Paranoia back with a vengeance re. tearing!

[staranise]

I've posted on here before re. my fear of tearing again with my third child (due December). Had just managed to talk myself into some PMA, but then my sister gave birth yesterday to her third child (a lovely baby boy ) after a short labour, nice homebirth - but ended up with a 3rd degree tear, which meant a trip to theatre and a night in hospital (after a HB!). She's now on laxatives, ABs, painkillers etc and all my paranoia re. tearing again is back full force. And my sister's baby wasn't even that big at 7lb 12, about the same as my two DDS!

I would be grateful for any reassurance or positive advice. I'm going to ask for a waterbirth though I know it can't be guaranteed. really I want a c-section

Hello. I am afraid I have no words of wisdom. Your thread caught my eye because I have 2dds and thinking about trying for another baby. I am petrified of going through another horrendous birth. How did you get over that enough to get pregnant again? Sorry to throw a question back at you.

what degree tear did you have staranise?

Just v broody I guess and it was always our plan to have three so i never considered not having a third. TBH the full horror of childbirth didn't really hit me until I was pregnant again. Plus I had a mc at Christmas, which meant I was really focussed on just getting pg and have only jsut begun to think about the getting-the-baby-out bit.
My first birth was actually fine as I had an epidural so it was painfree, though I was uncomfortable for weeks after with the stitches.
It was the second that was awful - refused an epidural (never explained why), panicked, tore badly, lots of v painful stitching and now lots of scar tissue that i'm convinced will tear again. Am worried that it will be worse this time, as with my sister. Want a guarantee that it will be okay and I know that's not possible except perhaps with a c-section (that I'm sure they won't give me as my births are textbook straightforward).

you should make an appointment with your consultant to discuss the risks to you of tearing again. Then you can consider your options-you would be offered a c section if the earlier tearing was really bad and there is a risk of maybe a thrid degree tear.

I had third degree with ds. DD was born by section on advice from my consultant and a previous bottom specialist! who looked at my healed tear 6 months after ds was born!

Episiotomy and 20+ stitches iwth first birth, 2nd degree tear with second. Think I am a bit of a wimp but the second birth in particular was a real shock for me, as the stitching and stitches were so painful and really spoiled the post-partum euphoria that I loved after DD1's birth. I had loads of drugs with DD1's birth and it was fab. With DD2, the mw was v v reluctant to give me anything (I had to beg for G&A) adn it was awful.
BTW, I do feel I do my bit to prepare for birth ie, keep fit, loads of pg yoga, OFP, perineum massage etc etc.

Thanks for answering my question. I think my problem is that I have left a big gap dds are 9 & 6. I am so scared of doing it again but not sure if i could live without another dc.

Would you, consider having an epidural this time? How helpful is your midwife?

Thanks, that's good to know that a c-section is sometimes advised/possible, I had just assumed they wouldn't let me. Will flag it up big time when I see the MW. Thanks again

I begged for an epidural last time but mw just kept insisting that I was being really brave and could manage without pain relief (including G&A!!!!!). I was 5cms dilated when admitted so I think there was time for an epidural - maybe there wasn't an anaethetist available, I don't know, i would have appreciated more of an explanation.
More than happy to have an epidural as it really stopped the panic the first time but feel v insecure about getting one after the last experience. haven't seen a mw yet as only 8 weeks! (7 months of worry to come!)

Very cheeky of me to say but try not to worry!! Congratulations by the way!!

How old are your dcs? Only ask as I seem to be obsessing a bit over the age gap thing.

They're four and two mamablue. I'm worried that the smallish gap means that I'm more likely to tear becasue of the scar tissue. I've heard that if you leave a long gap (though maybe that's 10 year+), it's equivalent to giving birth for the first time. Best of luck if you go for it!

I tore badly with DS2 had LOTS of stitches. Was dreading birth to DS3 which was only 2 years apart but it was fine. Baby "flew" out when waters broke and despite the fact that he had his hand on his head I didnt need any stitches as only had slight tear. Quite possibly DS2 left fanjo the size of tyne tunnel but was too relieved to care.

On the subject of epidurals I too begged for one and was "told to be brave"! Cant repeat what I said to Midwife but she was also pretty reluctant to give me gas and air too. Do you think it is secret ploy to save money for NHS???

Thanks staranise. Not sure about the idea of a long gap making it like the first time! Help! If we decide to go for it there will be at least a 10 year gap between eldest and new baby.

I would not like to say what I might do to a midwife who would'nt give me pain relief. What are they sadists!!! The lovely midwife I had at dd2's birth said she did not have children but I should stop moaning because she was sure it was not that bad! I quote "women in labour do tend to make a fuss"!

Don't wish to criticise all mws as i know they do a difficult job under enornmous pressures etc etc and the outreach MWs who visited me at home in particular were jsut fantastic. BUT I was just astounded at DD2's birth at their reluctance to give me ANY pain relief. Was literally told to try paracetomal as if I had a headache and not a bloody great baby splitting me in two. I jsut can't understand the logic behind it especailly as it was my second birth and I was very confident in requesting drugs. knowing that they had made my first birth so relaxed and enjoyable. Will be interesting (one way of putting it!) to see what happens next time...

I had a third degree with dd1, I then had dd2 at home and with a well-managed labour I didn't need any stitches at all. I was aware that if I had torn, then I would have had to be transferred into hospital so it was something I had given a lot of thought to.

How the pushing stage was done, was for me to NOT push during contractions but allow the contraction itself to do the work while I breathed through it, I then pushed inbetween contractions. This meant there was a more steady, constant increase in the strain on my perineum and it gave it time to stretch in reaction. I was also very mobile and at one stage, a small change in my position apparently opened things up much better - a good midwife can advise and help with all this. My midwife told me when to push, when to breath and kept it all very calm. And even then, it was only 8 minutes pushing!

Where tears can sometimes occur is in fast labours as the perineum just does not have time to react. (Wasn't the case with my first, that was an episiotomy that tore with forceps delivery).

I can't say how your delivery will go, but I did want to say it is NOT a given that you will tear as badly again as I didn't. I wish you all the best with it.

I don't know if it is helpful to hear a positive birth story involving a third degree tear but I have one! I had my first baby very quickly, 2.5 hours, and was told to push when in hindsight I shouldn't have been, he was coming reallyfast on his own! I tore badly and had to go into theatre after the birth, had the epidural then lol. I was sewn up, two spiral tears LOTS of stitches but had no pain afterwards at all, the registrar who sewed me up was fab, did an amazing job, was offered pain relife but apartfrom diclofenac for two days didn't have anything. Lots of baths with tea tree and lavender and was fine. So my point is even if you do tear it may be ok, tell your midwife, I told mine about my sister's experience with bad tear after her first and my fears and she really pushed for me to be seen and treated by a registrar.

Lots of luck xx

I can not understand the reluctance to give drugs either. I had a lovely midwife at dd1's birth, wish she had been there for dd2 as well. I do understand that they are under pressure but surely pain relief makes it easier for mothers and midwives.

You need to discuss this very real fear with your midwife nearer the time and ask her to help you to write a birth plan so that your carers in labour will realise how important this is to you.

If you have a planned section you will probably feel much worse for longer as it is a major operation. When you see your friends looking fine after a section that is because they are full of drugs. A week down the line when the constipation and other side effects of the drugs are showing things are not always so rosy. Of course this is not the same for everyone and some people do genuinely feel better after a cs, but this is not usually the case.

Hi staranise.
Firstly wrt midwives pushing to not use pain relief, there is a great deal of research that shows any medical intervention (including and epidural) increases the likelihood of more intervention. It's known as the waterfall theory (I think, lulumama or someone would be better placed to explain this but I'll give it a go) basically, your best chance at birth is to be mobile, and let your body do what it is meant to do, as soona s you stop being mobile, it becomes harder, we aren't actually meant to lay on our backs to give birth, which with an epidural is pretty much guaranteed.
After the epidural card has been played we are more likely to need ventouse/forceps/episiotomy or even emergency caesarian, and the quicker birth gets medical (ie if you go in and have an epidural straight away) the more intervention is likely.
This is why many midwives will encourage you to do it yourself, without the pain relief.

Secondly, I had an ELCS five days ago, it was my third so I am better prepared this time but I still can't sit up without having a lot of pain and having to pull on something, I can't bend over and where the overhang is left from my still swollen stomach my scar hurts because it can't heal as quickly as it would if the air could get to it. A CS isn't always the easy route.

You say you prepared with perineum massage? Did you take EPO? What position did you birth in? Have you considered a doula?

As for a waterbirth the best way to guarantee not needing much intervention and getting a waterbirth is having a homebirth, maybe you could consider this?

Oh and I back up what maxbear says about the drugs, day 2 I was up and about, looking all rosy and happy, the mw's even commented on how great I looked.
I was on diclofenic,codeine and paracetamol every few hours, plus some other drug that was put down my epidural catheter and another one that went in my drip.

Now I've cut down to just codeine paracetamol and occasionally diclofenic I dont look so pretty.

staranise, I can completely relate to your anxieties. I had a 3rd degree tear with ds1. With ds2, I had a wonderfully controlled and calm homebirth where I didn't push. Unfortunately because of the scar tissue I had another 3rd degree tear and had to get up after my lovely homebirth and go to hospital to get sewn up in theatre. With dc3 I opted for a section. I just couldn't face the thought of tearing again, and had bottom symptoms from my previous tears. Natural childbirth was for me sooooo much nicer than my section, but I'm glad I had my section and now don't have to worry about faecal incontinence.

Thanks for comments and advice, I will take it all on board especially re. the not pushing in second stage as that's where I went wrong last time I think.
Need to also recognise that it is possible to heal okay, despte a nasty tear.
Don't know what EPO is I'm afraid but I did lots of the massage, plus Janet Balakas active birth preparation etc. Not keen on a home birth, partly for reasons of space and also because my sister, having had her HB, then ended up with a night in hospital being stitched in theatre. DH really not keen on a doula but I may speak to one at least to see what they say.
TBH I'd still prefer an epidural and episiotomy as in my first birth, than no pain relief and a tear as with my second. I actually felt a lot more in control the first time than the second. Thanks again!

Acknowledge yoru point re. the drugs but IMO that was the same with me and VB - I was fine immediately, able to walk, shower etc. The days/weeks after were increasingly awful with constipation so excrutiating that I was too scared to eat. Though I was fine by six weeks in both cases, which I know is not always the case with CS.

You can have an episitomy without an epidural, epo is evening primrose oil, it apparently makes things stretchier.

I can understand your fears btw am just trying to think of ways less likely to make you tear.

I hope it allgoes well for you.