Childbirth injuries...

[daisym]

So, I had a baby 2 years ago. Had 3rd degree tear and to put it simply things have never been the same since. Have been enduring pain around the anus (feels itchy, sore) and have a tugging sensation whenever I change from sitting to standing up which I think results from being sewn up too tight internally.

Have seen various gps who have prescribed creams which dont help! I feel no-one is taking me seriously and I cant go on like this. Have been searching the internet and see there is a birth injury centre at a clinic in UCL hospital london. Can I demand my gp refers me there, or is there somewhere else I can go? Any help welcome...

Daisy, Sorry to hear you are having problems. I had a baby 8 weeks ago with 2nd degree tears. Similar problems to you, definitely the tugging sensation. I asked the doctor to check my stitches at the 6 week check and was referred to the gynacology dept at the hospital. Went on Monday and they said that it definitely is stitched wrong and needs "refashioning" (horrible word!).

I would go back to your GP and ask to be referred, best way to get into the system. Did your GP actually have a look last time? I don't understand what the creams were going to do.

Jeez, go back and formally request a referral. Definately don't settle for the NHS fob off.

Oh look here's a little magic cream to make you go away...

Thanks Noodleh63. I've never found anyone whos experienced the tugging sensation which I am blighted with. Mentioned it to several drs including my gyn consultant who I saw 6 weeks after the birth and none of them have ever heard of it. Would you mind describing what it feels like? I feel like everything deep inside is stretching and pulling whenver I change from sitting to standing up.

The cream obviously doesnt help but it was meant to help with the soreness and itching of the other area...

Eleusis you're right I should be firm. Infact I'm going to book another appointment with my gp and DEMAND I see a specialist. Last time they seemed to have no idea where to refer me too and tried to send me to any old gynae when I think I need one with specialist knowledge of childbirth injuries, its amazing that some gyn consultants seem to have no knowledge at all. I mentioned to my consultant about being cut open and restitched and he said it was incredibly difficult to do with no guarantee it would work when from what I've read on here its pretty straightforward and seems to work!

Just a thought daisym, do you recollect the midwife/doctor who did the suturing performing a rectal examination after wards?
They should have explained why they were doing it and asked for your consent.

never once had a rectal examination! The consultant I saw at the hospital for my 6 week check didnt even suggest doing one though he did do a pelvic exam and pronounced everything healed. When I told him about the tugging he said it was 'a bit like an old battle scar' and laughed. Infact my gp wanted me to be referred back to him, made an appointment which I then had to cancel as I knew he wouldnt take me seriously! I dont have any incontinence issues which I'm grateful for but even so I just want to get back to normal! Gp thought the itching I described was something that could be healed with cream but it hasnt. I keep hearing from other women who've had 3rd degree tears how they've had scans to check everythings OK, but I feel like I've been let down and made to feel like a nuisance. The first gp I saw told me I'd never fully recover as my injuries were to great which quite frankly led to me going home and feeling suicidal, to be in such permanent pain just from having a baby which people do everyday, well it was an awful time. I've resigned myself to the pain which I guess is a bad thing as I just live with it rather than fight to get anything done. I just want to see someone who will say we're going to do tests to find out whats wrong and then fix it. Problem is I dont know what to ask for... Everyone thats examined me says I've healed well and if I'd been sewn to tightly would bleed, but I dont.

Daisym, I'm being shy about discussing specifics with a wider audience , silly I know. Email me at noodleh63 at hotmail dot com

A rectal examination must be performed following every perineal repair, to ensure that suturing has not encroached the rectal mucosa.

I could be totally 'off course' here, but is your ongoing problem that prompted me to ask the question.

I had a 3rd degree tear 9 months ago, and I also know what you mean about the tugging sensation. I get the soreness as well. When I had my 6 week check the doc just looked at the scar and said it looked fine. However, so many things went wrong during my pregnancy/delivery that the tear was just the tip of the iceberg.

hey, i had a vontouse birth with 3rd degree tearing almost 9 months ago..

its so taumatic when these things happen. i know for me it was an avoidable situation, but i had a bossy midwife who was so pro vaginal birth despite everything going wrong and even risking my babies health (which i wont get into)

at 3 months i saw a gyn who said i needfed to have a repair,cos of painful sex and discomfort etc. and mid september i had the repair operation. i dont know what she did. buily up my perineum? straightened out a scar and made it all aligned again.

ill let you know how it goes when i try and have sex.

im a bit disapointed by how it looks now, and i totally still feel odd and tugging sensations but have been assured its the wound healing and hardening before it will soften. i kind of wish i had waited a couple more months though.

that was 'build' up my perineum. spelling mistake

poor you! make sure you demand to see a specialist! I had a 3rd degree tear nearly 9m ago and have never experienced the type oif problems you are describing. whilst i fully understand that no two people would heal up the same, i would think they could - should, do something to relieve your discomfort. good luck!

I had a 3rd degree tear 2 yrs ago. I went to see a gynaecologist who said if I had any discomfort they could cut it and repair it again, but they would only do that once you've decided not to have any more children, because obviously you might tear again. I think there is information about best practice for third degree tears on The Royal College of Gynaecologist and Obstetricians website. Sorry can't do links!
Also try the association of radical midwives website.

I had a 4th Degree tear four months ago, but have been really lucky. My area still has a womans health physio, who I went to three times a week to help with healing, and she checked my scar. I have had a lot of problems, but thanks to her help I am reassured that everything will be ok. The Drs I saw, were not even worried!

It is worth checking to see if you have one in your area - not sure they are everywhere. She said she deals with everyone who has third or fourth degree tears, or any problems after child birth.

hey clur79,

what type of problems did you have? how did the physio help to heal your tear? and what did she do for scarring?

I had an extensive 2nd degree tear (internal and externqal) tht didn't heal properly, and was redone at 8m. This was at UCH, by my gynae. It was vastly better after I recovered from the op, but still not ciompletely right. I was at least no longer in constant pain/discomfort, and was able eventually to conceive no2, though sex wszas still not discomfort-free.

I tore again with no2. 2nd degree aslong the scar, but not as extensive. This time I healed perfectly, with no residual pain or discomfort. No2 must have rearranged me!

I didn't tear enough to need stitching with no3 - and he was a whopper.

So, IME, you can be restitched, it does help, subesequent babies can hange things for the better, and you don't necessarily tear with subsequent births.

Only one 'hangover' from the tearing and stitching: although I have no pain from stitching any more, I definitely have less sensation internally than I used to pre-children, and it affects our sex life.

Viv24. My scar was very painful to start with, not being able to walk or go to the toilet without extreme pain. The physio said it was not healing properly (consultant at 6 weeks had said it was fine!), she offered me ultrasound for the scar and that helped it to heal correctly, and is now pretty much pain free. I had problems controlling my bowels and bladder, but she talked me through exercises and reasuured me, which I am sure helped me more.

I was also terrifed of having sex again,, and she talked me through different things to try. Although I haven't braved it yet, myself and my partner are a lot more open about it all, and I think it is because she assured me it was normal and I would get there in the end.

Also she recommended I buy a set of vaginal dilator(can't spell sorry!) to help with sex. This would increase the elasticity in my vagina and increase my confidence.

clur79, hey, my stitches have come out (6 wks later) and i am starting to feel better..

i hope the lumpy bit shrinks back to being flat.. it so far seems to be improving. my titshes were thick so it was probably so swollen around them..

thats helpful to know about ultrasound to heal scars. do you know how it works?? it sounds strange. Does it restore the muscle or something?

i will see my doctor in a month or so and see if she can refer me back to my physio.
i originally did not find her helpful at all - this is becasue she only told me how to do a pelvic floor and i already knew that. when i told her it was a great strain to lift the perineum cos it was so lax, she kinda fobbed it off, like it would get better with perlvic floors too.

after my surgery i have to say i dont think its as 'saggy' as it was.

i will definately keep you informed to how sex goes when i get the go ahead!

Hi eleusis,

Sorry to follow this thread on from so long ago, I just wondered did you have the 'refashioning'?
I am booked to have this on thursday and am very nervous about what will happen. Can't find anything on the web about it.

Hope to hear from you

Carol x

I had a Fenton's repair seven weeks ago to correct a bad episiotomy, and honestly, it's saved our sex life. It feels as if I'd never had a baby; before, I was constantly gritting my teeth and thinking of England.

In the Fenton's, they basically slice out the old scar tissue, and resuture, along with steroid injections to help everything heal without thick and ridged scar tissue. It helps that the tissues aren't hugely 'insulted' the way that they are in labour. I'd never even heard of it before I ran into problems with the episiotomy - the consultant who did it said that very few women actually got it done, although he thought that was from lack of information rather than because there was very little need for it.

I will say that it's not much fun running around with stitches after a very active nine month old, rather than just sitting around with a newborn. (Ow, ow, ow.) It was, however, very worth it.

I had this procedure too, twice. The first time the stitches weren't placed correctly and they left me too tight.

The second one left me looking and feeling far better.

I have lots of advice! :

You need to follow instructions afterwards for keeping clean, I rinsed with tea tree in water or salt water to avoid infection. Pelvic floors excercises are important too to keep blood in the area to heal it.

If you take Arnica before and after to speed healing, and I also heard that taking Calendula homeopathy in the days before and after helps to reduce the risk of infection. Double check with your surgeon if you do these.
www.ainsworths.com is a good source of guidance with this.

Depending on how much tissue is taken, you may or may not be offered a set of dilators to take home and use to maintain your "passage"! I don't mean to frighten you and you'll probably/hopefully never know what I'm on about but I'd have preferred to know in advance as they look like dildos !

Lastly I hired a Valley Cushion from the NCT to sit on when I couldn't lie. It's got a groove down the middle to reduce pressure on your bits. I found it essential. Having sat on a rubber ring after the birth and first op, I was later told they're not good for you, as they put too much strain on the area that hangs through the middle...

I'd also say to make sure before you go home they give you a direct number to ask any questions you may have once home.

Good luck, it is sore but not as bad as after childbirth as you're expecting it, and keeping on top of your painkillers helps loads. My physio told me not to lift anything heavier than a kettle of water for eight weeks so get those favours in with friends and family to help with your little one!

Charlotte x

p.s. sorry that was for Carol79 (or anyone having the op).

DaisyM, I got fobbed off with cortisone injections for a few months to reduce scarring. They're not pleasant. In the end my GP sent a stern leter of complaint to the hospital to say I clearly needed a repair and to stop mucking about! They suddenly agreed I needed the op.

If you are determined and can get your GP's support then you have a better chance. (I chose the GP at my surgery with a specialism in Gynae).

It is not only unfair but humilitaing to have to fight and beg for this as it's so personal but keep going and best of luck.

Charlotte

Resurrecting this thread to ask if anyone has a recommendation for a surgeon in the east midlands, my cousin is 3 weeks post grade 3B tear and her stitches have split, she's due to see her deeply unsympathetic OB tomorrow and, seeing as she has little faith in her(Cuz doesn't even know how it happened or what was repaired) she needs a second opinion from a sugeon who takes it seriously, even after the intial repair she's doubly incontinent and totally numb, and in her own words 'it looks like a plate of mince'. So wise mumsnetters, anyone spring to mind?