Epistonmeny and tear with 1st - what was your experience with 2nd?

[Morgan12]

Just as the title says really. I'm unsure what to do for 2nd birth. Recovery after 1st was horrible both psychically and mentally. I'm allowed a c-section but not being forced to, the choice is mine. I'm basically terrified of choosing wrong. I'd love a 'normal' labour and birth as I didn't experience this 1st time, but if I end up with epistonmeny and tear again I'd forever regret my choice.

Has anyone experienced this and had a good 2nd birth?

How extensive was your tear?

Big episiotomy with no.1 as she was stuck and they had to practically drag her out no.2 and 3 were born in the pool with no damage at all. There was a 4 year gap between 1 and 2 though, which might make a difference in terms of proper healing.

All I know is that it was a 3rd degree tear. I have a meeting in a few weeks to go over exactly what happened.

I did talk about a water birth this time but not allowed as I had a large pph last time round and it's too risky.

Thinking I should just opt for section as I've read that electives are very calm. Which would be welcome after last time. I'm just scared of recovery time.

How bad was your tear? I had episiotomy and a lot of tearing with my first. Was very very sore and very swollen. On my second I tore naturally where my episiotomy was the first time. The recovery was much better and I wasn't anywhere near as sore.
I think if there is scar tissue there from before it is very likely you will tear again as scar tissue doesn't really stretch as much.
Although some women will get away without tearing again after episiotomy.
There is no way of knowing how labour or birth will go.

Sorry just seeing your post now. 3rd degree tests are different story as effect the rectum. Don't know stats for reoccurrence but am sure your Dr will be able to tell you.
Sounds like you had very traumatic time so def c/s is worth considering.

I had an episiotimy and vontuse (excuse the spelling) with first as babies head was in wrong position. Second time round was fine, no intervention needed and no tearing.

Watching with interest as I am in the same situation....had a 3C tear and episiotomy with my first (with forceps)....very traumatic 😩

Personally I am leaning towards a CS if I have another....the fear of the same thing happening again is too much. Sorry no real advice, just sympathy 😔 its a crappy situation.

Episiotomy the first time, second was a textbook birth. Had a water birth and needed one stitch. I was home after four hours and at playgroup with dd the next day. I think perhaps the warm water helped prevent tearing. He was a bigger baby but came out fine.

I had a horrendous recovery from my episiotomy after it became infected. I have a lot of scar tissue and have been advised that as this will not stretch like normal perineal tissue, I would likely tear again.

I have requested ELCS and every single HCP has been very supportive and considered my request to be totally reasonable.

What was your recovery time with your first? A third degree tear is pretty rough, it must have been difficult for you, especially if weakened by PPH.

You do sound like you're leaning towards a section. There is a lot of certainty in a planned section - you know for sure you will have a wound but it's in a place that is easier to keep clean and dry, and the recovery process is mostly predictable. With VB, you could bounce back perfectly within a few hours or your could have extensive injuries, or somewhere in between, and there is no way of knowing what you will get. It's perfectly valid not to want to roll the dice of VB.

I had episiotomy with my first for ventouse delivery (almost 8 pounds) but thankfully it didn't extend into a tear. For my second (just five and a half pounds), I tore along the scar line for the prior episiotomy.

Talk to your doctor and ask lots of questions about your risk and pelvic floor health etc.

I had an episiostemy and a third degree tear with DC1 as she had shoulder distocia and got stuck. My recovery was awful and I had a lot of trauma after the birth.

With DC2 I had an ELCS and it was wonderful! Very calm, stress free, awake for it all and put at ease by an amazing medical team. My recovery was straightforward and I was back doing the school run a week after the birth (albeit very slowly!)

I don't regret my decision at all but struggled a lot with wanting the 'perfect' birth. Ican see now that it's not important, having a baby that you are well enough to care for physically and mentally is much more important.

Good luck with your decision and happy new baby!

I had an episiotomy and tore badly with the first (ventouse). Took a long time to heal.
I nearly had to have a C section with the 2nd as she was transverse until very late in the day, but ended up with a natural birth and it was fine - a slight graze but that was it.

I would have a section in your situation. Its not just the tear but the PPH that would scare me.... they wouldnt offer you a section for no reason so they must think it would be of benefit to you.
By all accounts planned sections are usually very calm affairs. Id certainly take one if offered. Why put your body through labour again if you dont have to?
Had an episiotomy with my first but didnt tear and that was bad enough... cannot start to think what you must have been thru!

1st - awful tear
2nd - nothing
3rd - small 'graze' but no need for repair

I had an episiotomy with ds1, because I'd been pushing for 90 minutes, and it was that or an assisted delivery.

With ds2 and ds3 I had slight grazes, but nothing requiring suturing - no real problems at all.

Episiotomy and 3b tear with first, planned section for second. Best decision ever for me, recovery was physically harder but mentally so much easier xx

3b tear with first. No episiotomy. Took a while to stitch in theatre. Second I had an episiotomy and still tore. Pph both times. With hindsight Cs would have been better for my mental health but it was discussed only once at a consultant appointment half way through pregnancy. Maybe because that was because I kept insisting that I wanted a water birth..

I’m 3 months pp of 3B tear and episiotomy after forcep birth - very traumatic.

I am 95% sure I already know I will pick a ELCS for 2nd baby. I have had an awful recovery an only now is pain really subsiding. I literally cannot face any trauma in that area again. I’m pretty sure it wouldn’t withstand a second birth an god knows what I’d be left with.

Look up the stats etc an speak to your consultant and MW. It’s depends how you felt you healed. Did you have endoanal scan to check healing on your tear? They normally advise if you can birth vaginally again and physically recover well. If there is any defect found they advise CS.

Although I believe it is known even if you give birth vaginally again 2nd time an don’t tear..due to the extent of 3rd/4th degree tear injuries it still puts pressure on that area having a natural birth again and the muscles and tissue can be further damaged even if it’s an easy delivery. Ie. It could cause some incontinence issues even without another tear. Worth bearing in mind.

🤞🏻 Good luck with whatever you choose. It’s a shit situation to be in. I hate to have to make that choice one day. But know I need to do whats right for my mental & physical health

Elective sections are amazing 😉
Horrific first birth, still have nightmares about it 8 years later!

2 electives after that and both were so calm and I healed very fast.

I had both with my first (although didn't find the birth traumatic? Just thought it was normal/one of those things)

Nothing with my second, but it was more painful!!

Hello just wanted to share my experience.

I had an episotomy - forcep delivery with my 1st, suffered a pph. I had a lot of internal and external stitches and recovery took a long 8 weeks, which involved a lot or crying as I was in such despair with the pain! Even for months after I felt tender and had terrible back pain for up to a year due to epidural.

2 years 9 months later and I've just had my 2nd birth last week. I was told I had to go to the labour suite not the birthing unit by my community midwife because of my pph previously. Upon arriving at the hospital the midwives led me round to the birthing unit and said there was no reason I couldn't go there instead and could be moved to labour suite if necessary this time. Had a water birth, coped with hypnobirthing breathing techniques and only gas and air for pushing stage. 2 small grazes and a small 1st degree tear but no stitches needed. Was up showering and walking about within an hour and the following day I was walking my dog! 10 days post natal now and feel amazing compared to last time! So yes it can be very different 2nd time round.

I had an episiotomy and tear, plus an anal fissure with my 1st baby, 9lb3oz with a huge head apparently it was horrendous for months
I had my second 18 months later and grazed but completely different recovery, was practically skipping down the supermarket aisles 2 days later!
3rd was 19 months later and I grazed again and 4th was 20 months after that and not a scratch.
The first was my worst definitely!

Episiotomy and tear with Baby No. 1. Baby no.2 was 22 months later, episiotomy but no tear, and they fixed the wonky stitching from No. 1 so that was good.

Episiotomy and PPH with DD1, went natural with DS1 just short of 3 years later. Tough labour, was all gowned up again to get him out and my body thought otherwise and I managed to push him out! Not even one stitch! Did have another PPH though, but because I had one the first time round they were ready for it. Good luck x

Vaginal delivery is generally easier to recover from if it goes well but it can be unpredictable. I had an episiotomy with my first but it didn't extend into a tear. I also have lichen sclerosus and so my skin just isn't that stretchy and I have some scarring from that. I did get examined by a consultant during my second pregnancy and she said the skin looked supple/good candidate for vaginal birth etc.
I had my second 4 days ago and did unfortunately need another episiotomy, but it was due to my big back to back baby needing more space to come out face up! I managed to avoid an assisted delivery but was a bit gutted about the epis!

How has your tear healed and what has the consultant said about the scar tissue? That could help you make your decision.