Birth injuries without instrumental assistance

[worrywilma]

Hi, just trying to gauge the risk of birth injuries from an unassisted vaginal delivery.

I'm terrified of having a prolapse or being doubly incontinent so will be considering asking for an ELCS when the time comes.

I know an uneventful vaginal birth is preferable, but how likely is that to happen? Im desperate to avoid forceps and for first births, they seem to be a regular occurrence causing massive problems later in life.

How has your vaginal delivery affected you?

Tia x

My first was an hour and ten mins labour. I had a very small episiotomy with three stitches after, no issues baby was 6lb. Second was born in 45 mins, no inteventions and was 8lb. Third was 9lb 9.5 woke pushing involuntarily in the night, never felt one contraction managed to breathe against my body pushing and hold him in till got to hospital when he was born, no intervention. Had absolutely no issues since having them 20, 15 and 12 years ago.

I had a second degree tear with my vaginal birth (first delivery was an urgent C section). Tbh it took until about 9 months before I could run without it feeling like all my innards were about to fall out through my pelvic floor. But things resolved and 17 years later I have no problems with continence or anything like that.

@worrywilma I had a 19 inch long baby ( an ounce off 8lbs) a natural tear that was stitched and no issues at all.

The prolapse is probably the lesser of my worries, it's the fecal incontinence and lack of control during the birth that scares me.

If someone could say "you're going to have lovely, untraumatizing (mentally or physically) water birth, I'd say bring it on.

But the risks of vaginal birth just seem to be swept under the carpet, and from people who I have spoken to, they were never made aware of what could happen.

You’re entitled to the birth you want. If you want a CS then you don’t need to give a reason, just let them know and get it booked in.

People don't tend to post their positive experiences, so don't let the scare stories put you off! I've had two forceps deliveries with episiotomies and I have no issues with my pelvic floor, continence etc. Both babies have been fine too.

I've had four babies. after my 4th I had a little urine incontinence but pelvic floor exercises has sorted it out. Nothing amiss so far

I know this isn't exactly what you asked but just as another take on it.. I know birth trauma is most often spoken about following vaginal deliveries, but I suffered immense birth trauma from a horrible c section and required counselling for it. I just feel it's important to note that a c section isn't the sure fire way of avoiding birth trauma.

You'll have to check the data, but if I remember correctly, after the first couple of months, the method of delivery has no correlation with whether you end up with fecal incontinence. It's pregnancy that can do the damage as well as delivery

Personally, I felt more in control opting for a vaginal birth, starting on low pain relief options and choosing how and when /if to ramp up when it felt right. But you should choose the birth that's right for you, just consult real data rather than anecdotes

I came out of mine pretty much unscathed. I had a few stitches from bad grazing but that was it.

I was in my mid to late twenties at the time, I didn't exercise apart from walking but I was reasonably fit and strong, as well as being quite flexible. If you do go for a VB, I recommend being strong enough to hold a squat so you can get good leverage on a push.

I’ve had 2 c sections, it’s major surgery and it’s not easy (no birth method is) but it was the best option for me. Risk for the baby and myself was lowest for a c section.

recovery is tricky for a couple of weeks but as long as you have a supportive partner who will pass baby to you and go things round the house so you don’t have to bend for the first few weeks you’ll be fine. In my experience, taking it really easy for the first week helps you massively with recovery in the long run.

good luck whatever you choose x

@remaininghopeful23 sorry you went through that. Was it a planned section or emergency?

I didn’t have forceps with any of my vaginal births. My pelvic floor is ok but I did have a very large episiotomy with my first ( I think the midwife was panicking as baby was in distress) which took months to heal and got infected.

I felt very similar to you so I FOI'd my local trust to get actual stats (in my case for first time mothers over the age of 35-of how many women had vaginal delivery's, assisted births, emergency sections and also tears to each degree) to help me make an informed decision.

In my case it reaffirmed my gut feeling that ELCS was the way to go. That's what I ended up having and it was absolutely the right choice for me.

But the risks of vaginal birth just seem to be swept under the carpet, and from people who I have spoken to, they were never made aware of what could happen.
I think the risks of C-section are not as well known as they should be. ELCS is not a walk in the park.

A friend had to have several. She then had an unplanned pregnancy that almost killed her and the baby, due to complications as a consequence of the prior sections (placenta accreta). She almost bled to death, needed an emergency hysterectomy, and if she'd started bleeding again, she would have died.

Ds1 spontaneous labour but prolonged second stage and foetal distress because he was stuck in a funny position. Episiotomy sorted it but stitches broke down very quickly and got infected. I also lost quite a lot of blood, but avoided a transfusion. Probably took 12+ weeks before I could walk without pain and at least 6 months before I felt remotely normal. Ds1 is 10 next week and the scar hasn't hurt for a long time but it still feels sensitive. I can pinpoint exactly where it is.

Ds2 induced labour but only a first degree tear, minimal blood loss and felt back to normal within 2 weeks.

First baby,four and a half hours,no intervention,only gas and air for the last 30mins,no stitches,no issues.
Second baby born with hand above face and back to back,no intervention,no stitches,no issues.
Third baby three and half hours,no intervention,no stitches,no issues.
Fourth baby,two and half hours,also back to back,no intervention,no stitches,no issues.
Fifth baby,forty five minutes,born at home,9lb 6oz,no pain relief or intervention,paramedics turned up after he was born.
Went to a trampoline toddler session so had to take part 7 months pregnant with number six,no problems taking part.
And have had no issues in the intervening 10 years.
Do it isn’t inevitable.

Pregnancy alone causes damage, my aunt had a prolapse, she only had CS's.

I had an intervention free VB & CS, my bladder had more weakness after CS because presumably 2nd baby. I preferred the VB hands down.

I had three natural unassisted births, however my first resulted in a stage four tear.

Saying that recovery was smooth, and I would never know now that it had happened . Would still choose a vaginal birth over a CS as every single recovery process was easier than that would have been I think.

Thank you. It wasn't planned but wouldn't deem it emergency either.. slow laboured for 48 hours then 10 hours on the oxytocin drip and very little progress so no further options. Issues stemmed from it being a very difficult section physically, getting DS out was extremely challenging. And complaictions with anaesthetic. (Im very conscious I don't want to derail OP's thread more than I already have so won't get too into it😅)
But in essence I don't believe there is any easy way to have a baby and there are certainly pros and cons to both. I know personally I hear a lot about trauma following a vaginal birth but I haven't heard so much when it's a c section so I just feel it's another stance to be aware of.

Bloody hell girl, do you not have a tv in your house 😂😂

Thank you for sharing your story. If everyone's births were like yours, I'd have no anxiety about it all.

Vaginal birth with forceps, baby had a >98th centile head.

Which was on the growth scan but no one seemed to clock it as a potential issue.

Ongoing pelvic floor and bladder issues, bladder ones have a lot to do with it not waking up properly after the spinal block for going to theatre.

I had forceps and an episiotomy, the first two weeks were agony, but now it's like nothing ever happened.

I'm a midwife and 3rd degree tears too happen, 4th degree very rarely.

I've helped deliver a decent amount of babies and non of my patients have ever had anything above a 2nd degree tear. That's anecdotal though.

So 3 generations of women in my family:
DGM 4 vaginal births continent till her death at 94
DM :3 vaginal births, episotomy with the first minor tears with 2 & 3 no continence issues at 78
Me : 2 vaginal births 1X episiotomy, single stitch with number 2. No continemce problems age 48 ( 21 years since first birth) I will advise Dd strongly to try for a vaginal birth.