Bad tear 1st time should I have c-section?

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Hello 1st time childbirth was hard. We arrived at labour ward it was full... had to wait in waiting area with waters breaking, fast labour and no pain relief. Only after begging a midwife did they check and realise I was almost 10cm and needed help.
When they hooked me up my heart rate was really slow as was the babies. It was a traumatic labour I had to rush to get her out as she wasn't breathing and she was taken away. As a result I had a major 3rd degree c tear. Had to have a spinal and surgery straight away and took weeks to recover... never felt the same since on my bum
Been to discuss the options of c-section this time as I'm terrified of another tear/ending up with a stoma as my recovery was so hard last time.
Thoughts and advise please x

When you say discuss options for this time is that with your midwife, the consultant or the choices team? What did they suggest?

Ultimately you need to feel as comfortable as possible going into your next birth. From your post you sound as though you are leaning towards a CS, and that's fine as this is your birth and your choice. How far along are you?

Hi

I also had a 3C tear with my first who is now nearly two.

It took me about 18 months to be pain free and feel relatively normal, although as you said, I'm not sure my bum will ever feel the same again, am still have issues controlling wind etc.

I have no experience of a c-section but know that there is no way I would mentally be able to push a baby out again for fear of tearing again, to the same degree or worse.

I was shocked at how long and painful the recovery has been from the tear and feel that I really missed the first 4-5 months of my DD's life due to being unable to leave the house to to pain and bowel urgency issues. Time I will never be able to get back.

Obviously there is a chance that things could be fine second time around, but personally the slightly higher risk of tearing and possible implications of that are way to worrying for me. If I am ever brave enough to have another I will do everything I can to push for a c-sec. Yes, it's major surgery, but so is repair from a 3C tear and a planned c-sec should be calm and controlled.

Good luck with whatever you choose!

No one should have to "push for" a c-section after 3rd degree tear, especially a 3c. This is a tear that came millimetres from your rectum, and a long and difficult recovery is a very good reason to have a c-section as another tear may give you permanent problems in that department.

I had a 3c tear first time round, though had a relatively 'good' recovery, with the only major problem being painful sex for a year or so. Debated long and hard over my second and decided to take my chances with a vaginal delivery. It was a much smoother delivery, only second degree tear which hasn't presented any problems. The delivery was very 'hands on' from the midwife, the warm compresses and controlled delivery of the head. Recovery has been a million times easier this time. So it was the right decision for me. But I think if I had been suffering any symptoms following first tear I would have opted for C-section.

During pregnancy, I met with a consultant midwife who said I would not have to fight for an elective section, as previous severe perineal trauma was considered as clinical grounds for that option. This probably varies between hospitals though.

Whilst deciding, I tried to do a fair bit of research. And in my view it came down to the following. You have around a 7% chance of suffering another 3rd degree tear, compared with around a 1.5% chance for someone who did not have 3rd degree first time around. A higher maternal age is associated with greater risk of tear (though this is only documented for first babies I think). C-section carries greater risk of something catastrophic happening (though still a tiny risk) and is associated with greater risks for future pregnancies (again, small). People often trot out the increased risk of breathing difficulties for babies born by C-section, though from my reading this only applies if delivered prior to 39 weeks.

So, can you tolerate a moderate 7% chance of another 3rd degree tear for the possibility of an easier recovery? Or do you prefer the certainty of no repeat tear, but equal certainty of having to recover from C-section? There are no right answers here. Good luck with whatever you choose!

I think I'm quite unusual in my view of being very pro c-section in some circumstances.

I think natural birth is a wonderful thing for those who are able to do it, but if your body is not one that's designed for it, you really shouldn't beat yourself up about it or push yourself to do something that is unnecessarily dangerous.

The NHS now accept that c-section is no more dangerous than natural birth, the risks are just different. So you should have the risks of both explained to you properly and be able to choose.

I had a c-section for my first birth because the risks of serious injury were high and I definitely made the right decision. My recovery was quick, only a few weeks and I was back to normal, and my recovery was complete, the only lasting issue is the scar which is much smaller than I expected and has healed very well.

If you have a high risk of injury for natural birth and are low risk for surgery, I would say you have nothing to worry about having a c-section, it's most likely the safest option in your case.

Good luck, I hope that whatever you choose everything goes well for you and your new little one.

OP, c-section is a no-brainer for you. Do discuss the risks but my recovery from both (one crash and one elective) was, like 88Nikki, quick and uneventful.

I had a very bad 3rd degree tear with my first, spinal and surgery. Exactly 2 years later I gave birth naturally again, much easier and only a small 2nd degree tear that has healed quickly.

If you are going to give birth naturally again then you need to research positions to give birth in and what support you will need from the midwife. My midwife second time was amazing and guided me slowly through the pushing phase, using warm flannel etc. It was a very positive experience.

Whatever you decide good luck!

I had a bad year first time around and was terrified second time, I had a homebirth and the MWs knew about my fears. They guided the head out and I never had any tears at all despite no2 being 3lbs heavier than no1.

I had a 3a tear with 6lb DS1 and had to have a spinal/stitches. I was advised that I'd be fine to have a 'natural' birth with DS2. My MW stated in my notes that I needed an experienced MW during birth due to previous 3a tear. Had a slight tear and a couple of stitches with DS2.

Hi OP, it sounds look our first labours were very similar- I also ended up with a 3c tear and all the joys that follow!

I'm currently 38 pregnant with DC2 and booked in for a c section in 11 days time. Midwife automatically identified me as a 'red route' (i.e. consultant led) at my booking in appointment due to previous tear and everyone has been very supportive. Option of c section was given to me at my very first appointment with consultant and, although they said they'd support me if I did want a natural birth, they definitely were happy with my decision to accept c section. If I go into labour between now and then I'll have emergency section (unless head is basically hanging out!)

I can still 'feel' my tear as tender these 3 years later if it's a cold day or I'm doing exercise. My friend also had a quick birth recently and said she completely broke down when she felt herself tearing again - her body refused to push anymore and she ended up with a more prolonged labour/ eventual emergency section anyway.

I'm really really really looking forward to being able to poo properly after birth this time!!! It took at least 4-5 weeks to have a reasonably 'normal' poo last time - something I'll now never take for granted again!

OP, c-section is a no-brainer for you

I got as far as stoma in your post and came to this conclusion also!

I had a 4th degree tear with DD almost 4 years ago. I had urgency and wind issues. When I was pregnant with DS the pressure on my pelvis exacerbated the urgency problem, and there was no way I was risking another bad tear (or making my issues worse without tearing badly, which is also possible). I also think I would have had a major psychological barrier when it came to pushing.

I had an ELCS with DS 5 weeks ago, I had no problems at all getting it signed off. The procedure itself was calm and easy, I was sitting up breastfeeding DS within an hour of getting called into theatre, and recovery has been fine even though I had very limited mobility due to a badly broken leg. 5 weeks on and it's as if nothing had happened.

Good luck whichever option you go for (though if you go for the c section don't forget to pack peppermint capsules and lactulose!)

Thanks for the advice everyone. I have spoken to my consultant who has advised c-section but said they will support me whatever option I decide. Ladies who have had c-sections can you advise how the process was for you. Was your partner allowed to stay with you after the section? Did you feel the recovery was very difficult or easier than the recovery from the tear?
Also @OuchBollocks what is the peppermint and lactulose for? x

I had a third degree tear with dd but I opted to try natural birth for ds anyway. It was fine, no tear at all. The midwife knew my history and talked me through labour. I almost had to have forceps both times because the babies heart rates were irregular but managed without both times.

Peppermint and lactulose is to help bowels post CS as you can get very blocked up. I had an ELCS three weeks ago due to medical reasons. It was v calm, husband was in theatre with me and stayed with me after. I was standing up by the evening although a bit wobbly on my feet, walking round the bed the next day and discharged on day 4 ( I wanted to stay in as long as poss). Pain hasn't been too bad - was on lots of drugs for the first few days and slowly eased off painkillers over 10 days. Now not taking anything and only feel the occasional twinge on my scar.