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Childbirth

Share experiences and get support around labour, birth and recovery.

Original poster

4th degree tear- 12 week Consultation help

32 replies

Tattybogle89 · 25/02/2018 22:40

Hi has anyone had a 4th degree tear? Did a search but found nothing recent. I’m struggling and jump when the letterbox goes as I know I’m due an appointment through for my 12 week follow up.. I assume this will involve my bits in the air and a bloke poking around down there again. And I don’t think I will cope.
I already ignored a physio check up after birth then cried because I was stupid enough not to go.

Anyone been through similar?Sad

OP posts:
Batterseapark · 26/02/2018 18:15

Hi OP, I'm sorry you're going through this.
I imagine the 12 week appointment is for a rectal scan?
I suffered faecal incontinence after birth and was referred to pelvic floor clinic with physio but also access to urogynaecologist and colorectal services. Had a rectal scan around 3 months and a manometry test around 6 months to check the strength of the anal sphincter.

There are 2 Facebook groups you could join. Birth Tear Support is for women who have suffered/suffer complications from episiotomy or tears and 4th degree tear support (I think that's the name - name given on the Birth Tear Support group if this doesn't work) for women like you.

I would try and go to see the physio. I had to change because the first didn't seem to understand the impact of my injuries so don't be afraid to change if you're not comfortable with the first person you see (call physiotherapy services and just say you want to change).
Flowers

Original poster
Tattybogle89 · 26/02/2018 22:48

Oh gosh I hope not no one mentioned a scan? What do the procedures you mention involve? I’m terrified.
I’m sorry for the issues you have suffered too
It’s just awful
I also thought more people on here would have gone through the sameSad

OP posts:
Tormundsbeard · 26/02/2018 23:11

I had a 4th degree tear 16 years ago.. from memory the 12 week check up wasn’t too bad. Try not to worry.

Batterseapark · 27/02/2018 07:25

I do apologise OP. I didn't mean to frighten you. A scan is normally organised following such injuries.
I found the rectal scan OK. It's only the sonographer and you. You lie on your front and they put a small probe in your bottom. It's only at the entrance so personally I didn't think it was invasive. It was over very quickly.
6% of first time mums suffer severe tears (3d or 4th degree tears) and 3% of all mums overall.
You haven't mentioned incontinence issues. This is a very good sign. Physiotherapy is the best treatment to make sure all your muscles are strengthening well (or are relaxed enough).
It's better to start physiotherapy as early as possible after birth.
Would you be willing to go and see the physio and say that at this stage you're not ready for a physical examination? I'm sure they have other patients in your situation. You could ask them all the questions you have?
Smile

Batterseapark · 27/02/2018 07:34

Forgot to say you could also explore the idea of asking for a chaperone to be with you.

Footle · 27/02/2018 08:59

Tattybogle, IMO batterseapark has given you a lot of worrying information which may have nothing to do with you.

It's a shame you didn't see the physio - she's the person who will probably be the most help to you, so please make yourself go if you're lucky enough to be offered another chance.

Severe tearing needs proper treatment or it will seriously affect your life. Accept the help that's offered : you'll be far better able to look after your child if you look after yourself first.

Original poster
Tattybogle89 · 27/02/2018 09:40

@batterseapark it’s ok I appreciate the replies it seems not as many people have gone through this that I can find on here

I called physio and it turns out it was made for my tummy muscles and nothing to do with down below.. I just seen women’s health on letter , and assumed. Apparently physio is not offered as standard for 4th tears unless incontinent.

I have had one accident and one near miss where number twos are concerned but that was in the first 3weeks after birth.
Maybe sneezing isn’t great ..occasionally.. where wee is concerned but not a massive issue if that makes sense?
But I have to run to the loo when I need a poo.. it feels so different and I never feel finished? Also still taking laxatives as pretty stingy and sore after a poo. Normalafter 3months?!
Sorry if this is TMI
I’m mortified

OP posts:
Bluebelltulip · 27/02/2018 09:57

My 12 check consisted of questions about incontinence etc then a quick examination. I understand it's daunting but if it hasn't healed properly the sooner it's picked up the better. Mine was fine and just reminded me to keep up with the pelvic floor exercises and if any problems arise go to gp.

hopeful31yrs · 27/02/2018 10:01

Get this sorted now. Get yourself to your GP and get proper pelvic floor physio sorted. You may not have incontinence issues now but may well develop them (sounds like you have an altered bowel habit already). You need proper advice. Don't leave it - it's more common than you think and health professionals do this as a routine

Batterseapark · 27/02/2018 10:04

I really didn't mean any harm in my comments. I can only apologise again. I don't want to start arguing with others and distract from your questions so I'm withdrawing from this thread.
All the best for the future 😊

mamas12 · 27/02/2018 10:11

Sympathies to you it is awful but you can ask for female doctors and health care workers and phone and ask in advance so they can organise themselves for you
P,ease let them know how you feel and they will be very helpful
Just talk it through with her first then decide when you're ready for any invasive procedures
Remember it is your nobody and they need permission to do anything to you but the sooner you go the better

mamas12 · 27/02/2018 10:12

Your body !

StarStruK · 27/02/2018 10:51

I had a 4th degree tear 2 years ago and have fully healed. I completely understand how you’re feeling about the appointments, it is daunting and nobody seemed to give any real explanations or ideas about the recovery which I found extremely difficult.
I think my 12 check may have been gynaecological, which in hindsight was fine and physio was offered after that appointment. I was referred to the colorectal team at 6 months (I was expecting this though and was dreading it from the moment I found out) and that was fine too, I just had to get over my own awkwardness. They could see from the scans that the muscles had healed and I’ve been left alone since then!
2 years on, I have no problems and I’m booked in for a c-section next week for baby number 2 Smile
I know how horrible it is, but I agree with the other posters and urge you to attend the appointments to help prevent any long term damage. Hopefully you will get more information on your recovery. Good luck!!

Footle · 27/02/2018 14:10

Batterseapark , I hope you are still reading. I didn't mean to upset you.

OP, there are lots of women with these injuries and lots of threads here, mostly under General Health, and also at least one Facebook group for support.

Original poster
Tattybogle89 · 27/02/2018 16:04

@hopeful31yrs thanks for being blunt.. I had hoped if I wasn’t incontinent now I had been lucky.
Was just looking for someone to compare experiences and reassurance
@batterseapark is a shame you’ve been made to feel that way

Oh well

OP posts:
Original poster
Tattybogle89 · 27/02/2018 16:07

@starstruk

Thanks for your story. Do you mind me asking why you were referred to physio and also colorectal? Trying to piece together what might come next for me.

Have really struggled coming to terms with what happened and developed a fear of what’s next so sorry if I sound a bit nippy

OP posts:
StarStruK · 27/02/2018 17:26

As far as I can remember, the referrals I had were routine follow up appointments for a 4th degree tear that were put in place quite early on by the hospital. I had referrals to urology, gynaecology and the colorectal team. The physio came as a result of some mild incontinence and bladder retention problems I had. The colorectal referral was because of the damage to the anal sphincter and they were checking the muscle and tissue.
I hope that makes sense and/or is some help? How do you feel your recovery is going?

Original poster
Tattybogle89 · 27/02/2018 17:38

OK THank you. All they said in hospital was down the line if I had any issues I could get things like scans, but that most people recover just fine..
I’m not sure. I don’t know how it’s meant to look or feel really. It’s still sore to pass a bowel movement and for a while after if I dont use laxatives. And I can’t ‘push’ on the loo like I used to empty.. neither am I sure I want to though.
I guess a scan would be a good idea so I know if my muscles are ok.. I can hold a poo but depending on consistency I guess, I have to run to the loo.
I’m not sure how normal all these points are. It almost feels like you are just expected to get on with it. I was discharged from hospital with just paracetamol and one midwife asked to check post birth but she never even put her hands on me and I’m sure couldn’t even see what she wasn’t looking for with the quick glance she took. Yes I should have probably seen a doctor since then but I just feel butchered and embarrassed by the whole thing Sad

OP posts:
Original poster
Tattybogle89 · 27/02/2018 17:39

*one midwife post birth after I was home

OP posts:
colouringinagain · 27/02/2018 17:45

Tatty big sympathies, I also had a fourth degree tear. I had physio for my bottom, and based on what you've said re urgency, emptying, cleaning I would recommend you ask for a physio referral. My physio was lovely, and it really helped. It also helps with your general pelvic floor. Best wishes.

StarStruK · 27/02/2018 17:54

It sounds like you’ve had pretty rubbish after care Sad I imagine my colorectal appointment was at 6 months because of the time it takes to heal, so perhaps 12 weeks is still quite early on. I know how you feel about not wanting people to check, I haven’t been able to go through with a smear test since, but maybe get a doctors appointment to just discuss your concerns initially.
I can’t remember much about the bowel movement side of things because I was having so much trouble with my bladder and my focus was on weeing, but you’ve been through a really traumatic ordeal and it’s tough, go easy on yourself Flowers

Original poster
Tattybogle89 · 27/02/2018 17:59

Thank you colouring I think I will and I’m sorry you suffered the same fate. Do you mind me asking if you ever felt normal
Again and how long it took?

OP posts:
hopeful31yrs · 27/02/2018 19:33

Sorry to come across as blunt but it's really important women understand the implications and the long term effects of a birth injury such as yours and my directness was my sense of frustration on your part for not having a plan already in place by your medical team. Long term it's the best to get it dealt with now and make connections you may need later. Hoping and wishing you all the best -

Original poster
Tattybogle89 · 27/02/2018 20:25

I understand hopeful. No one told me I can end up incontinent, just that I’m lucky I’m not? No one has asked to see my since other than a glance down there from a midwife. I haven’t even received the appointment yet for 12 weeks, it’s just the one thing I was told to expect, but it’s already late

OP posts:
hopeful31yrs · 28/02/2018 23:03

Please chase it up. And keep chasing it. Wish you all the best

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