Episiotomy tearing open during labour

[FuglyLurker]

I had a very rough delivery with my first child that ended with forceps and an episiotomy that tore further whilst he was being dragged out. My scar is over 2 inches long and it still pains me today after many years when I sit awkwardly or press on it in any way.

I’m due my second child in the next few months and I’m anxious about how the scar will be affected during the birth, I’m worried that it is going to tear again under the extreme stress even if this delivery goes better. Does anyone have any experience of this happening to them? Also if another episiotomy needs to be performed do they cut along the old scar?

My first baby was 10lb 6 and got stuck due to his position, I haemorrhaged badly afterwards and I’ve been told that second babies tend to be larger. I’ve been thinking of doing perineal massage but even the slightest pressure on it is very uncomfortable.

I had an episiotomy with my first after 1.5hrs pushing, baby got distressed and I clearly wasn't going to manage to push him out. I don't know if it was a big/bad episiotomy, but it was bloody painful afterwards and recovery was pretty horrible.

I have very recently given birth again, I had a water birth and pushing stage quick and easy (well as easy as these things ever are!) and although I tore a little bit, it wasn't anywhere near the episiotomy scar. I also had no idea that I had torn until midwife examined me. I had always assumed that tearing would be utter agony, but I couldn't tell you at what point it actually happened and it was just mixed in with the overall pain of crowning. Recovery and pain from the tear has (so far, it's only day six) been much more manageable.

I had an episiotomy first time and second time just a small natural tear. It was a huge worry of mine. The midwife said tjey can see the old scar tisdue very clearly. Im pretty sure she said they woukd cut somewhere else but hopefully a midwife will pop up with a good answer

Pretty sure I tore in the same place as my episiotomy with my second delivery. It was a water birth and like other PP I didn’t notice when it actually happened (probably when baby decided to come one shoulder at a time ). It must’ve been the same place because all the issues with my episiotomy scar were resolved after my second delivery. Much much better now!

I had a forceps and double episiotomy and 2 x fentons procedures (repairs) and plastic surgery. I was terrified of my 2nd birth but although the consultant would not let me have a c section as there was no medical reason he was prepared to induce me at 37 weeks to keep the baby smaller.

I had a much better time and used only gas and air and a minute tear which did not even require stitching.

Do speak to your midwife about your fears. She was a great advocate for me with the consultant.

I had grim, 20 hour labour, failed ventouse, forceps delivery, huge episotomy with post partum infection, stiches too tight and all of that with my first. Vowed I'd never have another!!!!

Changed my mind 2 years later and had DD. I told all the medical professionals I was really nervous and they very kindly gave me a late scan which showed that DDs head was way smaller than DS's had been. If it had been a similar size the consultant had agreed I could have a c-section.

As it was she popped out like a pea in just 1.5 hours of labour. I did tear really badly and it took over an hour to stitch me back up again afterwards but I didn't feel it when it happened as everything was so intense that I couldn't isolate any one particular pain!

Oh this is also my worry. I had an episiotomy then they went in again to extend the first cut. My scar is long and weirdly shaped. When I went for my 8 week check the GP told me it looked like a "war zone" but not to worry as when I had another they would just cut along the same line and stitch me up better next time.

So I'm due my second, and really worried about it this time. I would prefer not to have any episiotomy but don't want to tear either.

It's common for ladies to have their scars refashioned where they cause pain after healing, so you could have potentially had it dealt with prior to baby #2.

However, if you talk to your consultant and explain, it is possible that they could note it and, if you need another episiotomy, they could take the opportunity to 'tidy it up' so that it heals better this time.

If you do have any pain post birth, please pester your GP to refer you back to Gynae, though. You do not have to live with it forever.

I tore along my epi scar during my second labour and it was fine. Second degree, stitched up in the room with gas and air, healed just fine. I mean, I can sometimes feel the scar but it doesn't cause pain.

I had an episiotomy with my first which didn’t heal brilliantly, only had a tiny 1st degree tear with DS2 which didn’t need any stitches at all.

I too tore along my episiotomy scar during the second birth.
The midwife got someone in who was very experienced at stitching, and another midwife came in to watch (they did ask, I told them I didn't mind as everyone had seen it all by then!) it was fine and in fact healed better than the original episiotomy which was quite big.

@FuglyLurker - sounds like we had a very similar experience so I totally understand where you're coming from.

I just had my second baby on 29/01 by planned section. The reason I chose this was because of my first labour and similar concerns to yours.
The whole experience was a million times better than the first time. I am by no means saying it was the 'easy option' as it's major surgery. That being said, I felt in control and it took away a lot of the anxiety I felt.

I am recovery much better than I did first time and have found moving around etc painful but so much better.

I am not saying this should be your way forward as of course it's a big decision and it does come with risks. I just wanted to tell you about my experience as sounded so similar.

Good luck x

I had a terrible first birth. Very similar to yours.

When I got pregnant with my second I wasn't even willing to consider another vaginal birth. I didn't want to risk anymore damage. I healed remarkably well and with no real long term issues. No way in hell was I going to risk causing more problems. Statistics were 'favourable', yes but frankly, I didn't care.

I requested a section and was given one no problem at all. My consultant agreed it was the sensible choice for me. Signed off no bother.

Wonderful, empowering experience. I would have another planned section in a heartbeat. I would urge you to consider it.