Need some advice - birth after 3c tear

[FT123456]

Hi Guys;

I know there are a few threads already on this and believe me I've read them all but still struggling to make a decision.

I had my first baby around 13 months ago, ending up with a forceps delivery a 3c tear (was told it was nearly a 4th degree) and a fair amount of blood loss. I seemed to have healed okay but definitely have a weak pelvic floor cannot hold for longer than a few seconds.

I'm due my next baby in June I've had my first consultant appointment and they have said they don't see any reason why I can't try for a natural birth.

I keep going back in forth on what to do. The tear in terms of healing didn't bother me but I am absolutely terrified of it happening again and having more serious issues with my pelvic floor/incontinence.

On the other hand my little boy will only be 1.5yrs old and worried about the recovery of a c-section as his such a mummy's boy. I also live on 3rd floor flat no lift so worried i wouldn't be able to get out for walks and so on if I had a c section.

What would you do in my situation... I really need some help.

Thanks in advance.

I had a 3c tear and subsequently went the ELCS route. I found recovery fine but DH did the heavy lifting for the first couple of weeks when it came to the toddler. I navigated stairs fine after my c section, just take it slow and easy. I found the recovery much easier than the tear recovery which had been absolutely awful.

You have something like a 9% chance of another 3rd degree tear
seeing as your pelvic floor isn’t 100% the chances of this being worsened are higher (though pregnancy itself can also worsen things here).

personally I’d have an el lscs. I could manage steep stairs no problem 3 days after my lscs. Even if you had to take the stairs slowly you should be fine.

I had a tear and will opt for a elcs next time.

I think it would take the stress away out of what could happen.

I don’t have any experience of this, I had a 2nd degree tear and then no tear with second baby. I would however recommend you have a look for a “Mummy MOT” women’s health physio in your area as it has been fantastic for my pelvic floor. Either now or after your second baby is here.

Hi there
not exactly the same as I had a 3a tear with my first and was considering whether to go for an ELCS or another vaginal birth with second

went for vaginal birth and had small 2nd degree tear but the birth was great and all in all a very healing experience (first birth was quite traumatic). Pelvic floor is weaker, I have have have to keep up the exercises religiously but it is manageable at the moment (said second child is 2.5 and lifting him doesn’t help pelvic floor issues tbh).

my decision to decline ELCS was from a recovery point of view and also because I had an inkling it would help me heal my past birth trauma. I did some hypnobirthing practice leading up to second birth which helped enormously. Just my experience. Hope you get on ok, good luck, and whatever you choose keep doing the pelvic floor exercises ! Like 5x a day! NHS Squeezy app is great.

Slightly different perspective here. I had an emergency C-section with my first baby and then got pregnant with my second just after his first birthday. I had to weigh up whether to have an elective C-section or try for a VBAC. There were various factors to my decision, but one of the things that influenced me was the recovery, particularly with a toddler at home. Admittedly I wasn't in a great frame of mind for my C-section because it wasn't part of the plan, but I was completely unprepared for the reduced mobility afterwards. You don't realise just how much you use your abs for everything until a surgeon has sliced into them with a scalpel and sewed you back up again. In the first few days I found it really difficult and painful to sit and stand up, and needed my husband to pass me the baby for feeds. Luckily he was able to stay overnight with me until we were discharged. Lifting a 12kg toddler would have been completely out of the question for some time afterwards.

I did have a straightforward recovery afterwards, and aside from the scar (which is small and neat but I don't love it) I have had no complications from the C-section. After the first couple of weeks I was quite mobile again and I started doing Couch to 5K at 10 weeks postpartum, after a couple of weeks of feeling ready. I had minimal pelvic floor damage and obviously no tearing or stitches to contend with in the perineal area.

Second time round I decided to go for a VBAC for several reasons, most of which were emotional. The VBAC was successful and I had a quick labour and a very quick pushing stage, with a small tear. I suspect I could have avoided tearing if I'd gone more slowly with the pushing, but the doctor wanted the baby out quickly and I really didn't want to risk being carted off for a C-section at that stage, so I just pushed really hard and tore. At the time the doctor said it was a grade 1 tear, but in my notes it says 2nd degree so I'm not actually sure. Obviously the tear I had is less severe than the one you experienced. However, the recovery has been much, much easier than my C-section recovery, despite the stitches and the postpartum piles which unfortunately appeared the next morning.

I'm particularly glad for my toddler, who is struggling to adjust to having a sibling, and would not have understood why I couldn't pick him up and cuddle him if I'd had a C-section.

I will definitely need to do more pelvic floor exercises this time round though!

Hope this perspective helps in some way.

@HiImTheProblemItsMe @OntarioBagnet @NCcantthinkofanewone @tealandteal @Bigoldmachine @babyjellyfish

Thank you all for taking your time to respond and share your experiences. I have my next consultant appointment at 36 weeks so I have a little time to weight up the pros and cons of both. @babyjellyfish the main reason I want a 'natural' birth is my little boy, same as you I feel like it will already be a lot of him to have this new baby suddenly here. Let alone me not being able to do the usual things we do together don't want him to feel left out in anyway.

My consultant advised me minimum 3 years before my next baby after what sounds like a very similar tear if I wanted to try vaginally again but her view was elcs was safest. She was fab and very Frank about it all. Ultimately decided not to have another because I didn't want an elcs after 2 traumatic births but its a really tricky decision

@TheHauntedPencilCase so weird that consultants all have different views. Mine literally said anything over a year is fine. You'd think they would all have the same advice. Thank you for you input. Definitely is a tricky decision. I think what I'm finding most difficult is there really isn't a right or a wrong choice

I am in exactly the same position - down to the age difference between babies as well!! I'm going for another home birth.

A previous tear only increases your likelihood of tearing again by 1-2%.

I don't want to have major abdominal surgery to avoid a tear.

My tear healed well and I'm still seeing my women's physio - is that something you could do for the next few months to improve your pelvic floor?

@boogiebabies thank you for your reply. I've started doing my pelvic floor exercises again these last few days hoping to make a slight difference by my due date. But physio a good idea and definitely something I will look into.

I had a similar tear with my first and had to have surgery afterwards and then went on to have a natural birth with my second exactly 2 years later. I had a small 2nd degree tear which was absolutely fine.
Currently expecting 3rd and hoping for another natural labour. I think it’s total personal opinion. Many people opt for a c section, I would do anything to avoid a c section! Good luck x

Totally agree, I guess like any area of expertise opinions will differ. I had lost a bit of confidence as during consultation when pregnant with my second I'd been assured by a midwife that the risk of a further tear is minimal and that very unlikely to have the same experience again so I pushed on....to have exactly the same happen again 😫so I assume a lot depends on the individual but I've no idea it's completely not my area! Good luck with what you decide, remember to come back and update us!

Strongly advise ELCS. Went for a second vaginal and it ended badly. Very tough. 3rd baby was an ELCS and was absolutely delightful. Recovery was way easier than all the vaginal stuff!! Wish I had just been clear about the answer for baby 2.

@TheHauntedPencilCase. I've been told this time around if I opt for a vaginal birth I will have a specialist midwife which should hopefully help with any risks of tearing but of course there is never any guarantee. I will 100% come back and update you guys with what I went for and the outcome. Thank you for your well wishes.

@Lindtnotlint oh no, I'm so sorry you went through that. Recovery is never easy. But glad you had a positive c-section, I hear most people saying the same as you that it's so much easier.

Updating this thread as promised.

I ended up going for a ‘natural birth’ my DS arrived here safe and sound. I ended up with a 2nd degree tear which has been nothing like my first experience. No pain whatsoever. It’s still early days so can’t comment to much on things like pelvic floor but so far no incontinence issues. Can honestly say my birth was a very positive experience which I am extremely thankful for.

Thanks for the update and I'm so glad it went well. I'm in the same position as you and quite frankly terrified of a c section so this gives me some hope!

Yay!! This has given me hope as well. In fact I really needed to hear this today - I've been having a wobble!

Enjoy your baby and well done!

@UnexpectedDaisy @boogiebabies
Ah glad it's given you both hope. Wishing you all the best with your deliveries xx