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Childbirth

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

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Original poster

If you had an episiotomy with first birth, what happened second time?

134 replies

CoteDAzur · 06/02/2009 17:12

Please tell.

Obstetrician said that there is a 50% (!!!) chance I will need/have an episiotomy this time because I had one last time. Something about the scar tissue not stretching.

I'm freaking out like you would not believe

OP posts:

JulesJules · 06/02/2009 20:24

I had an epi with first delivery and then needed repair surgery (twice!) as it healed really badly. It was excruciatingly painful. I had elective CS second time around (after virtually immaculate conception ) and there was a bit of discomfort, sure, but nothing like as bad as the episiotomy, and the recovery time was much quicker. I was told that as I had such a lot of scar tissue, I would probably have to have an episiotomy if I had a second vaginal delivery, and that I would probably need further repair surgery to follow, which would be "tricky" .

Not surprisingly, given my experience, I would have a CS over an epi every time.

pointydog · 06/02/2009 20:27

I wouldn't expressly forbid an episiotomy. You never know what situation might crop up. You can express your strong preference for not having one, no?

Northernlurker · 06/02/2009 20:28

I think you need to ask your doc what percentage of women who just tear end up with permanent unfixable damage - and whht percentage end up with temporary but serious damage. Personally I would accept the possibility of a cut but as I keep saying - I haven't had your bad experience. Whatever you decide to do I think you need to make sure you've come to terms as far as is possible with your previous birth.

chegirl · 06/02/2009 20:30

If it is any comfort to you at all I will share the secrets of my lady bits (strictly in the spirit of sisterhood you understand).

I had a hoooooge big epi with my DD. I had a squillion stiches (yes I DID). I didnt tear at all 2 years later with DS1 and he was almost a 1lb bigger.

I dont know if it had anything to do with the fact that second birth was much much more mobile and I was 'allowed' to give birth kneeling.

When I had DS3 (16 years after DD) I was sort of ordered to lay down as he imerged. Does anyone know if there is a good reason for this? My MWs had been brilliant up to that point and it was a lovely homebirth. It seemed out of character for them to suddenly go all 'mothers MUST be lying down when giving birth'.

FrannyandZooey · 06/02/2009 20:38

i didn't need one second time - gave birth leaning over a birth ball - at home, with a doula, which i think helped

FrannyandZooey · 06/02/2009 20:42

oh and ds2 was 9 lb 3 - bigger than ds1
my episiotomy was a nightmare as well cote
i used to feel sick and shake with the pain if i had to walk or use the toilet
it got infected twice, stitches vanished, whole thing had to be redone at later date!
with ds2 i had small graze and a few stitches - all healed beautifully

Psychobabble · 06/02/2009 20:47

This reply has been deleted

Message withdrawn at poster's request.

hellymelly · 06/02/2009 20:47

Cote-I don't know if this helps,but having had a distressing c-section birth with dd1,a lovely consultant at my hospital talked to me when I was only three months preg,but really frightened,and he was going through the options of an elective section or vbac with me and he said that it wouldn't be the same again,it wouldn't be as frightening,because whatever happened I had already been through the first birth and so it would be familiar territory,however horrible the experience had been,I was still more experienced because of it,and he was right.I opted for v-vac and ended up with a section and it was all wonderful.I had a doula,which helped.You are justifyably scared and maybe a c-section is right for you,only you can weigh that up,but it will be better,really,whatever you choose.I am wishing you a lovely birth.

theyoungvisiter · 06/02/2009 20:52

I had an epi and ventouse first time, 2nd time I had a home birth (partly to make this an unlikely option!) and had a "graze" along the line of the previous episiotomy. No stitches required and it healed really fast.

MrsTittleMouse · 06/02/2009 21:27

I had a small second degree tear and (the really good news) the episiotomy scar was stretched internally and is much more comfortable.

thunderpants · 06/02/2009 21:35

Lots of stitches first time round - none with the second. He was 2lbs heavier and arrived in half an hour. There's probably a 50% chance of an episiotomy first time round as well, judging from this thread!

GreenMonkies · 06/02/2009 21:37

I had an episiotomy with DD1 for a ventouse delivery. Was stitched badly and never felt "right".

The scar of my episiotomy tore as DD2 flew out, she was a full pound heavier than DD1 and born a lot faster. The MW stitched the tear and it healed quickly and, compared to the episiotomy, painlessly and I now feel no different to how I did before I had DD1!

There are two "sides", one likes to cut, the other likes to let you tear, the "cutters" say they can control a cut etc, the "tearers" say only soft tissue tears and not muscle (as a rule, as long as you are not in stirrups or on your back), and that tears heal better. I'm with the "tearers" school of thought.

Original poster

CoteDAzur · 07/02/2009 09:31

pointydog - After the hours I spent crying talking to midwife, doctor, and psychologist, I don't think there is anyone in this maternity unit who is not aware of my strong preference not to have an episiotomy.

OP posts:

Original poster

CoteDAzur · 07/02/2009 09:34

chegirl - Did you have a tear or episiotomy in third birth where you were ordered to lie on your back with feet in stirrups? I'm asking because that is exactly what will happen to me.

Thank you for "sharing the secrets of your lady bits", by the way

OP posts:

ConnorTraceptive · 07/02/2009 09:41

I had an episiotomy with ds1(big baby at 10 pounds), took a long time to heal properly

DS2 no episiotomy despite shoulder dystocia (sp?) but I did tear quite badly he was even bigger at 11 pounds. BUT I did find that the tear healed far far quicker than the episiotomy.

Also IME diet and birth weight aren't that closesly related unless you have gestational diabetes. I had severe hyperemesis with both and by 40 weeks I was less than a stone heavier than my pre pregnancy weight and once babies were born I actually weighed nearly a stone less than before pregnancy.

(alas i have found it again since )

Original poster

CoteDAzur · 07/02/2009 09:51

11 pounds

I does seem from this thread that (1) 2nd time episiotomy unlikely, and (2) tear better than episiotomy.

OP posts:

ConnorTraceptive · 07/02/2009 10:01

I'm not gonna lie to you a tear will smart, but definately heals better.

muppetgirl · 07/02/2009 12:10

I agree wih the weight not being that important...MY friend delivered with G&A an 11 1/2 pound baby. Had shoulder dystocia right at the end but only 2 stitches.

I think shape of baby and size/shape of birth canal play a lot and this is smething you can't plan for.

Ds 1 was long (and still is) ds 2 was broad with a large head (and still is!!)

Highlander · 07/02/2009 14:46

my sister had a 3rd degree tear 2nd time.

theyoungvisiter · 07/02/2009 15:58

I think a lot of it is to do with how fast the pushing stage is, and how controlled the descent is (tears I mean). My MW encouraged me to "breath" the head out slowly and support the weight (I was standing) and it did seem to make a difference - it felt very controlled.

Original poster

CoteDAzur · 07/02/2009 19:36

Highlander - Did your sister have an episiotomy in first birth?

OP posts:

Original poster

CoteDAzur · 07/02/2009 19:37

Doctor & even midwives would never agree to anyone giving birth standing up in our hospital.

OP posts:

nappyzonehasastroppytoddler · 07/02/2009 19:44

I had an extended episiotomy (whatever one of those is) with my dd who was 6lb and took forever - was going to be sucked out with ventouse but i managed to get her out myself in the end - with my 2nd i had a water birth and it was alot quicker - my episiotomy from last was never taken into account - when i was in transition at my stretchest i suppose i felt what i can only describe as a tear or explosion and insisted something had happened which they said was waters going but i felt it was more - i deliverd ds who was 8 12 so alot bigger than dd - afterwards she looked at my bits and said just grazed - then came back with her colleague who declared i was off to theatre to sort out my 3rd degree tear. It sounds worse than it actually was and as oposed to my first time i had no infection and they did a lovely job stitching me up which i am now reeping the benefits off . On a differnt note i know friends who had this too first time and 2nd time didnt even have a scratch so dont freak out.

LilianGish · 07/02/2009 19:52

My second baby was almost twice the size of my first (2.5kg v. 4.2kg). Had episiotomy first time but not second. I don't think it follows you'll have to have one.

Sachertorte · 08/02/2009 18:18

You poor thing! Awful situation to be in, are you just feeling out of control of the situation? Is this the worst aspect of it? I know the kind of environment you´re going to give birth in but nevertheless think you are worrying too much. The reality of the situation is you are worrying yourself sick (potentially for nothing at all - you could have a brilliant easy birth) or worrying yourself sick could contribute toward having a bad experience. There are absolutely no certainties when giving birth and better with assistance than no help at all.

My experience of epis.: (DD1, big baby, ventouse - horrible horrible horrible, very uncomfortable for around 6 weeks, couldn´t sit down or walk easily). DD2, average sized weight, also delivered with epis., given ROUTINELY by the gyno/obs who happened to be there. Didn´t hurt a jot, was up and about immediately, no "recovery" time needed. I´m convinced that second time round the baby doesn´t meet so much resistance on the way down the birth canal, you´re just not so toned anyomre... so pushing phase much easier, a couple of pushes in my case.
Have you considered delaying going to hospital till the last moment, just to put off the medicalised bit as long as possible? Then resisting being put in stirrups? I refused the stirrups except for sewing - no problem. Can you birth in a pool?

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