Two third degree tears...

[GangAftAgley]

We haven't completely ruled out having a third DC (I'd dearly love another!) but had a third degree tear both times. First birth was very difficult and was repaired in theatre afterwards. Second birth much, much easier and although I did tear again, it was much less severe and was only just a third degree tear, but a doctor at the time vaguely mentioned having a C section next time to avoid any further pressure on the old pelvic floor.

I am very fortunate in that I have not as yet had any complications or problems following the tears and subsequent surgery, but am very conscious of the fact that another pregnancy with ensuing third degree tear might very well be the final straw! I'd really like to avoid an elective C section if possible, I would have thought the recovery on this would be very difficult with 2 other DCs to look after. I just wondered if anyone had similar experiences or advice? Is it possible to look after 2 DC post C section, or in the event of having another DC should I risk another tear and risk some potentially upsetting and unpleasant complications in the future? Has anyone had third degree tears and gone on to have an easier third birth experience?

I had a 3rd degree tear first time around, DD1 is 3yrs and I opted for an ELCS this time around. I'll be honest and say it was harder than I anticipated for the first week, then much much easier and now three weeks on I feel pretty good but haven't been out much at all and can't lift DD1 still. I can basically do everything except lifting and hoovering now and I wouldn't risk a long walk or driving (yet) but will probs drive as of next week as insurance company say fine as long as Dr approves it. Stopped all pain relief on about day 10. Initially harder than 3rd degree tear but from how I feel now compared to the pain and how long it took to heal up last time I would say I feel better this time.

I chose an elective for my second birth. My recovery has been easier than after my third degree tear - at 4 weeks pp I'm pretty back much to normal other than not really lifting my 2 year old (although I do if I need too)

For the sake of your future continence, I wouldn't risk a third 3rd degree tear. My elcs was fab - saw baby being born, immediate skin to skin etc and no separation from my baby to be stitched

Will be watching this thread. I had a third degree tear with my first 3yrs ago. I'm now 17wks pregnant with my second awaiting an anal scan

If scarring is extensive and deep they'll be recommending I have a cs.
I was in the frame of mind that I'll just do whatever is recommended. But having read a few things on here (and other sites), ppl basically say there is still only a risk of a tear and that a cs is in fact major surgery- so why would I put myself though it!?!
Tbh, I'm totally conflicted. What was recommended after your first 3rd degree tear OP?

This is really helpful - thank you for your replies. I find it extremely conflicting tbh and was undecided until fairly late in my second pregnancy. Several people told me that their recoveries from a CS were not as bad as is commonly implied, but then like you DoNotDenyMe, the phrase 'major abdominal surgery' seems very serious. But then to put it in perspective, I've had quite major surgery to repair the tear anyway and could need it again anyway if I went for a vaginal delivery.

After my first tear, when I mentioned my concerns to medical professionals, most of them suggested a CS but I realised this was more because they thought I was concerned about it, rather than any genuine medical need. I didn't have to have a scan, but that could just be as I'm in a different area to you. And for what it's worth, my second tear was so slight they weren't even sure it was a third degree. Also DoNotDeny have you read the RCOG guidelines for prognosis of women after tearing? I don't know if it particularly helped me make up my mind but the more information the better I suppose. If it helps you, if I was pregnant with my second again I'd definitely go for a vaginal delivery as it was all so, so much easier and the recovery has been a breeze compared to last time.

I think I'm worried about scarring with a CS, and as I'm quite keen on exercise the impact it might have. I've already been told that I should basically avoid high impact exercise for good if I want to remain continent (what a choice!).

This is as waffled as my thoughts about the whole thing, sorry!

I had a 3rd with my 1st, theatre repair job. Recovery was slow and I was petrified of it happening again. When I was pregnant with no2 the consultant told me he would refuse a cs request as the chances of it happening again were next to slim. I got lucky and only had a 2nd and a 2nd with my 3rd too. I'm not sure what I had with 4 & 5 (twins) too much going on at the time for me to think about asking, I do know someone was down there stitching for a while so my guess would be at least another 2nd. 10 months on and I have next to no pelvic floor with stress in continence. I'll never know what was the thing that finally broke me, wether it was a twin pregnancy or too many tears and strain. If you're in 2 minds I'd go with what your gut instinct is telling you, majority of time it's the best choice.

Thanks OP, not quite sure what I have read but will look up what you've suggested and also keep popping on here for further insight. Much appreciated!

I had a third degree tear and have opted for an ELCS for number two due next month. Although I recovered reasonably well (if reasonably well = "it took two years to be able to have sex without agonising pain") I was just too scared to have a vaginal birth. I was also concerned about causing further damage to the sphincter/pelvic floor that might cause me issues with faecal incontinence both medium term and long term (i.e. after menopause). I read those RCOG guidelines too and that really sealed the deal for me.

After a 3rd degree tear, a minor tear and then a reconstruction of my bodged perineum I was told a C section would be advised if I had another baby - I didn't! My sister had a 3rd degree tear with her first and had an elective section with her second and was up and about almost straight away and says she's really glad she had the section second time. Tiny scar below bikini line as well.

Interestingly there is evidence that female gynaecologists and gynaecologists wives tend to have c-sections.......

I had an elcs after a 4th degree tear. Yes it's major surgery but:

I was discharged from hospital sooner 2nd time around (2 days instead of 3)

Recovery was quicker and easier 2nd time around: I could carry baby upstairs from day one after my section - it took me 2 weeks with the tear.

Section was more painful the 1st week. My tear scar is almost 5 years old, it still hurts sometimes!

Hth

Watching this with interest. I've also had two third degree tears (I think they were both just third degree and borderline second degree but they erred on the side of caution and stitched me up in theatre both times). Have recovered fairly well - better the second time round. Both times I have had issues with recurring anal fissures and bleeding if I get even slightly hard stools for months afterwards so I have to be careful.

Not considering a third right now but if I did, this is one of the main worries for me. I had a very fast birth the second time around and gave birth before an ambulance got to me so this is probably why I tore badly again. Whilst they were stitching me up, a doctor came and mentioned hospitalisation from 37 weeks and csection if I planned a third.....needless to say it was perhaps not the most ideal moment to start talking about it!

Not sure what I would do....but the thought of incontinence scares me....maybe a c section would be better as I think with two third degree tears you are very likely to have another....and it becomes harder and harder to stitch up scar tissue apparently.