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Childbirth

Share experiences and get support around labour, birth and recovery.

Choosing birth option after traumatic first birth/difficulty healing from episiotomy

29 replies

FifeyWifey · 09/03/2021 21:24

Apologies for the long post. I've never posted before. I'd be so grateful to hear your thoughts particularly if you've experienced difficulties healing from an episiotomy or tear.

I am currently 20 weeks pregnant and trying to decide whether to attempt another vaginal birth or have an elcs.

My first birth 2 years ago was via emergency forceps, my baby went into distress following a drip induction at 39 weeks as my waters broke prematurely. I had poor pain relief, largely my own fault for not requesting an epidural early enough, but also through bad luck as it turns out I am intolerant to gas and air (vomiting and fever) and I was too slow to request an epidural, and it then took three attempts for one to work, the first was somehow inserted wrongly. DS was born with facial nerve paralysis, severe jaundice, and an infection. He did eventually recover from the paralysis, however, at the time, we were warned he may not and I found this incredibly upsetting - his face drooped on one side and one eye wouldn’t close. I had a haemorrhage from the forceps, multiple small cuts and grazes, and an episiotomy. I was severely traumatised by the whole event, and don’t remember it clearly, other than the pain and shock. It felt like I had been in a bad car crash or similar. I didn’t really sleep the entire 9 days we were in hospital.

My episiotomy stitches came apart on day 2 or 3 and from then on were ‘gaping’. The pain was excruciating, to the point I could not sit for many weeks. Going to the toilet was awful. After 3 or so weeks, the wound became infected. After antibiotics, it did eventually heal but it took several more weeks before I could sit. I was told the wound would ‘granulate’ to form ‘a sort of pocket’. Sex was very painful for 14 months. I felt utterly broken for a long time.

My gut feeling this time is that I would like an elcs, because above all else I want to avoid another traumatic birth and I would struggle mentally so badly if I had a similar experience. I do not want another child born in severe pain with birth injuries.

The consultant who was lovely said they will support me whatever birth option I choose, but that it is likely the second birth would probably be fine vaginally. She said because my wound gapes the birth would in fact likely be easier. However, she has never seen me in person, nobody has seen my scar since it healed. I am very concerned about the scar tissue. I can’t see how this would not tear, and I’m terrified of another episiotomy or damage. I am also concerned about a lack of options regarding pain relief were I to choose a vaginal delivery. I can't use gas and air, and I'm worried another epidural would result in another assisted delivery.

What would you do? Apologies again for the rambling.

OP posts:
WashableVelvet · 09/03/2021 21:26

In a similar situation I chose ELCS, due in a couple of weeks.

ficklish · 09/03/2021 21:31

OMG have the ELCS. I had a traumatic first birth experience (though not as awful as yours!) and went for an ELCS the second time and it was like a dream. Orderly, predictable, calm, no stress for me or the baby. Recovery is tough, but if you take it easy and stay on top of pain meds it’s absolutely do-able.

WashableVelvet · 09/03/2021 21:32

I would say though that choice was very much to manage my anxiety as much as or more than to manage my physical health. They similarly said a VB would more than likely be fine.

littlemisslozza · 09/03/2021 21:35

I also had a traumatic forceps delivery with my first, due to shoulder dystocia. Had two ELCS with DC2&3 and both were great experiences and recoveries were fine. Good luck.

grammarwoes · 09/03/2021 21:35

My episiotomy was nowhere near as bad as yours but was still painful for weeks after birth. I couldn't sit properly by the time of my 6 week postnatal checkup and didn't have sex for a year.
DC2 (born two years after DC1) was a natural birth with hardly any pain relief besides a couple of puffs of gas and air. My episiotomy scar tore during the delivery (2nd degree tear) but the midwife repaired it sooo much better than the Dr had done after DC1's delivery.
I'm so glad I had a natural birth as it fixed my uncomfortable nether regions! I've had no problems since.

Mummyme87 · 09/03/2021 21:45

Sorry you had such an awful experience with your first baby. I’m glad you are being supported by your maternity unit.

It is very likely your birth this time would be absolutely fine with no issues although nothing is guaranteed. Many women find having a subsequent vaginal birth after a traumatic experience healing. It’s tough as no one can tell you which way to go, and an elective CS isn’t necessarily going to be plain sailing either.

Look in to natal hypnotherapy/positive birth company. Lots of women have plans for the birth, so avoid IOL, low threshold for CS. Have you had a birth debrief? This may be helpful if not.

I had a traumatic birth first time, ended up with an emergency CS, baby in NNU with meningitis and I was very unwell for a week.m and had PND. Second time I wanted a vaginal birth unless was life or death. I did, lost a lot of blood and had a 3rd degree tear but I was much happier with my experience and will go for a VBAC again when we have no3.

georgiams · 09/03/2021 21:46

I had a traumatic first birth, was persuaded that my second would be better and it was 100000x worse than the first. I had an elc for the third and it was amazing in comparison! X

Lindtnotlint · 09/03/2021 21:49

First birth awful - ended up with reconstructive surgery after tear, stitches, infection etc. Second birth (vaginal) birth was fine but small tear and stitches got infected again. Reconstructive surgery again. Hideous.

Third birth ELCS. Lovely.

Strong advice: get the ELCS. Give your nether regions a rest :-)

Ohhgreat · 09/03/2021 21:53

Go ELCS! If you feel that's the one you would prefer, and quite frankly knowing what you went through I don't blame you at all!

brushlaptop · 09/03/2021 21:56

Holy hell go for the c section. You won't regret it! Recovery is tough but no where near as tough as what you've been through!

birdglasspen · 09/03/2021 22:00

I'm usually all for vaginal births however I think in your case you should have an ec-section. What you have been through sounds hellish and a ec-section is likely to be the opposite of what you experienced the first time around. Elective and emergency sections are very different I believe. I wouldn't compare the two.

cafedesreves · 09/03/2021 22:01

Definitely C section!

BaaHumbugg · 09/03/2021 22:06

Definitely c section, I'm sorry for what you went through it sounds bloody awful and you must be so brave to want to do it again!

Carolina24 · 09/03/2021 22:09

In those circumstances I would absolutely have the ELCS. It will give your the comfort of certainty and control, which I think would be helpful to you. The recovery isn’t fun, but it’s not terrible either - especially if you have a supportive partner and family.

Whatever you decide, I wish you the best of luck.

SwayingInTime · 09/03/2021 22:10

How large a family do you want?

NotNowPlzz · 09/03/2021 22:15

C section a million times over.

Yummymummy2020 · 09/03/2021 22:18

Similar boat here. Horrific forceps birth and baby was in nicu a few days. Was late getting the epidural as had an awful midwife who kept saying I wasn’t in active labour, due to ill health I was meant to get it very early in labour as it was an induction and the anaesthetist that I had to see weeks before said around the 2cm mark I needed to have it with my heart issue, they literally didn’t bring me till I was 8cm and was in agony, the baby had been in distress too so was a case of get the forceps out. Healing was really really awful, it took a very long time, I couldn’t walk beyond the toilet for ages and was in so much pain. I was advised if I wanted a section I could have it but I feel i want to try vaginal again purely as closure. This could go very wrong for me but if it goes ok, I feel it will help me a lot as I’m still getting over my first experience and am due in 2 months. It might get nearer the time and I may change my mind but at this point I’m hoping to give it a go, but in saying that we had complained about the experience and the fact the actual plan hadn’t been followed at all to our detriment and the babies and so this time I feel the hospital is going to take better care!

addictedtotheflats · 09/03/2021 22:20

I had a similar experience with wound gaping and a three month healing period with multiple infections, im not pregnant yet (or ttc) but realistically I think a elcs would be what I would push for. I couldn't risk that pain again, it was truly awful. And the thought of looking after a toddler with a newborn and having to go through that again is unbearable!

Shylo · 09/03/2021 22:23

I had a traumatic first birth and went on to have a relatively easy second birth, which like the other poster above fixed the issues with my episiotomy scar from the first birth ..... BUT I count myself as very lucky, it could’ve been very different and given your issues with pain relief if it were me I’d have a C section in a heart beat

turtletum · 09/03/2021 22:29

You need to think hard about what you want. Some people will have good stores to tell you, others bad. Only you know whether you can physically and mentally cope with the risks of a vaginal birth or c section.

My story, if it helps? First birth, induction (but no drip), assisted delivery, 2nd degree tear almost 3rd, episiotomy. Wounds didn't heal well. Had reconstructive surgery a year later, as it was affecting my marital life. They were originally reluctant to offer the op before my family was complete, due to risks of further tearing, scar tissue build up, etc. But I wanted it as the injuries were affecting my mental health too and had a supportive consultant. Surgery went well, things were all good. Recovery was much shorter, about 2 weeks.

Second pregnancy, I had a meeting with a consultant at around 30 weeks I think, to discuss my birth options. C section was offered. I chose to decline as I wanted a vaginal birth if possible, and was reassured by how successful my op had been last time. I figured, I already had scaring down there, so didn't want scaring on my tummy too, if I could avoid it.

Second birth, induced by breaking waters as my hind waters had begun leaking. No further intervention. Natural vaginal birth, minimal 2nd degree tear as pushing phase was so rapid. Midwives were great at applying perineum pressure to minimise the tear. Wound was stitched and healed well, no further issues.

I do think I was lucky though. The birth trauma you describe, the failed pain relief, that would tip me towards c section.

LouiseTrees · 09/03/2021 22:31

If you wouldn’t consider diamorphine then I think an elcs is best given your circumstances

MeadowHay · 09/03/2021 22:33

My experience was more similar to @grammarwoes - although part of my wound reopened at about 7 weeks pp which meant more pain again and an additional healing time. I had pain when using tampons until I had pelvic floor physio 9 months PP and couldn't countenance sex until then either. I'm pregnant with no.2 now and I'm wondering what to do, like you, especially as I'm intolerant to G&A as you too - it didn't do anything for me and made me instantly vomit every time I tried to breathe it in. However I did have diamorphine at 8cm which was really really helpful for allowing me some rest in my long labour. I also had no effect from the pain relief injections they used to stitch me up afterwards so that was probably the most agonising part for me. I'm only in first trimester so plenty of time for me to decide. I think really I'd prefer a vaginal birth and hope it goes better, but I am concerned about my pelvic floor, psychological trauma, pain relief options particularly if I need stitches again as that was traumatic...soo much to think about.

muppette · 09/03/2021 22:46

I had a similar first delivery. With third degree tear. Episiotomy with no anaesthetic. And various other bad stuff.

Also felt like a car crash. Had PTSD. You may also have that.

Second child: I thought fuck it. Nobody's touching us. I trusted my body and nature. I swam throughout my pregnancy snd kind of trained and prepared myself mentally.

Walked up and down through contractions. Gave birth standing up. Pain relief didn't even come into my head. It would have interfered with what was an ok process.

It was still sharp when her head crowned, but as the opening was wider after 1st trauma, it was all fine.

Actually a triumphant experience and really great to be active rather than having it done to me/us.

I went for that as was scared of intervention. But I think the most predictable bet is ELCS, I guess.

I had to be v brave but we did it! So yes it is possible!

Sunshinegirl82 · 09/03/2021 22:47

I've had two sections, one emergency and one elective. Elective was all very calm and straightforward, I was driving again after 3 weeks.

In your shoes I would take the section every day of the week. The only thing that might persuade me otherwise would be if I planned to have a large family. I only ever planned to have 2 so was happy to opt for a second section. If I'd wanted 4 I might have tried for a VBAC.

If you go down the route of a section I'd recommend having daily help (either your DH/DP or someone else) everyday for at least 4 weeks so you can take it easy and recover.

Duckchick · 09/03/2021 22:50

I had a bad but not as awful as yours first birth, and then similar to you my stitches failed completely leaving a huge gaping wound. However, I was lucky enough to have a pushy GP and they operated again 2 weeks post partum so my recovery was faster than yours. It still looks a meas but at least doesn't hurt.

We paid for me to see a private consultant when I got pregnant with DC2 who actually properly looked at the scar and confirmed I should be ok with another vaginal birth. She also told me that the more the stitching is rushed the higher the risk of infection. My midwife did refer me through on the NHS with the same question. They didn't examine me before telling me I'd be fine - but I knew the right questions to ask after the private appointment so they agreed a plan including prophylactic antibiotics and taking extra care with any stitching if needed.

I decided I'd try for a vaginal home birth but go for a ELC rather than be induced again. I got the home birth and did tear again but it all healed very well, possibly due to them stitching very carefully and the antibiotics.

No idea how accessible any of the support I got is in a Covid world, in my hospital a lot of it came through the consultant midwife.

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