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Childbirth

ELCS vs Vaginal Delivery after 3 degree tear?

18 replies

locomomma · 26/03/2016 23:20

Hi ladies,

I'm sure I'm boring my friends and family and members of this board and I'm finding it very stressful trying to figure out best option for me. Please forgive this long 'outer monologue'!

So DC1 was a small baby and arrived on due date. Pretty tough labour with episiotomy, ventouse and retained placenta. DC2 was 15 days late and weighed 9lb3. I was induced but found the labour very positive, only 2.5 hours, managed on my hypnobirthing and gas and air etc. I did have a 3rd degree tear involving sphincter and had to go to surgery for fairly considerable stitching. Recovery really wasn't too bad and up until about 20 weeks into this pregnancy I've had no symptoms of incontinence. As this baby has been growing, I've found myself in a few emergency situations involving a breach of the back passage(!!!) and that has terrified me. I've also ready plenty of grim stories on this website from people who've had bad tears.

I've seen the perineal clinic and they've said I have a 10% chance of a repeat tear in this delivery and that there's no way of anyone saying what the impact of that would be on my short, medium and long term pelvic floor health. The only way to avoid a repeat injury with total certainty is to have a c-section.

I've also spoken to the midwives about an early induction to avoid a big baby. While they're on board with it in principal, they will only induce me if my cervix is favourable so I really don't know how this will help me if baby decides to stay put like last time and I foresee a stressful negotiation with midwives as due date approaches.

I guess the final option is to take the normal 'wait and see' approach.

In general, I think the hospital feels it would be disproportionate to have a section, that it's not really necessary and the midwife did make some mention of 'mental health' grounds which wasn't very helpful. I know I'll get one if I really want to and perineal consultant is supportive. So I am very tempted to have a c-section. The main negatives in my mind are temporary (being sore for a while, having to stay in hospital longer, not being able to pick up baby for first feeds, not being as well able to play with my other kids etc).

But I fluctuate. There's a 90% chance that I would be putting myself through unnecessary surgery and all the inconvenience that goes with it. I think I am very sensitive to making the wrong decision. The idea that the hospital thinks it's probably not necessary is bugging me. I don't like to make a fuss or swim against the tide.

I would love to hear from people who had natural deliveries after 3rd degree tear to hear what the outcome was.

Has anyone felt that they must be wrong in wanting a c-section when medical opinion and research says I probably don't need one. Thing is, it's my bum and my life and I'm not a statistic. That 10% is so scary to me. Then the little voice creeps in and says 'come on, you'll be fine .... you don't want a section, that's major surgery ... get on with it and stop making a fuss'.

Thanks so much if you've read this far! All advice welcome!

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slightlyinsane · 27/03/2016 00:19

My first was a third degree with a lengthy recovery.
My next 3 pregnancies were all second degrees. I have a very weak pelvic floor with stress incontinence, probably more to do with number of babies (5).
Personally I think that 10% figure you've been told is rubbish and the actual number is much higher. I was told there was next to no chance of me tearing again, ha! They got that wrong.
I think you need to look at long term outcome rather than the recovery time for the first few weeks. Ask about the long term risks if you had a section v's the long term risks of tearing again.
Not that I'm having any more but there's no way I'd have a natural birth again.