4th Degree Tears...Does it ever get better?

[MrsEvans88]

Hey so I'm new to this site and posted this in another topic earlier today but had no replies and figured I may have posted in the wrong place. It's my first post so sorry it's such a negative one, just looking for some hope/support/anyone that's been through similar... My birthing story was horrific to say the least...Ended up in induction for reduced movements at 39+3 which happened at 14:00 on Tuesday 5th Sept. As the midwife was inserting the pessary she said that my waters had broken and sure enough I was sitting in a big old wet puddle.

Unfortunately though the midwife who was on day shift didn't tell the midwife on the handover who was doing the night shift about my broken waters. At 9pm that night I was in agony, I told the senior midwife that my waters had broken and that I needed to go to Labour Ward but she didn't believe me, and she said that the earlier midwife wouldn't have forgotten to pass that information over. I tried again and again to tell her but she wouldn't have it.

I gave in but said I definitely needed to go to labour ward coz I was having regular contractions n was asking for pethadin or any kind of pain relief. Instead at 11pm she finally decided to check me and found I was 2cm dilated. She told my husband I was still possibly days away from active labour and sent him home. She gave me a shot of pethidine saying that's all she would give me for 24 hours, but it didn't have any effect. For hours I was pacing the ward, crying out in pain and begging for more pain relief.

At 5am the midwife gave me two paracetamol and ran me a warm bath (not even birthing pool, literally was just a bath on my own on a ward!). In the bath alone with each contraction (literally 30 seconds apart) I started feeling like I had to push!! Managed to get out the bath between contractions n got to the front desk/nurses station and they were telling me I was over reacting- I was literally screaming at them "some one needs to help me I am going to have this baby right here".

So they said fine we will check you again go and wait on your bed...no one came for what felt like forever and I rang the emergency bell twice and was ignored. I was on all fours on my bed crying and screaming the place down and a porter came and told me I was waking up the other patients!!! Finally they checked me and I could hear them panic...said I needed to call Mike (husband) but I couldn't even talk at that point and just dialled his number and gave my phone to a midwife who called him saying "you need to get here immediately" and sent me straight to labour ward.

There they found that my baby was right down low stuck in the birthing canal and with each contraction his heart rate was dropping and not coming up again and needed him out immediately so they put a suction cup on his head to pull him out. I was in such a state by this point and mike still wasn't there n it's all a massive horrible blur now but all I remember is a lot of screaming and shouting and saying I couldn't do it but after just 9 mins in total on labour ward and with just the two paracetamol Logan was born and mike arrived four minutes too late 😓

Massive 4th degree internal tears through the perineum so had to go straight to theatre to get stitched up. They let me keep Logan on my chest while I was in theatre so he could suckle (he latched on at a funny angle and now I'm in a right mess with my left boob- blistered and agony and still trying to feed him with it now 😩) It was literally horrific but so glad Logan is ok. He's amazing! But I am a feeling massively battered and bruised both physically and emotionally.

I can't stop crying all day, my stitches are getting more painful as days go on and the bleeding is still very heavy. Also I have lost bladder control and pee myself daily. I thought the bleeding had stopped last night so DH convinced me to go for a short walk with him and baby today to try and clear my head a bit, but after 10mins my stitches had started to bleed again and soaked through 2 maternity pads.

I feel completely stuck. I don't want any visitors, I don't want to go outside and I can't stop crying. My baby is amazing, such a content little boy and I am head over heels, but I can't enjoy him or show him off. I stand to change his nappy and pee my self. Breast feeding is agony and so I've started to use a pump instead and combi feed. I have never felt so low or lost before.

Has anyone been through anything similar? Does it get better? I just want to feel like me again, and DH is back to work next week which I am completely dreading. Any replies will be appreciated even if you've not been through this yourself xx

I am so sorry you had such an awful time and was treated so poorly.

I has fourth degree tears with my first DC, 8 years ago. It did take a long time to heal properly, probably about a year, I didn't have sex again for this long anyway! To be honest if I put on too much weight now can cause me to have problems with control of my back passage and I get pains. But if weight is ok I am fine. Some positions for sex now can cause me discomfort too.

Things that help the healing are lots of Epsom baths with a little tea tree or lavender oil. Amazon sell big tubs of the salts. Taking lactulose so your movements are super soft, keep well hydrated so that things keep moving and are well diluted. You will be offered physiotherapy in a few months, try and do it, I didn't and regret it.

I had a second child by c-section which caused another set of problems but I went through pregnancy fine.

You can write to have your medical notes for the birth sent to you to see what was actually documented and you may want to go forward from there with some sort of claim, but I am no expert in this area. You like me just may want to move on.

Breastfeeding can be horrifically painful on its own, if you are struggling please call on the breastfeeding counsellors, one really saved me on a bad day by just chatting with me on the phone.

You need to be super kind to yourself for the next few weeks don't feel you have to be doing or going anywhere.

Best wishes, things will get better.

Big hug.

Sending huge hugs. Have you talked to your community midwife. I struggled and found breastfeeding agony she was brilliant. Managed to breast for a year

This is horrendous. I am so sorry you weren't looked after properly during labour.

I'd get yourself to the GP and discuss all this. Both the physical and mental impact of your experience need addressing really.

I would document all this in a letter and make a complaint. That might help recovery from the trauma.

On a brighter note, congratulations on the arrival of Logan

I am so sorry about your awful experience. It is still early days with the 4th degree tear but if you are having more pain and bleeding it could be due to an infection so worth seeing your GP for advice. With the breastfeeding, try and see a counsellor for advice re latch or have a look for the 'flipple' method on YouTube which I found helpful. I also used medela nipple shields when it got too painful. Two of my children had tongue tie which is worth ruling out.

Oh you poor love, please seak some counselling, I ended up with pnd and fecal incontinence, I had a sphincterplasty. Honestly I would call a lawyer once you are recovered, you received a substandard of care.

*Seek

Definitely go to your GP and discuss everything as they should be able to check your stitches and refer you to physio. you can also ask for a debrief at the hospital. This would allow you to give feedback too and to find out why things happened the way they did. Here you would ask your midwife to arrange it, not sure if it's the same everywhere, and although I didn't have one myself I know people who Had traumatic births and found it really helpful.

I'm so sorry you have gone through that experience. Whilst your nipples are sore I would recommend the use of nipple shields. They really turned breastfeeding around for me, I was ready to give up. Some people are negative about them but I've ended up using them long term with my LO. They are 5 months now and I still feed with shields with no issues.

Congratulations on your little boy

YY to everything here.

Get to your GP as soon as you're physically able, but don't push yourself if you're not physically ready yet. Ring for advice and explain your symptoms if you can't get yourself there yet, but if the pain is getting worse and not better, I would recommend trying to get there if you can. Talk to your HV when they arrive as well, about your symptoms.

Definitely agree with PP on this as well: You can write to have your medical notes for the birth sent to you to see what was actually documented and you may want to go forward from there with some sort of claim, but I am no expert in this area. Please note, though, that I am not an expert either. But this sounds like horrendous substandard care and possible even negligence to me (esp the failure in communication about your waters), and I would absolutely take the records and your experience to a SHL and at least see what they tell you.

You will get better, you will heal, and you will feel yourself again. But you've got to force yourself to rest for now and let your body heal. No more letting your DH talk you into physical activity, and in fact he's going to need to do basically everything for you for the next little while. Make sure he understands that you're really going to need to lean on him for a while, for your own health! It won't be easy and you may feel stir crazy, but try to concentrate on your lovely baby and get as much sleep as you possibly can. Perhaps send DH out for a few trashy but entertaining books?

I'm sorry love. This sounds absolutely awful. Take care of yourself.

This happens far too often

Go to your GP and explain what happened - perhaps show him your opening post. Do not assume the details of your labour were recorded truthfully and are "on the system".

Immediately: your stitches shouldn't be bleeding now, someone needs to check that they are healing OK. You might need stronger painkillers - I know paracetamol didn't touch the serious pain.

Short term: ask you midwife for support with breastfeeding. Use nipple cream or a nipple shield in the meantime. Also you might need support with day-to-day stuff - I know I couldn't carry baby up and down the stairs for weeks, couldn't walk to the shops and would have benefitted from detailed advice about toilet issues, I had to have a family member with me. Your injury is more serious than a c-section one and you need support to recover properly. You might need a physio referral to check that all your muscles are working properly. My physio was lovely and the most competent healthcare worker of all the sorry mess.

Medium-term: complain complain complain. You had appalling care and it was completely avoidable. I know you have a lot to deal with right now but ask your GP about how to get started so you have names / forms/ etc for when you are ready. You went through a traumatic birth and it might take time get to terms with it and move on - most hospitals offer a debrief service which can be helpful, perhaps your area offers counselling, too.

Long-term: it does get better. I had a 4th degree tear over 5 years ago. Sex is fine, I can only feel my scar when it's very cold, I can exercise, run and jump without a problem, only have very mild stress incontinence occassionally. My next child was a section whih was a walk in the park compared with my first child.

I don't agree with the "sue" culture but I would consider it in your case as it was so avoidable. Also women's continence and genitalia seem to be an afterthought for many maternity staff (not doctors IMO) and are treated as cannon fodder during childbirth. That needs to change and if it's financial pain that is needed to bring this change about, so be it.

for what you had to go through and congratulations on your baby, hope you are enjoying squishy cuddles now

Oh gosh OP, that sounds dreadful. Get yourself to the GP to see if there is anything they can do to help in the short term. Longer term I'd make a big complaint, sounds like your treatment was terrible and all of this was avoidable.

Congratulations on the arrival of Logan

I read your thread and feel for you so much, I had a traumatic birth and my bladder packed up afterwards.
I wasn't leaking, but I couldn't wee at all and had a catheter (leg bag) for 3 weeks afterwards and was left needing to catheterise myself for several more weeks afterwards.
The shock was horrendous, I didn't know that could happen! Add in worrying if I'd be doing that forever, recovering physically & mentally from birth. the nipple pain, the stitches, A sick baby who didn't feed well and cried all the time. The sleep deprivation and fucking hormones.

I didn't go out (apart from hospital appts) for a month. I didn't want visitors or to see anyone because of the state I was in.
With hindsight I was depressed, and a year on and having counselling which seems to be helping.

My advice to you is to talk about it. Do you have family or friends who could come over? I had an older cousin who insisted on staying with me, even though I didn't want her to, it made a massive difference just having someone in the house.
You'd be surprised how many people have been through similar, even people you know already, but we don't talk about it.

I'm sure things will get better, breastfeeding support - have a google for stuff near you/phone lines. Talk to your midwife/GP about what's going on physically with you.
And if that's too much keep posting here, there's a wealth of support and people who really do care

This sounds horrendous, you poor thing. Great advice above but also your DH must take some more time off work if a friend/relative can't come and stay for a bit, you can't be on your own yet when you are still in such a physically & emotionally fragile state.

You need legal advice, op. I know you won't feel like it, but it is really important that there is proper recognition of what happened to you so that you receive sufficient medical care to recover. You will need proper monitoring to check how you are healing and what damage requires further treatment. I am so sorry this happened to you, it is absolutely appalling and you did not deserve it.

Good god you poor woman. It is just horrendous what you want through.

I haven't experienced a fourth degree tear but did have trauma from my first birth, and I've also had a terrible recovery from emergency surgery post ectopic pregnancy. Both those times felt very dark but you do come out of them, so please keep telling yourself that this isn't forever. It's early days.

In the meantime I agree that you need your stitches looking at, and stronger pain relief. It is not acceptable that you are expected to look after a baby in this state, and proper pain relief can take the edge off at least. Do not shy away from making a 'fuss' if you need to.

Once you're stronger I would honestly speak to someone legal about what happened during your labour. What you went through sent chills down me.

I had a 4th degree tear 14 years ago and I would like to give you a positive story. I had surgical and physio follow up (just to check on repair and to offer advice). Just one appt with each. I am fine. I have never had any form of incontinence, although I am prepared mentally for an increased chance as I get older. I was fortunate in that my repair was done by someone who had attended a conference about 3rd and 4th degree tears that very day. You can be lucky.

So sorry to hear this. It sounds a traumatic experience. I suffered a 3rd degree tear, so not as severe as you, but it healed well.

Try to get hold of the highest strength arnica tablets you can as that should help with the swelling and bruising. Were you offered any follow-up support from the hospital?. I had to see a continence midwife a few weeks after the birth. It is very important to try to do your pelvic floor exercises as soon as you feel able.

I would also make a formal complaint to the hospital about their appalling treatment of you.

Is today your final home visit by the community midwife? Have they been checking your stitches?

The bleeding when you were walking may not have been the stitches - it may have been your uterus because of the physical exertion on your body from walking for the first time. That's what happened to me (and the bleeding didn't stop for over two months).

Do you have diclofenac (think that's how you spell it)? If not, ask the midwife or GP for it. It's much better than ibroprufen and paracetamol.

I'm so sorry, what you have been through is horrendous. I had a similar experience with an induction and then my son coming fast (they didn't believe me either ).
I was left completely incontinent, I couldn't even feel my bladder initially. But after 2 weeks it was starting to get better, and after about 5 weeks I stopped wearing a pad. My bladder just needed time to recover.
I remember clearly the fear of standing up, and I wet myself many times a day. Not easy with a newborn.
I am fine now and can even go on a trampoline! Pelvic floor exercises are your friend.
Be kind to yourself and please don't be embarrassed, it is so normal.
wrt the breastfeeding have you tried lasinoh nipple cream? It is the best and works wonders, apply it after every feed.

You poor thing. I had a very similar experience to you with dc1. Put on an antenatal ward, absolutely no midwives to be seen, me pushing on my own and a drunk bloke pulling back the curtains to tell me to stfu as his wife was trying to sleep when I was on all fours with my vag out!

It was only when I got pregnant with dc2 that the midwife was asking about my first birth and I just just hysterically crying. She referred me for counselling for ptsd which has helped a lot.

I'm so sorry this has happened to you. Going from being a completely independent woman to begging people who should help you for assistance is fucking dreadful.

I'm so sorry you went through that. Thank goodness your baby is OK. I really think you should visit your GP and get her to have a good look, and also ask for a referral to a specialist perhaps? Keep going every week or two for a while to keep getting the stitches checked. I had ventouse too and very bad tears. I had no check up on the stitches afterwards (before the 6 week check) and ended up with infected stitches, so had to go on antibiotics. Still no check after the course to check they'd cleared up. In hindsight I wish I'd got myself to the GP more. They won't call you , you have to seek out the help. And you need it! Good luck xx oh and also try Breast Angels and also i used nipple Shields every feed for about 4 weeks, they are a lifesaver and i could not have breastfed without them.

Correction to last post. I used nipple shields for 4 months, not 4 weeks.

Hi Mrs Evans,
I'm sorry your birth unfolded this way.
If you'd like to look into complaining I'd advise you get in touch with personal injury solicitors (specialised in obstetric injuries).
They'll get hold of your notes (count 1 month for that and costs £50 I think) and look whether you have a claim (this will take a few weeks so in all I'd say around 3 months for the solicitors to tell you what happened and what they think).
When you know this then you can decide to sue or not. You can start a claim up to 3 years after the birth injury however because it takes 1 year to prepare a case, you effectively have only 2 years from the date of birth. So you have a bit of time to think about it.
You need to be aware that if the NHS admits liability you're looking at 2 years of back and forth with lawyers. If they don't settle and the case reaches court, it may 5 years without guarantee of winning at the end. The solicitors will be best placed to explain all this.
Personally I'd take the first step (contact solicitors) and see what they say.
I'd also ask SOMEONE ELSE to take on this task (contact the solicitors) so it doesn't add to your burden now.

You will get better physically and mentally but it will take time. At the moment you've suffered a serious injury and you need all the help you can get.
It took me 10 weeks to walk further than half a mile. 2 month for the episiotomy and tear to heal completely.
You need to start pelvic floor exercises 5/6 times a day until you see a women's health physiotherapist.
Buy a Valley cushion to sit on and freeze wet maternity pads you then use 3 times a day for 10 min to help reduce the swelling (until it gets better).

Contact the Birth Trauma Association. You will sadly but fortunately find other women who have been through similar experiences and who will be able to support you.
You may need to ask your GP to be referred to a perinatal mental health service so you can freely talk about what has happened to you. If you feel ready, talking will really help you.

Before I go, I want to stress that things will NOT stay as they are and you will get much better.

I'm so sorry you had such a hard time. I would see if you could speak to community midwife or health visitor, as I felt they were the only ones after having my wee one that really had time to sit and listen.
I think I had a 3rd or 4th degree internal tear and I remember feeling really down about it, and so anxious about moving the wrong way or tearing again but when I eventually (weeks later) was brave enough to have a wee look it actually didn't look nearly as bad as i had thought and i found that reassuring.
I also lost a bit of bladder and bowel control which was embarrassing but they should explain all the exercises to do and it will get better.
It might be a tough few weeks but you can do it, be kind to yourself and don't put too much pressure on yourself xx

Oh bloody hell OP. Your story is awful

I'm nearly 14 years on from a 3rd degree tear. I tore right through the perineum (is that a 3rd?? I was told it was). I don't think I had too much internal tearing though.

My story isn't as awful as yours. I had a long back to back labour and then baby got stuck, vontuse and forceps were used. When dd was finally born she came out in an OP position. So she was facing up. This can cause more damage.

For me (14 years on) it's still a blur. It took me nearly a year to mentally get past the birth. My GP sent me for physio because I had no bladder control. Things did get better and I got a lot of control back eventually, however I still struggle with a sensitive bladder and can never hold on for long.
I used to cry hysterically when people innocently announced new births if they tagged a line about the birth on. The worst was when my dh's friend texted to say they'd had a ds a his wife had

"done it all with the slightest whiff of gas and air. Now that's what I call a woman!"

That floored me.

OP, you WILL feel better in time but it will take a while. You need help. Ask your GP about your stitches/healing. You need to be refered for physio and possibly counselling. In my area they good provision for post birth counselling, hopefully yours does too.

You've been through a huge trauma. Don't expect to feel fine just yet.