Birth after 3rd degree tear

[SouthDownsSunshine]

I'm pregnant again after a fairly traumatic birth for dd. She was brow presentation, so after many hours of pushing + syntocin, and a gungho consultant, I was wheeled into theatre for a forceps (and failed ventouse) delivery.

Amazingly, dd was ok. I wasn't - third degree tear, double incontinence until 8 months later, couldn't poo without pain for almost a year, plus severe pnd.

I'm pregnant again and have made it as far as 9 weeks, so after recurrent miscarriages I nowas feel I can look forward in the pregnancy.

Talking about dd's birth at the booking in appointment has bought it all back. I haven't slept well since as the last birth keeps flashing though my mind. All I can think of is what happened last time.

I've asked for an ELCS, but I'm nervous that a) the violent nature of the last birth might have done damage that'll impact this pregnancy, and b) that having a section involves risks to my unborn child.

I know childbirth is ages away, but equally, I can't be going through this anxiety for the next 30 weeks.

I really feel for you. I had a similar first birth and I'm currently awaiting an appointment for the follow-up on my incontinence (ds is 4 months). It's so awful that I'm not sure I can even contemplate a second child- for exactly the same worries as you.

So no experience, just to say I totally get your anxiety.

I had a dreadful labour and birth was kept in hospital for 6 days and only allowed home if someone was with me looking after me I still can cry over it all if I let myself think about it. I didn't want any more children- then fell pregnant with my second and was so worried begged for a cs or and epidural on admission but this labour delivery was completely different 2 pushes baby in my arms no stitches and back home straight away. Tell your Dr your worries they won't want this to happen again either. Good luck and enjoy your pregnancy

Your first sounds very similar to mine. Horrible 3rd degree tear after forceps delivery (DD was back to back), and horrible tear through to back passage, which was sooooo painful recovering from. Took me nearly a year before I could go for a poo without crying... I didn't have PND but I definitely think I suffered from post traumatic stress - I didn't talk about my concerns, instead I bottled it up. I felt I didn't have any right to "complain" about the birth as many of my friends ended up with EMCS so I would think "well at least I got a natural delivery" when there was definitely nothing natural about the way my daughter ripped through my body...

Fast forward 2 years and I gave birth to my son at home, after 10 mins of gentle pushes, and a small tear to my labia (completely opposite direction) stitched at home. Was out and about seeing friends in town 2 days later. I feel my 2nd delivery helped me heal emotionally from the first. When I was pregnant with my second I did A LOT of research, spoke with consultants re: the tear/healing, attended lots of local antenatal classes/groups, started talking about my recovery experience with my first to my husband and friends, went to birth reflections at the hospital etc, and felt really happy with my decision to try for the the 2nd birth at home, and I'm lucky it went so well. A friend of mine had a similar story with her first and chose the ELCS route for her second, and she has been very happy with her decision. So only you know what the right decision for you is.

Hi SouthDownsSunshine,

You didn't actually ask any question in your post so I'm guessing these are the two points you'd like some help with.

a) the violent nature of the last birth might have done damage that'll impact this pregnancy
Yes, it is possible. There was a thread recently (might be worth scrolling through a few pages to try and find it) about a mother of 1 who was pregnant with number 2. I can't remember her exact circumstances but as baby 2 was growing she was starting to have incontinence issues.
Relaxin and the weight of the baby are contributors to incontinence (+ having had a serious injury of course). Do get referred to a women's health physio asap if this happens to you.

and b) that having a section involves risks to my unborn child
Other posters are better on this point than I am so please step in with facts and figures!

My general understanding is that a C-section planned because of problems related to the pregnancy itself (twins, pre-eclampsia, mother with underlying health condition etc) is safer for the baby than a vaginal delivery.

A planned C-section to protect the pelvic floor might increase the risk of baby being admitted to a neonatal unit. I think breathing difficulty is a common problem after C-sections (because baby hasn't gone through birth canal and therefore mucus? hasn't been squeezed out of their lungs).

I didn't have a C-section so I'm really not claiming this is all very accurate.
I suppose you're trying to balance out the real risks of incontinence for you against a possible admission to a neonatal unit for your baby?

Hopefully this is pointing you in the right direction.

By the sounds of it a planned section would have considerably less impact on the baby than another traumatic birth would on your mental health. Having done brow presentation too my heart goes out to you, there is just no good way for those stuck babies to come out!! I opted for planned section 2nd time and mentally it mended me, but you have to choose whatever is best for you as a family and that means a happy mummy too!! Just my own experience but once that planned section was booked it gave me breathing room to work through first birth trauma. Recent research shows planned sections extremely safe, older research on risks tend to include emergency ones which by necessity factor in poorly patients. Wishing you all the luck this time, it will be better!! Xx

I'm having a section next time! DS is one this month and I'm still having physio, ugh! Good luck!

Georgia that's good to hear. So you had incontinence issues throughout your 2nd pregnancy? God I am really scared to get pregnant again!!! 😬 Glad you had a positive experience with the section.

Dd1 delivery was very similar . When fell pregnant with Dd2 my consultant said I should have a cs. He said there were increased risks of incontinence if I delivered naturally . After all the trauma first time around it was s huge relief to know when I was delivering. Recovery was so quick compared to first time and the whole experience was so much calmer for me and baby and poor husband !

Thanks so much for all your comments. It's so useful to hear that a planned c section has been a much better experience. I've talked it over with dh and we're agreed that we'll push for an ELCS, and that it'll be best.

I'm already feeling the impact on my pelvic floor, particularly at night I find it hard to control. If it gets worse, I'll ask for a referral at my 16 week appointment.

that's a really interesting and useful read, thanks dornishmans.