Who gave birth on their feet/knees and had a bad tear?

[Dragonhart]

Just making my final descision about whether or not to have a CS in Jan after a bad third degree tear with DS (will be 17 months old when baby born).

Read that giving birth lying down adds to your chances of having a third degree tear. As this is what I did, was just wondering if anyone did it standing/kneeling and still had a bad tear?

I gave birth kneeling in a birthing pool and had a 3rd degree tear which took months to heal, far longer than friends who'd had a c-section. I was told not to sit for the first 3 weeks which is actually more difficult than it sounds! I had some ultrasound tests done about 9 months later which showed that I've recovered pretty well although not 100%. Before they ran the tests I had to fill in a questionnaire about my syptoms and luckily could answer No to most of them but I was shocked to read of all the possible problems that could have resulted, including (sorry if this is tmi) leaking during sex. I realised what a lucky escape I'd had! I'm now expecting my second in April and have opted for a c-section (my consultant agreed it was a very good idea). I'm lucky that my Dh can take paternity leave and my parents live close by to help out, but even if I didn't, in my opinion there's absolutely no way I could push out another baby knowing it could happen again but with more serious repercussions. The muscles of the sphincter are very complex and can easily be damaged. I know that I could possibly give birth without a major tear second time around but I'm just not prepared to take the chance. My future continence is FAR too important!

I gave birth to my second lying flat on my back "the worse position". I didn't tear like I did with my first, when I was in a more upright position. The main difference was that I was really relaxed and calm with my second. She was also delivered very quickly, my position didn't hinder her exit in any way.

Is it possible to have an epidural and be propped up in bed so you're not lying completely flat and pushing babbie up your pelvis?

I had an epidural with DD1 and was propped up in bed, the epidural only worked on one side though - Never agin!! You can be in whatever position you want as long as you have a mobile one I think.

Cheers mrsratty, sorry to hijack but just wondered what to do! Although I'm sure my body will tell me at the time....Really hope I can have a good epidural as not good with pain and everybody I've spoken to says just go for it, it's brilliant, but I don't fancy laying down and making the labour even more difficult than it will be.

I am also sorry to hijack but how do you know what degree your tears were? I gave birth to 9lb 4oz dd on my back with forceps. I tore and had an episiotomy. I was told I had torn internally and externally and when I asked how many stiches the dr said she had no idea as she had been stiching for an hour! However she reassured me that it had not town into any of my passages... I was in real pain for 3-4 weeks. dd is now 14 weeks and yesterday I was on my feet all day and walked 5 miles, by the evening I really hurt down there again a bit like in week 4. Is this normal or should I see the doctor? Do you think it was a 3rd degree tear?

The way I understand it is a 3rd degree tear goes all the way back to your back passage and can be a "minor" 3rd degree tear if it's just the entrance with is damaged or a bad 3rd degree tear if it goes right inside. The midwife at the antenatal class said you could also get a 4th degree tear but wasn't going to describe that as didn't want to scare us!

MumToAPiglet, sounds like maybe yours was a bad 2nd degree?

Thank you all so much for your replies. Sorry It has taken me so long to respond but we have all had a tummy bug in the Dragon household (exactly what you need when you are 33 weeks preg and have a 16month old!).

I think that I have pretty much decided that I will go for a section as I just dont think it is worth risking becoming incontinent to seem like a 'good earth mum' IFSWIM. Spaceturtle, I too have found that the more I read about the risks, the less I want to take the risk of tearing badly again.

Sounds to me me like if you are going to tear, you are going to tear no matter what position you are in?

Mumtoapiglet I had to be stitched in theatre by a surgeon rather than by the midwife with my third degree tear. Think it is a case of them only specifically telling you if it is actually a third degree tear. Would prob say you had a second? If youare still having probs I would go to the doc anyway though just to make sure. I did have more pain when I was on my feet for long periods for afew months after I had DS though. Hope everything is ok. x

Thanks to everyone for sharing your experiences, it has really helped. xxx

Haven't had time to read all replies, but my experience might be relevant. I had a third degree tear with DD1 - bad enough to be stitched in Theatre with a spinal block. I delivered her kneeling up and she came out at express speed and tore me with her shoulder.

I did consider asking for a CS next time around, but I really didn't want to have to deal with the recovery time. I went ahead with a second vaginal birth, but briefed the midwife that I needed help in delivering in a more controlled manner. When the time came, she got me to lie down and push very gently. It took all the self control I could muster, but I did it. I still tore, but only second degree and easily mended.

As far as positions go, everything I read said that you need a fairly horizontal position to avoid tearing - so lying down is better, not worse.

I must say that neither tear gave me any long term problems and I wasn't even in too much pain afterwards. In your situation I might also opt for a CS, if that is going to make you less worried. As you say, no point being the earth mother if it is going to make life harder - as long as you are realistic about the aftereffects of a CS as well.

GOod luck with whatever you decide.

gave birth to dd lying down, small tear, ds - tried kneeling, tried squatting, tried every undignified position, then they tried to get him out via vontouse in the end, but gave up and did an emergecy c-section. The next day, we found out they punctured me too far with the epidural and had to be operated on again. Stayed in hospital for 8 nights.
It was such a nightmare that my husband said if we have a 3rd, we will have a scheduled cs. good luck on your decision - the recovery time after my emergency cs was longer than with my natural birth with dd - but i'm convinced that's because it was because they made me push for so long....

I had my 3rd child on my knees and had a 1st degree tear but that was left to heal itself.

I gave birth on all fours with a mobile epidural and had a minor 2nd degree tear that didn't need stitching

Personally I think I would have taken the same decision as you Dragonhart. For what it's worth I tore/was cut all 3 time:

DS1 was an episiotomy - on my back as he was being monitored
DS2 was a 2nd degree tear - on my back because they lost his heartbeat when he moved down very quickly
DS3 was a 2nd degree tear - on my knees.

DS2&3 were very fast second stages which may have contributed.

I had a terrible tear with ds1 whilst lying on my back.

I had ds2 on my knees and needed 1 stitch, and that was only because his hand was on his forehead!

I had DD flat on my back as needed monitoring my 2nd stage was very quick. Fortunately I had a great student midwife who talked me (and her mentor) through what was happening and what I needed to do. I had no tears at all. I had seen a chineese medicine doc for accupuncture throughout my pregnancy and in the last 6 weeks she told me to use almond oil to massage the perinium area twice a day, I rub almond oil everywhere cos I was terrified of tearing. I think it's important to do what you feel is best for you and not worry about what anyone else thinks.

I had DS1 on my back, no tearing, and DS2 kneeling over back of bed, again no tearing. Yes, I know, spit on me now. I don't know why, apart from the fact that I drank gallons of raspberry leaf tea for a month before each, and was manic about PF exercises. I tried perineal massage, but couldn't bear it, so didn't persevere. The only other thing I can think of is that I was the world's most reluctant pusher with both and had to be bullied into doing it, even though 2nd stages weren't that long (45 mins and 9 mins respectively) but both my first stages were boringly long, so whether or not that adds up to anything helpful I don't know. GOOD LUCK!!!!!