Natural or ELCS following 3rd degree tear?

[mamablondie]

Currently TTC and can’t help thinking about giving birth again. I had a third degree tear with DC1 and just wondered whether anyone else has a second natural with no issues? Am I better to just opt for a csection?

I'm currently 34 weeks with my second and have opted for a CS... it's entirely a personal decision

There is something like only a 7% chance of ending up with another 3rd/4th degree tear, so lots of people do give birth with no problems. I have opted for a CS because I'm more scared of what another tear would do to my pelvic floor than I am of the surgery.

All of the midwives/consultants I have spoken to so far have supported my decision, I have another appointment with a consultant at 36 weeks to finalise it, so they give you a lot of time to change your mind if you want to

I have had an EMCS at 9cm, then an SVD with 3B tear. Once I’ve improved my pelvic floor issues I will TTC number 3 and likely go for VBAC again unless any major issues

I had a 3b tear with my first & was fortunate to heal really well following the birth.

When i got pregnant a second time I was really worried about labour, whether I'd tear again & whether I'd be as lucky with recovery if I did.

My previous tear was barely mentioned, no one ever suggested I should consider a c section or even made it feel like a big deal. I did mention it to my midwife who reassured me but also gave me the option to discuss further if I wanted.

As a result I didn't even consider a c section & opted for a midwife led unit with hopeful waterbirth. That's exactly what I got & it was such a different experience. I had a 2nd degree tear this time (different area to 3rd degree) & again have healed well from it.

You have choices, it's your birth and don't feel pressured into making a decision one way or another. Get as much info as you can & make an informed decision about what's right for you.

Good luck, hope you get some happy news soon

I’ve got a suspected 3rd tear from my first birth with ongoing pelvic floor issues due to forceps

Because of this, combined with a traumatic first delivery I’ve opted for a CS for my second

I wouldn’t forgive myself if my current issues worsened or became permanent due to another vaginal labour, even a straight forward one. My physio and consultant both advised a CS due to all of this which I was more than happy to agree too

I had a 3b tear following a shoulder dystocia during a waterbirth so I opted for a section with my second baby. Was booked for the day before due date. Went into labour naturally a week early, during the night. The surgical team were already doing an emergency when I arrived so I gave birth naturally an hour after admission (very fast labour). I still had a couple of stitches but the midwife was very hands on and it wasn’t as bad as the first time. I’m glad in the end I didn’t have the section as I did recover much more quickly but I would have had the section if I had made my date.

Did your 3rd degree tear heal pretty well? I was lucky that mine did with my first DC and went on to have a further 3 DC roughly two years each apart with no further problems. I think I did have a small tear with my 2nd but it wasn’t that noticeable and caused no further issues. You are so much more in control with subsequent babies because you know what to expect and how everything feels and you are also inevitably more stretchy Good luck, it’s all worth it!

I had a 3b with my first almost 6 years ago, but healed really well with no lasting issues. Due to this and after discussions with consultants and midwives I opted for a natural birth as for me, major surgery wasn't what I wanted.
My first birth was fast and we discussed that this and me pushing too quickly was the reason.

Unfortunately my second also resulted in a 3a tear. A fast labour (45 mins) and a large baby this time (over 9lbs), but midwives don't think I could have done anything better, I'm just not as stretchy as other people.

I am 11 weeks pp and still have slight bladder incontinence issues but they are getting better weekly and I see a women's physio team for help. I also have a likely prolapse which isn't something I can resolve unless it becomes more serious and requires surgery. However the prolapse is very common with women who haven't had serious tears.

I'd discuss your options with the team as many people go on to have minimal tearing, sadly I'm not one of them. There are risks either option.

@Frizzy1986 - I am the same in that I had no permanent damage from the first 3rd degree tear although recovery was longer than most and needed physic.

So I am yo-yoing between VB and ELCS at the moment. The hospital have already said they will support my decision considering previous birth trauma however I am not too keen on major surgery. At the same time I don't want to regret going for VB if it ends badly with lasting damage.

It's a tough one for sure.

I had a 3rd degree tear with my first 6 years ago. It helped well and I haven't had any lasting problems so I was nervous to give birth again. But I had ds2 4 months ago and it was fine. I did end up with a 2nd degree tear but that was mostly due to his hand coming out with his head. But it healed so fast and was a much better experience.