Anal Fissure - Second Pregnancy - C-Section or VB, any experiences?

[Bobsmyaunty]

Hello,

Hoping there's some mums out there that have been here before and can offer their experiences to one confused petrified mama...

I developed a chronic anal fissure shortly after my the birth of my DD (long second stage, back to back, ventouse) - which got much worse postpartum as I thought it was just piles. Took about a year to clear it completely after much consuming of Laxido and Apricots (used to like then, don't now..).

I'm pregnant with my second now and my midwife has referred me to a consultant to discuss the option of a c section. She said to consider long term health implications e.g. at 60 + the bowel is a bit more feeble anyway.

I'm staying on top of my diet during pregnancy but am already getting the odd fissure twinge and I have a very slow digestive system anyway. And am a bit petrified of pushing tbh as I don't even strain on the loo - even minutely - out of fear of tearing.

However, I've also heard about lots of mums developing anal fissures after a c-seciton due to the strong painkillers and lack of movement.

So, basically I is confused!

Anyone out there with any experience to share?

Hope you get something sorted! x

Hope it gets sorted for you! I'm now 7 months PP and STILL have a fissure with no sign of it healing. Any advice for how to help?

My women's health physio has contacted my GP (who I've seen several times about this now) insisting that they refer me to colo-rectal surgeon :-/

Hi Blondie. The only thing which cured mine was GTN cream and laxido (or movicol) for about 4 months...thus was so that I could heal and the stools were soft enough not to interrupt the healing. What are you using at the minute?

For info to anyone else on this thread my (supportive) midwife said to book an appt with GP to get a colo rectal referral which could thn inform choice of birth.

Blondie is this your first preg/fissure?

She just mentioned that she'd published a paper talking about how women who have had 3rd degree tears can still go on to have vaginal births so...

Biased much?

I posted on this thread earlier and have since seen a consultant to request an ELCS. He took was completely dismissive of my fears for my pelvic floor and my continence, even though I had guidelines from the RCOG in my bag that said women giving birth vaginally after third degree tears should be counselled about the risk of incontinence. He also said I was unlikely to tear again. Well, without a crystal ball, he couldn't say that for sure.

Anyway, he nevertheless agreed to the section on mental health grounds. I was annoyed that my physical health concerns were brushed aside, but as long as I get an ELCS I don't particularly care what goes on my notes.

Bobs, don't watts money or energy getting experts to convince the consultant to give you an ELCS. If it's what you want, you are entitled to one. According to NICE guidelines, they cannot refuse. I would ask to see another consultant and take it from there.

Taking exactly that Bobs and still no difference. Have been summoned by the doctor for an app on Monday (after a letter from the physio) so going to push for a referral now as I'm back to work in feb and don't want this to continue. Yes first baby, DS born in May and I had a 3rd degree tear .

These docs/books might help make a decision.

www.sciencedirect.com/science/article/pii/S0301211506005756
www.amazon.co.uk/Bumpology-myth-busting-pregnancy-parents-be/dp/059306996X
www.amazon.co.uk/Choosing-Cesarean-Natural-Birth-Plan/dp/1616145110

Personally I wouldn't risk a vb (in nutshell, suffered pelvic floor collapse after failed ventouse(s)+forceps which led to major incontinence/sexual problems, some that will require further surgery + will never be able to run at full speed again or play "high impact" sports ie no more leisure tennis etc). ELCS does not greatly appeal to me (would need one for other child but think will pass as don't want any more trauma for my body, of any type) but seems can be lesser of two evils.

Have you had your baby? Are you and her ok?
:-)

I didn't know an anal fissure Could be a problem. I'm pregnant with my first but have had a fissure for a god couple of years and no luck fixing it but have only lying used an ointment and never went back to docs. I just use the cream when it gets more painful or itchy (I think its called proctocol ointment or something)Should I mention it to my midwife or see my gp?

Hi Hidingthefear. I'd go to my GP. They'll be able to advise you on best course of action (ointments, laxatives or changes in diet).
Congratulations on your pregnancy!

Thanks, might as well while prescriptions are free eh. Only ever tried the one ointment and a laxative is defo not what I need in my case lol.
maybe I can get it sorted before birth so ill put it on my to do list :) 24+6

blondie the movicol and the GTN did take a while to work. Is yours not healing at all or healing then busting open? Btw - the colo rectal specialist I saw this week said that surgery is now very rare especially on post partum women. So in her opinion it should be cream, laxative/stool softeners, botox and repeat until the problem is sorted. I had mine for a year in total and felt like it was never going to go. She said had she'd been my specialist then she would have suggested botox at that stage.

Thomas thank you so much for those links. I will read avidly.

Just to share what my colo rectal consultant said in case it's helpful. She said that, in her opinion, the fissure in itself was not a reason to go ELCS. Although she recognised getting another fissure would not be comfortable. She said that she would be more concerned about the 'urgency' I now have as it could be there is undetected damage. She said both were reasonable options. i.e. if I wanted a vag birth that was a reasonable option (with risk) and if I didn't want to risk any more damage to my bowel an ELCS was also reasonable. I asked her 'what would you do?' she said 'probably ELCS. But I would say that as I've had one and know it's ok and am a colo rectal consultant so am acutely aware of the risks.

Sorry to take so long to get back to you all! Hope you are still checking this thread! I've got 10 weeks until D date and my next meeting with the gyno is on the 4th Feb. Need to make up my mind and convince her. But I think I'm erring on the side of caution with an ELC...