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Childbirth

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

Original poster

Elective C-section or vaginal birth after 3rd degree tear?

33 replies

Happybirthday123 · 21/12/2022 06:44

Hi everyone,

I am pregnant with my 2nd son due in March and I am trying to decide whether to opt for a C-section or vaginal birth after a 3rd degree tear 3 years ago.

During labor I was given an episiotomy but still had a 3rd degree tear. Recovery was quite painful but I have healed well I think. My pelvic floor probably isn't as strong as it once was and I sometimes let some pee out when I jump or run. I also find I need to go to the bathroom very very often ( some of this I think may be psychology - going "just in case").

Looking for any advice anyone has on my 2nd birth. Any experiences with elective C-sections would be hugely beneficial too.

Some things to consider:

-This will be my last birth, my husband is getting a vasectomy after this baby.

  • My sex life took a big hit after the birth and only recently has it been a bit more normal. I am terrified of another bad tear setting this back again.
  • The midwives I am seeing advise against epidurals and say this will prevent tearing but also said they would like to do an episiotomy to prevent me from tearing again. Getting an episiotomy without an epidural sounds horrifying to me, I would not consider it unless I have an epidural (which I have been told can contribute to tearing next time!)
  • The midwives are also very pro natural birth and may discourage me from getting a C-section.
  • I have a 3 year old son at home but he is in nursery Monday -Friday.
  • My husband will be taking 6 weeks paternity leave once the baby is born so will be around to help a lot.
  • I will not need to drive anywhere for 6 weeks after the birth (my husband can do all the driving)

Given all of this I would love some advice to help me make my decision.

Any personal experience on elective C-sections and recovery would be very much appreciated!

Thanks 😊

OP posts:
bravotango · 21/12/2022 06:57

I had an emergency section 4 weeks ago and it was fine, I'm feeling mostly.recovered now and for my next pregnancy I will choose an elective section. I had planned and had a preference for a vaginal birth but it didn't work out that way in the end, but I still got to listen to music, have skin to skin etc so really ended up with pretty much the birth I wanted anyway! If your DH is around for 6 weeks then I'd absolutely go for it if it's what you want, mine went back to work after 3 weeks and that was fine.

hoopyloopy2 · 21/12/2022 07:05

I had the same dilemma after a 3rd degree tear first time around. In the end, I went for an elective c-section and years later I still think it was the best decision. First time giving birth was scary and out of control, I lost a lot of blood and was exhausted. Like you it took a long time for my body to recover. I just did not want to risk that again - or worse. Recovery from elective c-section for me was a breeze by comparison and a much more positive experience all round. Good luck!

LouLou198 · 21/12/2022 07:05

In your situation I would definitely book an elective section!
I was offered this after an emergency section with dd1. I didn't, but really wished I had as I ended up having another emergency one anyway!
I have friends who have had experience of both emergency and planned sections. They say planned ones are much more relaxed and recovery was better afterwards.

Christmacrumble · 21/12/2022 07:09

I had a 3rd degree tear with my first and an elective Caesarian with my second.

The recovery after the Caesarian was so, so much better - I could sit down without feeling like I was sitting on pins. It is so much easier to look after a scar you can see

It is much easier to plan the care of your 3 year old as you get a date for your c-section

so happy with my decision - yes the recovery from an operation is significant but I found it so much easier than recovery from a 3rd degree tear!

paradyning · 21/12/2022 07:11

Section

Christmacrumble · 21/12/2022 07:12

Oh, and another thing - you should be able to run and jump without leaking. Get thee to a women’s physiotherapist - it can be fixed with proper pelvic floor exercises

(wish I hadn’t waited years before seeing one - it’s amazing to be able to sneeze, cough and run without the feelings of shame and embarrassment that leaking gave me)

Twizbe · 21/12/2022 07:17

I had a third degree tear. I must be in a strange trust because no one even mentioned a c section for my second.

I'd assumed that if you tore once you'd do it again.

My second baby (2 years after first) was a beautiful water birth on my hands and knees with just gas and air.

The big surprise - not a scratch! The midwife was super pleased as she'd stitched me up the first time.

Id do a vaginal every time.

olivehater · 21/12/2022 07:17

Section every time. As others have said the recover from my section was so much easier than my tear. I don’t want to end up with a prolapse when I am older either.

spare123 · 21/12/2022 07:19

CS definitely. recovered much more quickly from my CS than my forceps delivery. home the next day, off all painkillers within a week, driving at 10 days.

TheBirdintheCave · 21/12/2022 07:41

Twizbe · 21/12/2022 07:17

I had a third degree tear. I must be in a strange trust because no one even mentioned a c section for my second.

I'd assumed that if you tore once you'd do it again.

My second baby (2 years after first) was a beautiful water birth on my hands and knees with just gas and air.

The big surprise - not a scratch! The midwife was super pleased as she'd stitched me up the first time.

Id do a vaginal every time.

This is interesting! I had a 3b tear and was told I wouldn't be allowed a water birth if I had another baby. I hope it is actually possible as I would like to give birth vaginally again.

Lj8893 · 21/12/2022 07:49

TheBirdintheCave · 21/12/2022 07:41

This is interesting! I had a 3b tear and was told I wouldn't be allowed a water birth if I had another baby. I hope it is actually possible as I would like to give birth vaginally again.

Show quote history

There is absolutely no such thing as “not allowed” when it comes to your body, your baby and your birth.
There is some evidence to say a hands on birth where your birth provider manually protects your perineum can reduce your risk of a more significant tear, and this can’t be done in water.
However, it is only a small chance of you having a repeated 3rd degree tear and water also is thought to be somewhat protective of your perineum.

I am surprised at the person saying a midwife stitched her 3rd degree tear though as midwives don’t do that, it would be an obstetrician in a theatre setting.

dontpickupthemob · 21/12/2022 07:53

I had a third degree tear with my first and my god the pain was awful. I had natural births for my other two children and didn't rip or need pain relief. In your case I would have a c section, it will take the worry about birth and recovery off you.

Cantbelievethis1 · 21/12/2022 07:54

I had a 3rd degree tear in May and lost 1.5 litres of blood. I think if I have another baby I'd like a c section. I did not have an episiotomy (even though I requested one, ds just came out too fast) no pain relief either and think the tear hurt more than the birth. I still have issues with my pelvic floor

IrishMamaMia · 21/12/2022 07:57

I had the same and chose an elective c-section second time round. My main priorities were protecting my future pelvic health and to have a calmer, more predictable birth experience after first time round being traumatic.
Loved my c-section, it was a perfect birth and as others have said recovery was easier/quicker than a 3rd degree tear for me too :)

strawberry2017 · 21/12/2022 07:59

Section without a doubt.

Twizbe · 21/12/2022 09:30

@Lj8893 all I know is what happened to me.

The midwife who delivered my children was a very senior one. She usually did birth centre but was on the labour ward that day. Perhaps because it was an easy one to do she did it 🤷🏼‍♀️ I had a student midwife watching too lol.

Lj8893 · 21/12/2022 09:36

Twizbe · 21/12/2022 09:30

@Lj8893 all I know is what happened to me.

The midwife who delivered my children was a very senior one. She usually did birth centre but was on the labour ward that day. Perhaps because it was an easy one to do she did it 🤷🏼‍♀️ I had a student midwife watching too lol.

Not even a senior midwife should be repairing a 3rd degree tear so that’s quite concerning. A 3rd degree tear should be sutured by a competent obstetrician in a theatre setting.
Im a senior midwife.

Lj8893 · 21/12/2022 09:37

Midwives can suture, but not 3rd or 4th degree tears.

TheBirdintheCave · 21/12/2022 09:40

@Lj8893 Ok good to know :) If I make it to my booking in appointment I will talk this through with the midwife.

Twizbe · 21/12/2022 10:51

Lj8893 · 21/12/2022 09:37

Midwives can suture, but not 3rd or 4th degree tears.

Well I don't know then. They said third degree and midwife stitched. Maybe it was only just or something.

This was almost 6 years ago now. I know my scar goes pretty far down.

Original poster
Happybirthday123 · 21/12/2022 13:16

Thank you so much for all of your responses. After reflecting a good bit on this over the past few days I think I have decided I will request a c-section. To me, the risk of another tear is too great. I feel like I am finally feeling normal enough down there and another setback to my sex-life and potential pelvic floor health would be devastating to me. Given the choice between an episiotomy ( with the potential to still tear like last time) and a c-section, I would rather go through the c-section recovery. My concern is I tend to be quite swayed by any medical professional's opinion ( midwife, DR, etc.) and I know that the midwives I am seeing will try to discourage me from a c-section and will more than likely make me more nervous and unsure about the whole procedure - but will not change my mind. Any advice for the conversation with the midwives?

OP posts:
TheBirdintheCave · 21/12/2022 13:18

@Happybirthday123 Maybe write down a list of reasons for your decision so that you can refer back to it if they try to challenge your choice (which I hope they don't).

Kimberz · 21/12/2022 13:24

Hey. Congrats on baby.

Having had both types of birth myself, (csection then vaginal) i'd go C-section again if we were to have another.

I tore and had an episiotomy (epidural) and would be anxious of it happening again. Recovery has been a breeze but I wouldn't want any more damage.

It's fab your hubby is off work that long as you'll need the help for the first few weeks.

Adelais · 21/12/2022 13:32

I had a elective csection for my second child after a 3rd degree tear with my first and so glad I did as the recovery from the csection was so much easier than the recovery from the tear.

Lj8893 · 21/12/2022 13:55

Happybirthday123 · 21/12/2022 13:16

Thank you so much for all of your responses. After reflecting a good bit on this over the past few days I think I have decided I will request a c-section. To me, the risk of another tear is too great. I feel like I am finally feeling normal enough down there and another setback to my sex-life and potential pelvic floor health would be devastating to me. Given the choice between an episiotomy ( with the potential to still tear like last time) and a c-section, I would rather go through the c-section recovery. My concern is I tend to be quite swayed by any medical professional's opinion ( midwife, DR, etc.) and I know that the midwives I am seeing will try to discourage me from a c-section and will more than likely make me more nervous and unsure about the whole procedure - but will not change my mind. Any advice for the conversation with the midwives?

They really shouldn’t do that.

As midwives and obstetricians it is thier job to ensure you have had all the relevant information and are making a fully informed choice based on up to date evidence.
Once satisfied that is the case they should support you with whatever your decision is, even if it is not the decision they may make.

Have a look at The Ockenden report and quote this at them if you feel they are resisting your choice.

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