Advice/own stories please: 2nd baby due - options after 3rd degree tear with first...

[Bluelaura123]

Hi everyone,

My second baby is due in October. After a traumatic birth and 3rd degree tear (that took a while to heal) with my first baby, I'm already getting nervous about labour this time round!

I've received great support from the hospital and they have given me various options including planned induction or planned c-section. But I just cannot get my head around what option to go with as every professional has a different opinion!!

How did others in similar situations make minds up? Did you regret your choice or would you do something different?

Any suggestions/stories appreciated!
Laura

[Queenofknickers]

I had complex 3rd degree tear with 1st DS and not even a graze with second DS who was 2lb heavier. He was also born within 3 hours so no time for hospital! That's probably no help but it's my experience! My best friend had same problems with her first and was very happy to have a csection with her second. Either way is fine. Have they told you if you need any more repair work?

[Canyouforgiveher]

I had a 3rd degree tear and a pph and opted for a c-section for later pregnancies. I felt I had dodged a bullet with my repair (no problems with bladder or sex) and would not have risked it again. Tbh I would not have gone to an obgyn who would not have offered me an elective c-section.

[Starsaboveyou]

Hi Laura,

How have things been since your first DC?

I was advised after my first that the course of action for my 2nd would largely be based on whether I had suffered any symptoms from the tear. Thankfully I hadn't so I decided against a C Section.

I did opt for induction at 38 weeks but this was because my DS had shoulder dystocia and not because of the tear.

I'm very happy with the choice I made, my DD was born in under 3 hours and although I had an episostomy as her heart rate was dipping and she needed to be delivered quickly the recovery was much quicker than with my DS and I was feeling normal again after a few days.

Good luck whatever you decide.

[gnoomi]

I'm in a similar position to you. I was advised they only usually recommend a ELCS when there have been problems following the tear. I've been advised to have one as I have had problems - I'm pretty nervous about it, as whilst the birth/tear wasn't fun this feels like a big step. My consultant said that if you've had a 3rd degree tear there is a 1 in 10 chance of it happening again: at my hospital you'd be with an experienced midwife etc.

[GingerbreadHead]

OP I have been thinking of writing a very similar post to you, as I am in the same situation!
I am 35 weeks with my second, my DD is 3.5 and I had a third degree tear with her, but the mw at the time only thought it was a second degree tear, so it essentially hasn't been stitched up properly. I do have some issues with urgency, and it definitely doesn't feel 'right' down there, but it's hard to judge how drastic these problems are really as I've lived with them for over 3 years now! I've been told I will need reconstructive surgery at some point, but have had very mixed opinions from consultants as to how to birth this baby. One very strongly recommended a c-section, he said the chance of me tearing again at a 3rd/4th degree stage is about 30% and he wouldn't be confident in how good a repair job they could do after that. Another has told me that since damage has already been done I may as well opt for a vb and then have it all stitched up at a later date.
I am in a real quandry as to what to do. Unfortunately there is no right or wrong answer, it is only a decision we can make ourselves, no one has a crystal ball as to what will happen in the birth, which is why consultants have such varying opinions. Weigh up the risks of both options and see what option you feel most comfortable with. Have a read over the rcog website, I have found it to be really informative, I'll try and find the link for you. It does say on there something like if you are still suffering the effects of a third degree tear, to opt for a cs, if you are happy with the way everything is performing (!) and it doesn't feel uncomfortable then perhaps try a vb.
Sorry for the essay!

[GingerbreadHead]

www.rcog.org.uk/en/guidelines-research-services/guidelines/gtg29/

Just noticed it was updated yesterday, so not sure if it will still say the same thing I mentioned!

[goestoshowyouthough]

I had a similar experience to you first time round, and I opted for a planned c section 2nd time. I had a wonderful experience, and my recovery from the section was easier than that from the 3rd degree tear. Obviously it's major surgery and not to be taken lightly, but I personally found it a lovely experience compared to my first.

The fear of double incontinence if the same happened again, plus the awful recovery from the tear pushed me towards the surgical route.

Good luck with whatever you choose

[blowinahoolie]

I had a 3a degree tear after having DS1 (8lb4oz) and a 2nd degree tear after having DS2 (9lb1oz). Currently pregnant with DC3, in final trimester, and have an appointment to discuss CS but they have said to me that usually it is only offered if you've problems from the original tear, which I don't have. I have now decided to give birth vaginally again, after much thought. Possibly with epidural? I may tear again, I may not, so I've been told...

OP I hope you come to a decision that you're happy with as the baby has to come out somehow (that's the most anxious part IMO).

[MuffMuffTweetAndDave]

I can see why planned section might be helpful, but what would be the benefit of planned induction? Is baby likely to be very big?

[MrsCaptainReynolds]

I had a third/fourth deg tear first time, episiotomy lengthened during forceps delivery...healed slowly but well with minimal problems after...

Second time was amazing really. Nice natural labour, delivered after a few involuntary pushes. Minor second deg tearing which healed really easily. I was high as a kite after, compared with feeling like I'd had a near death experience first time.

The main difference was position of the baby. First was back to back, second in the ideal position. I think if I'd had a second baby shaping up to be back to back I'd have requested a section. But I did loads of exercises from the spinning babies website to avoid this...