C-section or natural after a 3rd degree tear?

[lauradotp]

Help, please?
I'm 34wks now, and have been umm'ing and ah'ing over this for, well, since I found out I was pregnant again! I had a pretty rough time having my ds two yrs ago. Although it was fairly straightforward to start, once I was wheeled down to delivery things started to go a bit wrong. My waters were broken, which is when they discovered that ds was a mec' baby. He'd tied a knot in his cord, there was no time to get me knocked out for an emcs (I have a back problem, and they couldn't risk trying to get an epidural in) so it was a case of sitting up on the bed, grabbing hold of the backs of my knees and pushing. Thankfully, he suffered no ill effects after his very speedy entry into the world! I ended up in theatre for 2.5hrs though, getting a 'severe' third degree tear and an episiotomy mended and needed 4 bags of blood to top me up. The repair job was less than great, and I have been told that i'll need that tidied up...basically, skin was stretched over the tear and the epi' site and stitched the other side. Not only has it made things very uncomfortable (it's amazing that I managed to get pregnant again, seems that those extra 'oh go on, it's Christmas' glasses of red wine must've helped relax bits that the exercises and physio failed to) but it's also left an odd little hole that my Consultant would like to fix during the early stages of labour...
So, I'm facing being cut again and the possibility of tearing through/around scar tissue. I have asked about having a Section, but my Consultant seems to think that i'll be able to 'breathe' the baby out without any further damage - unfortunately, I'm less than convinced that this will be the case! I know that a Section is a fairly major op, but it took me a long time to recover last time and I can't help but wonder if opting for a controlled delivery by c section would be better than waiting to see what Mother Nature has in store for me. I'd be interested to know of anyone else's experiences, whether a second natural delivery was better or worse or how a Section and subsequent recovery fared in relation to healing from a tear. Thanks in advance!

I have a consultant appointment next month and will certainly be printing IT out!

The sentence in question is the first bit in bold in section 12:

All women who sustained an obstetric anal sphincter injury in a previous pregnancy should be counselled about the risk of developing anal incontinence or worsening symptoms with subsequent vaginal delivery

right thank you

My first child came with a massive tear and my second child I had naturally despite seeking opinion. I wish now I had a c section 2 years down the line things are not right and I am very scared about faecal incontinence as I had another third degree tear.

I so wish I went down the c section route. I feel I have brought some of these issues in myself and wish I had been stronger when speaking to the consultant.

Good luck!

very sorry to hear that snapple.

I had a (thankfully very brief) period of faecal incontinence after the birth, and it was traumatising. So I am absolutely terrified of it.

You are speaking to my fear of not being able to stand up for myself with the consultant, around doctors I always feel like a silly little girl who doesn't know what she's talking about. That's why I want to arm myself with as much knowledge and information as possible.

I've chosen to have an elective. I work in the 'birth realm' and despite desperately wanting a home birth I feel it is the best option for my future health

Thanks I still can not believe I listened to that consultant and wanted a c section wtf was I thinking in going for a vb second time around!!! When I was in hospital post the second birth months down the line - the colorectal surgeon first said "now tell me why after your first birth and that first tear did you not opt for a c section for the second birth " and I had to explain that a consultant at his same hospital had counselled me against it!!!!! Actually the colorectal surgeon was helpful to talk to.

But then when I was getting further tests the nurses where patronising and made me face the wall why they looked at and out stuff up my arse and used that air balloon stuff - they called me mum even though I had said what my name was - and didn't tell wtf they were doing until after they had done it. They asked me "what I do you do mum when You need to clear my kids away to make it to the toilet" Then a male consultant joined the examination and they did not even introduce him to me and still told me not to turn around. To be honest I was shocked and felt disempowered. That and a painful colonoscopy has put me off seeking further treatment.

I am just going to try live with it. So far I have not had accident at work. It took me so long to recover from the first birth that I just can not believe that I did not push for a c section second time around.

That's awful snapple. You really shouldn't put off further treatment though. Continence problems tend not to go away and can get worse with age. You really don't want to live with continence issues and worry about having accidents at work.

I understand why you were put off, I really do. I haven't had to endure any worse than a rectal ultrasound, and the doctor and nurses were very kind and respectful. There's no excuse for the way you've been spoken to.

Oh snapple that's not right... sorry that happened to you.

Weirdly right after the birth I didn't have major issues showing my healing tear to midwives and consultants (and a fair number looked at my bits, let me tell you), but the further removed I get from it, the more difficult it seems. I guess we regain our sense of dignity somewhat as time goes on!