Help - Second birth after a first traumatic assisted vaginal birth

[Hopitihop]

Hi All,

My first birth was very traumatic. I was induced at 39+ weeks because of gestational diabetes, was in extreme pain when the contractions started, no doctor was around for an epidural, I was crying and begging them to get one and finally got it 4 hours later when on 5cm. Then, 6 hours later, when it was time to push, baby's heart rate dropped, the emergency button was pushed, the doctor said that the baby needs to be out in 5 min. I had a massive episiotomy, I lost almost 2lt of blood, and at this area I am still in pain 2 years later. Also, it was a ventuse delivery.

Now, I am pregnant to my second one and I have gestational diabetes again.

Has anyone else been in this situation again? I can't go through the same again and I know that I will have to be induced.

I just want the baby out the easiest, most predictable and uncomplicated way. Should I ask for an ELCS?

Has anyone else had an induction and uncomplicated, easy vaginal birth following a bad tear from a previous birth?

Please share your experiences!

Exact same first birth as you.
I'm asking for a section if I should be lucky to get pregnant again.
Don't put yourself through the stress and anxiety of it.

Save yourself the hassle and worry and ask for an elective c-section.

Exact same as you. I was offered c section ( well, not quite but I know they would have given me one if I asked for it). In the end I was induced and had a vaginal birth but I wish I'd gone for a c section. Things weren't easy and didn't go that smoothly and now I'm even more damaged. I shudder when I think about what I put my dc2 through in the birth.
So much less risky to have a c section. For both of you. Ask for a c section.

No GD or blood loss but gas and air only and episiotomy and forceps when HR dropped. Very, very scary and traumatic with little care or kindness. I still have lots of unanswered questions.

2nd delivery was a textbook delivery, gas and air again, pethadine a little later. Much bigger baby too.

Have you had any kind of birth review from your first? This may help process your thoughts. If you want guaranteed difference to first time round, ELCS seems the right choice.

Go easy on yourself x

All babies near 42 weeks and induced (no gestational diabetes though)

Pessary was horrible, breaking waters was better, but totally depends

One obgyn told us that she refused induction for herself and chose CSection

First was forceps and third degree tear. Second was induction as big baby - was very straight forward and fast - mild grazing, home same day. Was given option of ELCS because of first birth but my preference was not too. Friend in similar situation did opt for ELCS and said it was the best decision for her.

(FWIW third was also straight forward induction)

Not quite the same, but I had a very difficult first birth (I have a v small pelvis and dc1 got stuck- he was eventually born with help of ventouse). I was offered an elective C-section with dc2 but (for various reasons) decided against. Bad decision! If I’d ever had a third I would have requested a section. I’d definitely ask if I were you.

I should have said, first time I had a massive episiotomy. Second time I ended up with a bad tear, just short of third degree. Went further than the episiotomy although not internal like the cut. Lots of stitches although recovery quicker than from the epi.

OP I could have written this post a few months ago (apart from GD)

My first was induced at 39 weeks. Horrendous contractions, epidural failed, baby's heart rate kept dropping when the drip was increased, after 4 days had an emergency episiotomy with forceps. I then had several infections in my stitches and was agony.

Second pregnancy I was absolutely terrified. I'm now holding my 6 day old son after an amazing second vaginal birth.

In preparation I had lots of meetings and referrals which were super helpful:

-I did a birth reflections which everyone is entitled to where we went over my labour notes and talked about the areas that gave me concern and where other interventions could have taken place
-I had a referral with the anaesthetist team to agree pain management and what to do if the epidural failed again
-I was consultant lead and my notes flagged up my traumatic first labour which meant I was treated extremely compassionately and felt very well looked after unlike labour 1
-I went through my birth plan with a consultant we agreed I would have an early epidural and not wait to be 'almost there'. If the pain was not managed or my progress was slow, we would move to a c section (and everyone was aware of this when I was in the birthing suite).

Ultimately I had another induction but only needed the first pessary. Once my waters were broken I didn't need the drip as contractions started naturally. My epidural did fail but was resited quickly and I gave birth within 6 hours of waters breaking. With the epidural I could feel everything but without the pain and so wasn't numb to my DS being born. I had a second degree tear and stitches but didn't feel much pain and only needed a few paracetamol in the days after.

A c section was offered and the only reason I didn't take it was my DS1 become clingy in the build up and I knew I wanted to pick him and carry him afterwards. But I was very ready to call time on a vaginal birth if I had needed to.

I know it sounds silly but many people didn't really understand how bad my first labour was and why I was so traumatised. After having a relatively 'normal' second labour, I understand why as it's so much calmer when you feel in control, have a plan that everyone is behind and your body is more ready for it.

Good luck whatever you decide and know that it is ultimately your choice to push for whatever you feel is right.

My first time was an induction which ended in a traumatic forceps delivery with a long recovery period. The second delivery was amazing, it was quick and I felt in control throughout. Looking back I wasn't expecting my second delivery to be as bad as the first and felt much more knowledgeable. I think that if I had been very worried about it I probably would have requested a C-section.

I've been there and in your shoes I'd have an elective section.

First birth was failed ventouse, episiotomy, forceps. Lots of blood loss, loads of stitches needed.

Second birth was fast, easy, no pain relief. All great - or so I thought. It soon became apparent that I'd suffered a lot of internal damage giving birth to DC2, due to the damage caused by DC1.

Had to have prolapse surgery afterwards, and the recovery was far worse than recovering from the original birth trauma. If I could go back I'd have a section second time, no doubt whatsoever.

I had a traumatic birth with forceps first time.
I am currently pregnant and consultant has agreed C Section. I feel much more relaxed knowing that, even though the recovery might be harder, the risks are more predictable. My physio thinks I will find the c section recovery a lot easier than my first birth.

I'm only just trying for my second now, but already know after the birth of my first I will be asking for an ELCS rather than it ending the way it did last time. as long as baby gets here one way or another, it really doesn't matter. Most important thing is you're happy, healthy and able to cope with a new baby and current child. Good luck x

Yes. I had my eldest in 2000. 42wk induction, back to back, drip, epidural, ventouse, 3rd degree tear and episiotomy and minor pph. Stayed in hospital 7days.

Had my second in 2009, and was referred to a consultant who said I had a less than 5% chance of tearing badly again. CS was not offered/mentioned and I didn't really know to question it. Dd2s birth was spontaneous, I still ended up with a second degree tear but it was uncomplicated and I was home same day.

Dd3 was induced again at 42wks born 2hrs later weighing 9lb 10. Another 2nd degree tear.

DS was induced at 40wks due to his large size, not as easy to get started and I needed the drip again but opted for the epidural first. Second degree tear and home that day.

Dd4 was another induction at 41wks, 2hr labour. Home 4hrs after she was born. A graze.

So in answer to your question, yes I have had uncomplicated but induced subsequent labours but I dont think I necessarily had the knowledge in 2009 when discussing options. It's only on here since having 4&5 that I've seen women being offered ELCS after 3rd degree tears. My trust only approved maternal choice CS last year though so perhaps that was a factor in why it wasn't offered.

It's hard to say what I would have done if it had been a conversation. My 3rd degree/episiotomy thankfully never left me with discomfort but it has left me with a prolapse, although further large babies delivered vaginally won't have helped that (and neither will my age and weight)

My first birth wasn’t like yours - no GD or forceps - but I had a third degree tear, a perineal haematoma, lots of blood loss and it failed to heal properly so I needed revision surgery a few months later.

After a lot of to-ing and fro-ing I had an ELCS last week and I really do feel it was the right decision. It’s not a walk in the park - the first couple of nights were tricky, especially given my DH couldn’t stay with me in hospital - and there are risks associated with the operation and anaesthesia - but the surgery itself was a genuinely pleasant experience and the recovery has been an absolute breeze so far compared to my vaginal birth. I lost less than 30% of the blood I lost with my first. I was still shuffling around painfully two weeks after my first birth feeling like I was carrying a brick in my vagina, whereas I’d say I’m 90% back to normal now after the c-section (although I’m still being careful and not lifting anything heavy or walking too far).

Good luck with whatever you decide.

I have gestational diabetes and I'm having a c section next week at 38 weeks. I had a normal vaginal delivery first time around but they gave me the choice of induction or section. Your diabetes team will support your decision for a c section I'm sure. Especially with your history

That sound awful OP, I’m so sorry that happened to you.

I had a really traumatic first birth. Like you, I had ventouse and episiotomy and didn’t get my epidural. My pain wasn’t managed well and I wasn’t treated well by my medical providers, who if ores my questions and carried out intrusive procedures like catheterisation when I hadn’t consented and was yelling at them not to.

My second birth was ten week ago and oh my god what a difference! It was amazing! The birth itself was weirdly similar (minus ventouse, but the timing and the way it started etc. was almost identical) but it was managed so much better and I managed so much better too. I thought I would definitely want an epidural but in the end all I had was gas and air and pethidine. It was agony, don’t get me wrong, and the pushing stage was long and grim, but it was a brilliant experience overall.

Last time I barely registered when my baby was born and whipped away for no reason. This time they put him on my chest and I was absolutely elated.

Good luck OP!

My first birth resulted in forceps, an episiotomy, 3b tear and a litre of blood loss. Fortunately I don’t remember much of the glory details but my husband shudder whenever it’s mentioned. When discussing no.2’s delivery my DH was shocked I would risk a repeat and told me it must have been because I was “off my face.”

After much deliberation I decided on an ELCS. Best choice I made. It was a fab experience. The recovery was so much easier (and no unfortunate surprises unlike with my first when I discovered I had a prolapse) I remember it all and am so glad I have that memory of my sons first moments of life. It sounds corny but it was beautiful and so so healing.

Bless you. Fellow traumatic first birther here (like, almost died and baby needed resuscitating…) now pregnant with #2 so I feel you with this debate.

Only you can make this call. Unlike others, I am feeling positive about going for a second vaginal birth. I know that it is the best thing for mine and baby’s health (immune system benefits if nothing else) and the chances of the precise circumstances of my birth happening again are minimal - between 2 and 5% according to my consultant. For me, a CS is major abdominal surgery which I would only consent to in a genuine emergency. For others, it’s a great way of ensuring a non-traumatic birth experience.

Whatever call you make will be right for you and please don’t let anyone make you feel bad about your choices

I had a horrendous first birth. Totally unsupported by hospital staff throughout and it was just an all round traumatic experience. I had horrendous PPD which I fully believe was triggered by this.

I never thought I would have another baby as I couldn't even consider going through it again. However, I fell pregnant and asked for an elective section. It was the best decision I have ever made. It was very calm and relaxed. The recovery is a bit of a nuisance but wasn't anywhere near as bad as lots of people make out.

Good luck!

For me, a CS is major abdominal surgery which I would only consent to in a genuine emergency. For others, it’s a great way of ensuring a non-traumatic birth experience.

Not to nit pick but for me an elective was about preserving the functionality of my lady bits which have already been comprised quite significantly by my first birth.

Hey OP, I had a similar first birth to you. Complicated by fissures which took months to heal.

With DC2, she was breech so they gave me an ELCS. I remember going in on the day and they said they would just scan to check if she had turned and if she had, they would send me home to wait for labour and a Vbac.

I was terrified she might have turned. I would never have hD the nerve to insist on an ELCS even though I desperately wanted one. I thought it would be seen as lazy or cheating.

ELCS was amazing. So calm and easy and I recovered more quickly and with less pain that from Vbac with DC1.

There is no shame in asking for an ELCS and no shame in really wanting a Vbac. But speak up and be heard.

My second was breech until the morning of the ELCS when the little contrarian decided to turn head down. For various reasons I requested (insisted) on going ahead with the CS, and they did. If you stick to your decision you will almost certainly get what you ask for.

@HogDogKetchup

For me, a CS is major abdominal surgery which I would only consent to in a genuine emergency. For others, it’s a great way of ensuring a non-traumatic birth experience.

Not to nit pick but for me an elective was about preserving the functionality of my lady bits which have already been comprised quite significantly by my first birth.

I would include that under ‘ensuring a non-traumatic birth experience’ Your ladybits remain untouched and therefore avoid a repeat of the trauma they suffered first time round.

I totally agree and understand women wanting to avoid re-damaging themselves. I also have long-term consequences from my first birth so I am extra sympathetic to this reasoning! I’m just banking on the second birth being different. Not everyone wants to take that gamble and I respect that.

Given you had traumatic first north and episiotomy, your consultant will talk with you about options.

I had an ELCS for my 3rd north. Totally recommend it as was far easier to recover from than a birth with episiotomy and 3' tear. 6 weeks compared to 6 months!

But it's a personal decision and consultant won't try to influence you. (I asked mine if she herself would have vaginal birth again with my labour history and she said "good god no" having told me several times up to that point "it was up to me" )