Terrified! Natural or Csec!?

[skjamathome]

I had my daughter 17 months ago, was induced, had forceps, episiotomy, borderline 3rd degree tear and hemorrhage. I am still in pain from the scar tissue, can't walk too far or sit for too long. I get worse pain when using the toilet. I am terrified that if I go natural that it could be worse and that I could end up even worse than i am now so am seriously considering c section, however that also scares me as its major surgery! I also only have 11 weeks to go! Eek. Just looking for some advice. What would you do in my situation? I did a pros and cons of natural based on my previous birth and with all the issues the only actual pros were that it's natural and less painful than c sec! Help please! Xx

Have you had a debrief with a midwife about your last birth? It may help work out what went "wrong" and whether it is likely to progress the same way this time.

As I understand it, elective CS is a far calmer affair than an emergency one and you'll be prepared for it.

I had a third degree tear with DS1, healed well, and went on to have two more children vaginally. I did tear with them but again healed well and am happy with my choice.

I had a similar first birth (but no tear) and was completely freaking out about 2nd one being the same. But, I was reassured that haemorrhage was likely the long labour, intervention etc and therefore much less likely 2nd time. If you're still in pain though from last time you need to have an open conversation with a doc about that as that doesn't sound right.

I shared my fears with a mw, wrote in my birth plan how freaked out I was and had a wonderful team on the ward around me when I delivered ds2. I was induced so a bit different, but much much easier delivery.

I had a 3rd degree with dd1 four years ago. I had an elcs for dd2 10 weeks ago and it was brilliant.

Have you spoken to a consultant about this?
They often say the best way to deal with poorly healed tears is to have a vaginal birth again and re suture if required obviously.

You should be seen by urogynae as well and possibly offered an endoanal scan to ensure all is functioning normally

I feel you OP, I'm not pregnant, but with forceps + 3c tear last time, I'm already dreading giving birth again. And dreading having to choose my poison, there are no good options here :(

out of curiosity, did they offer you the choice of a C-section? I had a debrief with a midwife a few months ago, and she said they were no longer advising C-section after 3rd degree tears. Her attitude was "it happens all the time, you'll probably be fine" :-/

Fwiw I asked to see a consultant at 16 weeks, I told him straight that I was not going through natural birth again, that however small the risk of a repeat third degree tear, there was just no way I'd be doing it and that I wanted a csection. He booked me in for 39 weeks there and then and was totally supportive of my decision throughout. If one consultant says no, request to see another.

How would it be less painful than a c section??!!! You are still in pain months later!!! Take the section, definitely.

With DS, I had forceps with episiotomy (which tore and extended) and a separate 3rd degree tear with DS, and retained placenta too. All in all was horrific, I had flashbacks for months and PND in part I think due to his birth. I also had long term issues- urgency, some scar tissue discomfort- though just with PMT after a year or so- and I have an area with very limited sensation, sex has not been the same since (tmi?)

Roll on 3 years I had an ELCS with DD almost 8 weeks ago. My consultant didn't say anything to try to convince me otherwise, perhaps because I have longer term issues? The pain was worse initially but now I am pretty much fine, whereas after DS's birth I was still very uncomfortable at this point- I remember going to a baby group and not being able to sit on the floor! I regretted the ELCS to start with because I couldn't do anything for the first couple of weeks, couldn't drive for a month or so, and the spinal was horrible (I'd had an epidural before but that was fine!), lots of pain afterwards and 2 days in hospital. However now I'm very pleased, it was reassuringly calm, staff were great, and my recovery has been straightforward so far (though I was on painkillers for the first 4-5 weeks!).

My main reason for ELCS was the gamble- yes the odds are quite small of reoccurence/worse, but being symptomatic already they are probably worse, and a 1/10 chance of being totally incontinent (as I was quoted) was too great for me.

Bear in mind if you choose CS it is hard looking after another child as well- my DH did absolutely everything in the first two weeks, and we had help from my in-laws too. When he went back to work I found the first few days really hard as I was still very sore (though mobile). I think you need good support in place afterwards.

Oh, and if bf is important to you, we had skin to skin asap, she had her first feed within the hour and is still ebf at 8 weeks, so ignore the 'bf is harder with a cs' thing, I don't think there's any truth in it :)

Sorry for the essay!

I think you need to see a gynae consultant and also an Osteopath to get the existing pain issues healed. it sounds like they've just left you to get on with it by yourself?

What i thought was scar tissue after a 2nd degree episiotomy (as confirmed by gynae and causing huge pain during intercourse) was actually a crushed pelvis and fixed in two minutes by an examiner in an osteopath exam i had volunteered in for my dodgy hip to worked on.

There are also specialist midwives that can help if your especially anxious.

Forgot to say, I was off painkillers after 12 days from my section and felt great almost straight away compared to my 3a tear where I couldn't sit or walk comfortably for months!

that's the issue, isn't it - consultants tend to compare the pain of a C-section to the pain of a straightforward vaginal birth, so obviously they tell you it's more painful. But if your only experience of vaginal birth is not being able to sit down, walk or poop (sorry!) without pain for several months, it's just not very convincing.