of another tear, but my situation is further complicated in that about 15 years ago I had major stomach surgery, and the consultant is concerned about doing a section because of that.

His advise is stick with vaginal unless the baby appears really big. At the scan yesterday they predicted a birth weight of close to 9lbs - although obviously this is only an estimate, I have another scan at 36 weeks - I think he will say that unless the predicted birth weight is 10lbs plus then he will recommend vaginal.

I just wish I had a crystal ball to know what would be the best outcome! The consultant and midwife are advising me that second third degree tears are rare, but they can't guarantee it won't happen, and of course the consequences this time could be worst.

It is great to find others in similar situations though. Thanks for your responses and Good luck too.

The scans aren't terribly accurate in predicting birth weights. I've known several women who were predicted to have +10lb babies, and had babies of 8 or 9lbs. That said, I suppose one only remembers the things that were wrong - I don't know how many get the predictions right.

As a second vaginal birth, this one should in theory be easier; as you say, you've already done the stretching. The SPD shouldn't be a problem. I had SPD with my second and delivered lying on my side as a result - far more 'comfortable' than the almost-on-my-back position in which I gave birth to no1.

I don't know about the hernia, but two strategies occur to me: firstly, would you be allowed to labour in a birthing pool? That would allow you to keep in an upright position fairly effortlessly, which would I imagine put less strain on the hernia and the SPD. It would also facilitate the baby's progress downwards, reducing one would hope the need for any assisted delivery. It might also reduce the likelihood of tearing. The second thought is that you could try hypnobirthing and other breathing-related birthing classes, so that you can try to 'breathe' the baby out, rather than push. Again, less stress on everything. I know the urge to push is phenomenal, but if things are going well it is not strictly necessary to push.

An epidural might be recommended, from a purely medical point of view, as it would also remove the pushing from the labour, but then it would make an instrumental delivery more likely.

Hope this has given you some alternative ideas.