4th (yes 4th!) degree tear....and trauma of seeing scar

[rachelvs]

I had deliberately not looked but then caught a glimpse in the mirror a few weeks ago and, quite frankly I am not dealing with what I saw.

I had a 'normal' delivery, 4wk prem, baby 7lb 13oz and her shoulders got stuck leading to a 4th degree tear (well actually 4th degree cut by doctor). I was taken to main theatre to be sewn up and to be fair the surgeon did a fantastic job. I never experienced any serious discomfort nor complications.

I had never looked at or checked down below, I think because I didn't want to know what it looked like. It was something I was happy to be ignorant of. BUT - after shower a few weeks ago I caught sight of a red scar running along the inside of the (sorry to be blunt) crack of my bottom. Yes, my scar goes all the way to the top of the crack in my bum!!! The cut went from my vagina through my anal muscles and up - it couldn't have gone any further - it's like a c-section scar only underneath.

Since then I have felt disturbed by the whole thing and it has reignited memories of the birth and how traumatic the delivery finally was. I have discussed with DH what he saw and what happened at that end when DD was born. It was not a pleasant experience for him either and I suspect he too is traumatised by what he saw.

I feel violated and no longer a sexual person. I don't know how to move on from this. DH and I had not had sex after DD born upto my discovery (at about 12w post partum) and now the likelihood seems further away than ever. Being only married last July I love DH dearly and want us to be intimate again but don't know how to rediscover my sexual self, that person before the butchery.

It's a good idea to write and talk about it . I had a baby last September and had a third degree tear which has healed up really well but the tissues are sort of hard if you know what I mean . When you go to your checkups in hospital for your tear you should ask the midwife / doctor to see a specialist midwife in the area of birth trauma . I've heard from women with different problems that they do exist ( in London anyway ) . You need to speak up about the emotional side as well as the physical . On the plus side all these tears can easily and frequently lead to urinary and or faecal incontinence so that is a major deal if you haven't suffered that. BTW Congratulations on the birth of your daughter .

Oh rachel, I'm so sorry, that sounds really rough. There is an org called the Birth Trauma Association or something - you could find them through searching on Mumsnet or through Sheila Kitzinger's website, I think. What you went through sounds really traumatic and I think you should take seriously seeking some proper help with this.

Good luck.

Rachel,
PLEASE take hester's advice to heart.

And bump this thread a few times for other times of the day/week.

Because you are NOT alone and there is help here on this board.

Hi Rachel

congratulations on the birth of your baby.

I am so sorry that you feel so disturbed by what you have seen... a 4th degree cut or tear does go right into the bottom, which can be reallly distressing....

you can contact either of these organisations to talk about this,

birth crisis

or

birth trauma association

there are other women here who have had 4th degree tears or cuts, whi can offer good coping advice..

i think it would be really important for you both to speak to someone, to come to terms with what happened at the delivery, articulate how you felt at the time, and how you feel now. Simply writing it all down can really help too.

agree with lulu et al, you need to talk to the BTA or simillar about your experience. it must have been very frightening but a thought worth remembering is that you are still the same person you were before the birth, its just you are a mother as well now. it might help your dh to discuss his feelings about the birth as well, they find it v traumatic too.

btw, congrats on your new arrival

Thanks for the links. I have been to see my urotherapist a couple of times and she advised me that the head of midwifery in Jersey will be happy to talk to be about what happened & why it happened etc. She is a trained counsellor in this area. I think DH and I will also contact the agencies in the links as I agree it is an experience we both need to offload - seperately and together. It is also affecting how I feel about having more children so really need to deal with it as ideally don't want DD to be the one and only.

Traumatic as it all was, our DD was more than worth it

Oh my god, bless you. That sounds awful for you, and also your husband in a different kind of way. I dont' have experience but just wanted to say that seeking advice and support on here hopefully will help you enormously.

Thankfully you have a lovely baby daughter, she will be such a joy over the years - you have so much to look forward to as she grows up and develops.

There are many ways of being intimate without having penetrative sex, you obviously have a great open relationship with your husband if you can both talk about things like this which is a head start. Make sure you get loads of cuddles, have a snogging session, massage, oral if you enjoy that anyway and feel comfortable enough, try and have a romantic meal with candles and soppy music etc. Make sure he knows that you want to take things slowly so he doesn't put undue pressure on you (without realising).

no advice hun but its sounds very traumatic

(((((((((((( ))))))))))))))

hope you feel better soon xxx

Oh sweet, its difficult to reconcile isnt it?

I had a 3rd degree tear and an episiotomy scar. The surgeon cut it in a 'J' style so it curls out towards my thigh and anus. I cant really explain it more than that but i'm sure you dont need graphic details. It did bother me for a while. Physically and emotionally. I think I could have coped with a scar on my face more easily than one 'down below' at the time. It's left a slight 'pull' to one side, and the scar tissue was very sensitive and tight for a while too.

I didnt realise the extent of it until I went to the docs at around 12 weeks post partum and explained the problems with hyper sensitivity of the scar and she told me how deep and how far the tear had gone. It got better after time, although very slowly. I felt more and more comfortable with it too. I'm not 'aware' of it now so much, except when I am on my period...dont ask me why its more sensitive then.

I did go on to have a second baby. This time with no tear or episiotomy - just a little graze. Its four years nearly since the tear and I cant say that it bothers me at all. DP seems to be fine about what he saw too now, especially after having our less traumatic second baby.

I agree with the others, its worth getting in contact with the associations suggested for further help.

Oh rachel, poor you. I was about to suggest birth trauma association but see lulumama got there first. I don't have any experience (crap birth 2nd time for me but got away with just stitches) but hey, I'd have thought what you're feeling is normal after such a difficult birth.

i suffered a bad tear after ds1, although not as bad as yours , and at the time, i thought i would never have sex again.
i felt a bit, ugly down below i guess. hard to explain. for some reson i thought dh would not 'like' my fanjo anymore.
i waited until it all felt healed, then had a look one day.
i had another look a few months later and was glad to see it had faded a lot and was silvery, a bit like a stretch mark in colour. nowadays, it is hard to spot at all.
if you have internal scarring, once you feel ready to resume sex, (and you will! i told everyone on here i wouldn't and they said i would and i did! hence ds2!) it actually helps as it massages the scarred tissue.
all the advice already posted here is excellent, as always!
if it helps at all, i didnt tear at all with ds2.

good luck, im sure it will all come right and many congratulations! Xx

Rachel, just to say I can sympathise as I had a bad 3rd degree tear, bordering on 4th, and spent the first few months of my babies life in tears. Felt so rotten after all the surgery, and kept thinking about how I went into hospital a normal healthy young woman to have a baby (something thousands do everyday) and came out with a ripped and torn body. I like you, felt butchered and brutalised. I went in very innocently to, thinking the worst that could happen would be a few stitches, had no idea you could end up ripping your bum apart. I've looked at my bits many time, but to be honest found it to upsetting and dont look anymore. On a positive note (because there is one) what people have said on here about sex helping with the scar tissue, is SO right. Sex really does seem to help elasticate the area and I find that its no longer painful for me anymore (I wont lie, at first it was excruiating, it felt so tight like I'd been stitched up to much). I'm also relieved that I dont suffer any incotinence issue which is definitely something I'm grateful for.

What helped me so much is the knowledge that many other women (amazing how many poor souls out there this has happend to) have had 3rd and 4th degree tears not only on this board but also on babycentre to. It happens more often than people know. I suppose its not something that people shout about, I certainly didnt tell anyone but very close family about my tear and I dont think even my mum knows how badly torn I was.

Do post on here if ever you need to and I will look out for you and reply. All the mumsnetters on here have been invaluable to me with their kind words and support.

Daisy

I'm glad I read this after my labour and not before, it is shocking. A couple of babies back I had a couple of grazes which I looked at, two gaping gashes seeping with blood but too shallow and wide to stitch...grazes! Huh! But remembering how traumatised I was by that puts into perspective what you must be experiencing. No advice, just really feel for you.

No advice but just a big hug for you all. This sounds dreadful. You have my full sympathy !

{{{{{{{{{{HUG}}}}}}}}}}}}}}

rachelvs - I am really sorry to hear of your horrendous delivery. I would advise that you go and see your doctor as I am concerned though that perhaps you have misinterpreted what you have seen when you looked. Correct me if I am wrong but you have described a scar from your anus up the cleft (crack) of your buttocks. That is not where a third or fourth degree tear goes.

It is really common for the skin there to get red which could be mistaken for a scar.

A third or fourth degree tear extends into the anal muscles but that repair is inside. The scar is usually between the vagina and the anus but does not extend through to the other side.

I think that mentally you are visualising a tear going right through and beyond up between your buttocks but that is not what usually happens. Please make an appointment with your doctor who should be able to reassure you. It also is a good idea to contact the birth crisis organisations to discuss through what happened.

I know the 'tear' went through my vaginal and anal muscles. The doctor who performed the delivery and the surgery to repair was great and explained exactly what had been cut and sewn up. He did an excellent job. I have had no incontinence from either side and never really suffered any real discomfort. I have spoken to my gp and she confirmed that the external scar I have seen is exactly that.

Sorry rachelvs - I am a midwife and have never seen a tear extend up between the buttocks if that is wahat you are saying. Have I misinetrpreted you? I am just concerned that you are confused with what you have seen which will cause you greater distress. Have you shown your GP the scar you are describing here? I just want to make sure that your trauma is not being made worse by thinking that the scar is worse than it is IYSWIM?

Are you in pain, has this scar made sexual intercourse impossible?

If yes then you need to seek medical attention.

If no, then its just something you're going to have to grow to live with.

As a person who carries obvious scars which can be seen by the public (i.e. on limbs, not bottom) I've had to do the same. They eventually become a part of you, they mark your experience, you hate them for a while, feel sick at the sight of them and then learn that they're as familiar as the colour of your eyes and that's the end of it.

I hope I haven't scared you away rachelvs

mears - I believe this is what rachel had.

rachel - you are a VERY lucky girl if all this caused little discomfort and no loss of function. For your scar tissue to heal well (and not get hard and painful like some do) I highly recommend this cream. Rub on scar (and continue rubbing a long time) twice a day.

I hope you feel better soon. With time, the scars fade and so does the memory of them and the actual "butchery". [That's how I referred to my birth as well for a long time afterwards, incidentally]

mears I hope you're right cos it sounds horrendous to me.

I feel shocked that I didn't even know women suffered such terrible 'tears' (how could I not know?).

I was under the impression that if any difficulty was encountered an episiotomy would be performed to prevent such trauma.

It IS an episiotomy that she suffered.