Natural birth after 3b tear?

[Newhere9]

I had a natural/unmedicated first birth using only hypnobirthing techniques. Sadly at the last hurdle when pushing I had a 3b perineal tear (fortunately healed well with no significant complications - just low muscle tone in my pelvic floor - which I'm working on). Other than being a first time mum I had no other risk factors for a perineal tear. Although I felt empowered and so happy with the birth experience (obviously delighted to have a baby at the end!), I almost feel a sense of grief that I can't do this again, I have been advised that for any future births I should consider a C-section. I would like more children but would also like to have some faith in having a natural birth again - therefore I am keen to hear from other mums who have gone on to have natural birth again following 3b tear and if it was worth it or do you wish you'd gone for the C-section?

I had a 3c degree tear with my first, he was massive and forceps delivery, but I healed well. C section was suggested with my second but never pushed, and my consultant was happy for me to try for a vaginal delivery again. The delivery was a million miles better than my first, she came out fast so I tore again but not in the same place and only 2nd degree so felt like a breeze compared to the first time! Really glad I went for it again.

I had a 3c tear with my first. With my second I only grazed. But my 3rd was a 3c tear again. But only because I tore over the original tear because of the cord being around her neck.

there has never once been a mention of a C-section.
im considering it this time around. But only because I have quick labours either my longest labour being 30 mins.

I had a 3b tear with my first and then a second degree with my second child and just grazes with my third child. Recovery with my second two children was so easy in comparison with the first and I'm pleased I went for normal deliveries.

Thank you for responding so quickly and to you all for sharing @Beebel @sunshineandrain82 @Armpitwoes

It's interesting as at times I have kind of felt like I'd be silly to choose a vaginal birth options but to know that there's also a chance it could be "better" as such (in terms of not sustaining as deep as tear again), is reassuring.

Also sorry if this is too personal to the three of you. But I'm assuming after your first birth/tear there were no complications - is there anything you recommend doing to improve recovery and adjust to having new anatomy?!

@Beebel congrats on going again and having a better recovery. Is there anything that helped you second time around to mean it was a "better" tear?

@sunshineandrain82 amazing that you have 3, my thoughts were similar to have another vaginal then maybe 3rd time opt for ECS.

@Armpitwoes so great to hear how it actually got better and better with each birth. Similar to me asking beebel is there anything you felt helped to improve active labour each time?

Honestly thank you as i'm the trenches of recovering atm - your disclosures really do give me hope that we do recover and go on to have more!

When you are in the trenches recovering it is awful! I was in so much pain for a good few months after DC1. I hope you feel better soon.

I don't really have any long term issues at the moment. Probably TMI but there is a bit of my scar which is more bulgy than the rest which can get swollen after intercourse, but DH doesn't notice it and I am also more prone to piles I think.

It was 13 years ago and I am a regular runner and don't have major issues with urinary incontinence apart from the day or two before my period when I am on a run. It is on my To Do list to get to a physio to work on that though. From discussions with friends, my issues are no worse than those who didn't have a third degree tear. And I don't have any issues at all with fecal incontinence.

I feel for you, the recovery from a third degree is rough, especially those first couple of months. But it does improve, like @Armpitwoes sometimes I can notice my scar during intercourse and probably more prone to piles, but other than that no long term effects for me. I did work super hard at keeping up with pelvic floor exercises and I think that made a difference, although have got lax with that recently!

I think second time part of it was luck as my little girl was a lot smaller than my boy. But also my midwife was very conscious of my scar and applying counter pressure as I was pushing, I think that made quite a difference.

I’ve not had any knock on affects from mine. My issue comes from the spinal block being placed wrong.

my recovery wasn’t awful. More uncomfortable. I used liquid savlon in the bath sort of thing. Warm water to help soothe. Drank plenty of water. I was out shopping in London when my youngest was 6 days old.

Again, thank you for being so honest @Armpitwoes @Beebel @sunshineandrain82 I can't believe how much 3 responses on the internet has actually reassured me 😂 so glad I started the thread. I'm optimistic that my recovery will go well, I plan to give it at least 3 years before trying for a second baby anyway so hopefully that will be ample recovery and confidence building in my own body again.

@Armpitwoes Great to hear you're a runner - I too loved to run pre pregnancy and hope to re-establish this routine again when I can. So pleasing to hear you have!

@Beebel that's interesting, the consultant did mention that there are things midwives will try to reduce the risk (like you've mentioned the counter pressure)!

@sunshineandrain82 amazing to hear you were out and about too. With reference to your first reply, are you due to have a 4th baby soon?

Women's bodies truly are amazing!

@Newhere9 I’m due in the summer so I have a while yet to change my mind on type of birth 🙈

@sunshineandrain82 Congratulations, I hope your pregnancy is going well. It's such a tough decision isn't it, I've read a few threads on here and it's just so variable people's experiences on recovery from ECS Vs vaginal etc!

Curious, any other experiences of this?

I had a 3b tear first time. Second degree tear with my second birth but just stitched under gas and air then and there. I read that your risk of another third degree tear is something like 7-8% instead of 2% for someone who has never had one, so a significant increase but still a fairly small risk overall.

I had my first in the birthing pool. I was told no to that second time so the midwife could watch better and apply pressure when needed, plus they had some special scissors they could use to cut you if needed to prevent the tear (I think, it was a while ago). The scissors weren't needed. I had DC2 in the birth centre, all fairly straightforward and in hindsight a bit less painful than 1st time at the pushing stage.

I had a birth choices appointment and they were happy with my decision. I had read about it and was reasonably informed, plus no long term side effects and the medium term side effects had been manageable for me.

I had 3rd degree year with my first and also an episiotomy, they had to get the baby out quickly. Just a small tear with my second and third babies and no problems since.

I had a 3rd/4th degree tear with my first. Luckily I healed really well. I opted for a c section for my second. I was 13 years older than with my first , and quite frankly didn’t want to end up with permanent damage. Second baby was 1.5lb heavier too. My section was great. I’d definitely opt for a section if I had another baby. I did haemorrhage, but then I did with my first anyway. Felt much better after the birth of my second as I had slept the night before instead of spending hours in labour.

Just to offer an experience from the other side.

Thank you all, I appreciate you sharing your experiences. I have a gynecology review pending to potentially refer for an endoanal ultrasound. I have said I'd really prefer to have an objective measure of the damage... I have healed relatively well but still hung up on wanting to have another VB for subsequent children (if we're lucky to conceive)

Also remember that recovery from a c section isn’t a walk in the park! Get medical advice but ultimately many women tear with one birth and not from another, I asked my midwife why and she said it isn’t always obvious but in my case dd1 unfortunately decided to have her arm up around her head which was the likely cause, no long term effects for either of us, no tears at all with dd2

Thanks so much for the reply @mamagogo1 I know I am hoping for another VB and would like to avoid a C-section as to me seems to have more associated risks... Really reassuring to hear your second you didn't tear. I understand tears are common but 3rd and 4th degree are less common...

Same as you, I opted for two subsequent elective sections. The way I saw it, I thanked my lucky stars that the tear only left me with relatively mild issues (some incontinence, some ongoing pelvic floor issues) and I didn’t want to roll the dice again and risk further damage. Plus the recovery from the tear/ episiotomy was horrible and took a whole 3/4 months.

Sort of replying to myself here but also to any other mums who may have stumbled on this thread in their own quest for finding whether a natural birth is possible following a tear... I am now 7 months nearly post partum, all symptoms associated with the tear are gone and it has healed well, as noted above I am hoping to have an endoanal scan to assess any impact (requested by me as an objective measure)... I also had a birth debrief this week and was told whilst I'd be under consultant care in the next pregnancy it is ok to opt for VB and could have a birth choices app in subsequent pregnancies...

As always though if others can continue to share if they went on to have VB after 3b tear please do keep the thread going...