Likelihood of stitches reopening in 2nd labour

[lucieinthesky]

I gave birth to my son 18 months ago. I only had 2nd degree tears in 3 places but (in the consultant's own words), these tears were 'long, and involved every part of my nether region'.

I'm now pregnant with my second baby due February next year and have been given the option of having an elective csection. I'm not sure what to do.

Ideally, I would have a vaginal delivery and it would all go swimmingly, I wouldn't tear any more and would be up and about in a couple of days. However, I'm terrified of all these stitches reopening or doing any further damage. I currently suffer from an intense pain in my pelvic floor that comes and goes but has been so bad on occasion that I've not been in tears and unable to walk. The consultant has referred me for a scan but this probably won't happen until after I've delivered.

The only thing putting me off a csection really is the thought of not being able to pick up my toddler son for 6 weeks +, but in all honesty I'm so terrified of the thought of doing more damage when we don't even know the extent of this damage to my 'nether regions' i am edging that way.

Does anyone know the likelihood of old stitches reopening? Mine are so extensive it seems hard to imagine a scenario where that wouldn't happen. And can anyone share any positive experiences of managing csection recovery with a toddler in toe?

I had a three year gap between births but the prospect of stitches opening up was never mentioned . You should be fully healed by now and your midwife should be able to put your mind at rest.

I'd have thought it would all be healed by now as there's no guidance for birth after stitches, only after x section 😁

Thanks for replying

Hi Lucie,

I’m due in 2 weeks and also cacking it at the thought of stitches down there after episiotomy with dd who is 5.

I’m hoping for a pool birth at midwife led birth centre but in all honestly just going to go with the flow. If first labour taught me anything it’s that what will happen will happen. I too contemplated c sec but then worried about doing school run etc and recovery from that.

Anyway I suppose all we can do is hope for the best. If it’s any help I know a lot of people have an easier birth second time and get away without re tearing or only have a minor graze xx

I had a similar gap between births and a tear that went front to back after the first. Nobody mentioned the possibility of the wound reopening and miraculously my second labour was 10 times shorter and easier than my first even though the baby was a pound bigger.

With my second child I tore in 3 places, 2 severe 2nd degree and an extensive third degree tear which I had to go to surgery for repair following the birth. Recovery was long and my pelvic floor has suffered, although I do not currently suffer incontinence.

I had another baby 20 months after this birth and I was indeed advised by the consultant that I could opt for a c section if I wanted to because there was a 7% chance of re tearing in the previous places. Whilst nervous of this happening I felt like the risk wasn't high enough for me to choose c section and that I would prefer a vaginal birth. The birth went really well (was an induction at 38 weeks) and the midwife did a great job at applying pressure on the 3rd degree tear location as baby crowned to prevent it from splitting and it didn't. It didn't even feel as if it would do. In the end I only had a very small tear which didn't require any stitches. So was a very positive experience. I will say tho that my active labour phase was very short and pushing was only a few minutes so I don't know if it would have been different if there had been pressure for a longer time.

Make sure it's in your birth plan for the midwife to be aware of needing to apply pressure if you go ahead with a vaginal birth and mention it when you go in to have baby too so they know you're nervous about it.

I am actually expecting another baby in February too and it hasn't been discussed with me yet but consultant appointments haven't been super helpful as I have only had one on the phone. But again I am happy to try a vaginal birth.

The other thing I would say is that after my subsequent birth I have struggled with my pelvic floor much more and had the beginnings of a prolapse due to weakness in the vaginal wall. The gynecologist concluded that the damage was done by the second birth and tearing, not the more recent one. It is much better than it was currently bit was bad when still breast feeding due to hormones so I am expecting it to be worse again after this birth. In the meantime I am doing lots of work on my pelvic floor exercises!

Ultimately you'll have to weigh up what is best for you. Good luck!

I was told the chance was 2%

That was ok and I took the risk. All went fine.

Thank you everyone, really helpful to hear your experiences.

I left the consultants appointment last week fully content with having a vaginal birth, but since coming out of the appointment I've got more questions, so I'm going to quiz my midwife when I see her next week and maybe get another call in with the consultant or something.

I've been referred for a scan due to the pelvic floor pain but it probably won't happen until after I've delivered. So my worry is that if no-one can identify what this pain is and a scan is needed to do so, how can we be confident another vaginal birth won't make things worse.

Honestly when I'm not feeling the pain I'm so confident in going for a natural delivery. But when the pain comes it's so intense I'm nearly in tears.

There really is no good way of getting them out is there!

I had a 3b tear with my first & no one ever suggested I should consider a c section for the second. I was worried about further tearing but everyone was so casual about it I stopped worrying!
My baby girl was born just a few days before my son turned 2 so only a slightly bigger gap than you by a couple of months. I had a perfect waterbirth, had a 2nd degree tear but in a different place to the 3b one & have healed really well.
For me I'm definitely glad I had a vaginal birth as recovery from a c section with a toddler would've been really difficult.

Your stitches can't really reopen as they have fully healed. You may tear along the same lines, but even that is less likely with a second birth.

I had a lot of pain in my episiotomy scar after my first birth. It was more of a dull, heavy ache than a stabbing pain, but I would wonder in your case if this is scar tissue. It was my second birth that fixed my problem- I did tear but was stitched much better that time and I've had no more pain or pressure.

I'd also strongly recommend finding a women's health / pelvic floor physiotherapist. You will likely have to do this privately but they can be real experts in postnatal pelvic pain!