Experiences of labour after a 3rd Degree Tear??

[Gillyan]

Hi

I had a 3rd degree tear with my first baby and have had a 2hr appointment with MW today to dicsuss options this time round. I'm 24wks. I can have an Elective Section if I want. I think I am leaning towards a vaginal birth but MW explained that my last tear was about half a cm away from me needing a colostomoy bag. My idea so far with advice form lovely MW is to maybe have an elective episiotomy ( diagonally) to keep any further tearing away from bum area! I am keen on this as it seems better than a section. MW said that the over all trauma to your body after a section is wosre than giving birth. She also said more complications arise with sections than vaginal deliveries. I found the pain agonising last time but still I don't seem keen on a section. I must be mad...

Can I have any info from you guys on your second time round after a bad tear??? Thanks in advance

I had a 3rd degree tear with DS1. I think it was possibly due to bad position to give birth in and not controlled enough.

When PG with DS2 I spoke to my MW about HB and thought they may not let me because of previous tear. My MW said that they can't possibly know if you'll tear again unless they are certain of why you tore first time. In the end I had an HB and did have 2nd degree tear which was stitched at home.

Good luck

LadyPink - I'm so encouraged to hear that you had a HB, as I assumed I would be unable push for one, having had a 3rd deg first time round. Thanks for this info!

Hi guys

Mrsmerry Thanks for your advice - Unfortunately there is no obvious reason why the tear happened - I had total control over pushing, DD was 7.5lbs, she came out the right way and had no arm or elbow by her head, I was fully dilated etc etc they just don't know why I tore so badly so therefore there is nothing that i can think to do different next time except trust them to notice if I need an episiotomy ( which they didn't last time) or have an elect episotomy which might not even stop a 3rd degree tear and I have heard off some people that the stitching from an episiotomy was worse than their 3rd degree tears.

ilovesweets I love sweets too! Recovery wise I was told last time that my recovery was as bad as a section recovery. I didn't sit on a ring but sat on cushions and found that once I was sat it wasn't too bad, it just hurt again when I moved or got up but I imagine that would be the same as a section.

heated and marne thanks again for your advice.

ladypink Thanks for your message also - again I was in a good position and controlled so I don't have that to work on. Well done on HB - I looked into this time as had terrible care last time but they said not recommended as also had some other problems.

All in all I'm starting to now lean towards a section as I just can't get the colostomy scenario out of my head - also I had a bad time last time with horrible midwives who were so short staffed and I got left on my own most of the time and was ignored when I requested pain relief etc etc and I keep convincing myself I am not bothered about that this time as at least I will know what to expect but i suppose with the section thats all taken care of and it's calm and controlled and at least you know for definate you are going to receive care. Recovery from a section doesn't really concern me either as has a few surgeries in the past ( althought a section would be by far the most major) and I do seem to recover very quickly and just get on with it. I had my appendix out in Feb 08 at 4pm and discharged myself at 10am the next day. My DD is 3 now and goes to the loo on oher own and climbs the stairs and walks everywhere and not in a buggy and I don't drive. Also my partner will have 2 wks leave and another wk holiday and we'll keep DD in nursery 3 days a week till I'm better, so there will be only 2 days a wk when I have to look after her on my own and I have my Mum and in laws and my best friend who is 5 doors away...sounds like I am trying to convince myself here...

It boils down to the worry I now have about the worse outcome versus a planned section. I just don't see now how I am going to relax and stop worrying about the tear - especially as there is nothing I can do to prevent it and there is no crystal ball to predict. I understand the risks involved with a section, thrombosis, haemoragh, loss off sensitivity, hysterectomy in extreme cases but in the less extreme I would rather have an infection in a section scar than my fanjo/bum! I am also worried about the mental repecussions, if I end up with a colostomy bag or even just having to go to surgery again after the last bad experience I feel I really will start to get down about it. I keep telling myself it'll probably be fine but I just don't think I can risk it not being. There seems to me to be more risk of my old scar tissue opening up again than something terrible happening in a section.....and I am worried about my pelvic floor later in life, and if I did have an lect episiotomy then thats yet more damage to the muscles down there.

SO SO SORRY for going on and on andon! It's just such a crap decision. Thank you to all of u for taking the time to listen xx

Bless you, what a huge worry. The idea of having long-term bowel and bladder problems is just unthinkable. Best of luck and have fun with your lovely new baby!

Hey guys, hope you're all well.

After much agonising and tons and tons of research I have decided I'm going to have an elective section. I see MW next wk for 25wk appoint so I'm going to ask her to refer me to the consultant so I get it booked in. I just can't risk ending up with a colostomy bag especially since finding out my last tear was half a cm away from leaving me with a colostomy bag. In my mind fi you break your ankle, that ankle is always going to be weaker if you do whatever broke it in the first place, does that make sense?? After researching I haven't found many positives about an elective episiotomy stopped an anal tear. All this about the tear coupled with the awful care I had last time I think I'm going to give up on my idea of a better birth and feel I have more chance of tearing again than of any major complications from a planned section. Sorry just thought I'd share this with you all as been up ALL night worrying and haven't even gone into work today...Any comments??

Gillyan, I think you've made a wise decision. The colostomy bag concern is a real worry and, as someone said above, would affect your whole life, as well as your self-esteem, etc.

I really hope it all goes incredibly well for you! xxx

Thanks xx

Not sure if you want to hear this now!]

I had a 3rd degree tear with dd, had a section with the twins first. DS3 after dd was a text book HB, all well. I had a 2nd degree tear that needed a few stitches. I went on to have 3 more births after this, 2nd degree tears, minimal trauma.

The last baby was HB and NO STITCHES!

But LGAT, OP has been described as half a centimetre from a colostomy bag.

That's not a lot.

CS is a procedure carried out 1000's of times every day with good results.

A VB for someone with a history of bad tears could go any/either way. In your case it went fine but it's the luck of the draw.

A CS at least follows a particular procedure designed to minimise "unnecessary" trauma and avoid birth complications to the woman.

LGAT Thanks for your message - I keep dreaming that I will have that luck and like ilovesweets says it is just the luck of the draw. I think for me I just can't get the real possibility of a colostomy bag out of my head, I have heard of lots of people who have been fine second time and you are so lucky and I just wish I could go for itand hope for the best but no, I think if I had had the first degree of 3rd degree tear then maybe but since finding out how vad last one was I'm too scared

Thanks though, and my god how many kids have you got??!!

Only sharing my experience ilovemysweets that's all. I was not telling the op to have a vaginal birth.

Gill you can speculate till the cows come home but you are quite right, there are no definitive answers in birth.

I am hugely lucky with my birth experiences since the twins and dd. I have also had a shoulder dystocia at home so am well versed on the unexpected. You never know what may happen.

All you can do is be comfortable with your decision and know you have researched all the options.

Good luck

I have 7 children btw.

7 children, you must have some kind of award surely!!!

Yes I just can't risk it so feel happier to have the section. Fingers crossed that goes to plan now!

Yes, sorry LGAT, I didnt mean to sound critical. I just didn't want Gillyan to possibly doubt her decision so soon after making it. I am really pleased you had a successful outcome. 7 DCs, wow, you must be an expert on babies!!!

I had 3rd degree tear after ds 2 as he got stuck and was 'forceped' out.

I had incontinence from bladder and bowel fro about 6 weeks afterwards. I also had, and still have, vaginal flatulance and pain before emptying my bowel. I've had a barium enema and other investigations but nothing has been found.

I am 24 weeks with ds 3 and knew from the start I wanted a c-section. I am fully aware of the possible complications but for me I cannot contemplate another vaginal delivery (ds 1 was ventouse + episiotomy and tore anyway and ds 2 was forceps with no episiotomy) I found both my births traumatic as they both went very wrong right at the end.

My decision was baed on not wanting any more damage to my 'bits' incontinence etc especially as it was only 16 months ago I had ds 2. This decision has huge impact on my life and has not been taken lightly, We have no family that can help and will have to have a nanny for the duration of my recovery. It's a hard decision to make, good luck x

Hiya muppetgirl We're due the same time aren't we? Sorry you had such a bad time too. I think you are dead right in your decision, the incontinence must of been awful for you. Your tears seems to be becuase of instrumental deliveries don't they, I still have no explanation for mine which is why I'm finding it hard to think it could be ok next time. Are you worried about going into labgour before the day you'll be booked in? Just hope I don't have a fast labour and end up having to give birth when I've decided on the section!

Well done for making your decision, the recovery might not be as bad as you expect. Have you had any op's before?

Just heard jade Goody has died! Today of all days! So sad!

Hi Gillyan

Yep the incontinence was awful. I had to take spare clothes out for me as well as ds 2! Bladder was much easier to live with than bowel I found.

I will be booked for my c-section at week 34 and it'll take place at 39 weeks. Yes the tear was caused by instrumental delivery but I did ask for a c-section at the time and they said no that forceps would be better for recovery, oh the irony. I also expressed concern at possible tissue damage and my concerns were brushed away as being insignificant. I was induced with my 1st son as I was overdue and he arrived after 27 hrs, ventouse as he was distressed and I had an episiotomy but still tore. Ds was spontaneous labour the day before my due date but he was too large (growth scans every 4 weeks from 20 weeks confirmed this, he was a large baby, not a weight issue at all. At the 36 week scan he was measuring 40 weeks and the sonographer joked that if I?d walked in off the streets they would have given me a due date of that day which totally terrified me!!

I had 2 highly medicalised births and I totally understand that the decisions I made weren't the best -I would never be induced again for example - but due to the traumatic 1st delivery I really didn?t trust my body at all for ds 2's birth. I had no confidence, was absolutely terrified at the thought of birthing this large baby (I'm 5" 2, size 8 btw. Ds was 9lb 1oz and ds 2 was 1/2 oz off 10lbs) I was a disaster waiting to happen.

With this baby I was told that 3rd's can be bigger (I also accept they can be smaller also as there are no guarantees at all with these lovely babies!!) So again, the anxiousness started. I was having flashbacks to both births and was becoming very agitated. My Dr wrote to the consultant advising a c-section due to previous traumatic births, 3rd degree tear and large baby that got stuck and the consultant agreed.

C-sections aren't for everyone and if I were starting this whole giving birth thing again with no previous knowledge I would love a home birth with dh, midwife and to just be left the heck alone, but I know it's not going to happen. I am too young to be left totally incontinent and too scared to take any more risks with my lady bits!

Poor Jade Goody?

Aww god muppet that sounds awful. A size 8! Thats half of me!

I would love a HB too, but not going to be a good idea.

I don't relish the thought of the section but I think for peace of mind for the rest of my pregnancy it's worth it. I'm too not prepared to risk incontenance problems, I'm only 26!

Thanks for your info xx

Just wanted to reassure you about c-sections. I've had two - one emergency and one elective and will having a third in july.

I recovered really well from both of them - and you're right you do seem to get particularly good care from the midwifes post birth. They keep you topped up with pain relief in a way that didn't seem to happen to ladies who'd had bad tears.

I also had a 3 year old when i had my second c-section and a DH back at work one day after i came out of hospital and i coped fine.

I think i do heal fairly well though and know i was lucky.

Good luck!

I had 3rd degree tear with DD1 and was very wooried about givingborth the 2nd time, however I had a fab mw and didn't tear at all.

I think the trouble with DD1 was that I needed to push and couldn't stop myself - its all very well saying don't push but she didn't tell mw how not to oush.

With DD2 the same thing happened, I needed to push beofre I was fully dialated, but the mw told me how to stop pushing (Panting- suprisingly worked reall well) and as I said not tears at all.

Good luck with it all whatever yopu decide.

Apologies typing is so crap this bloody computer drivesme mad!!!!!

thanks traceybath (don't mean to hyjack xx)

friends have had c-sections and recovered far better than I did. I had no post-natal care with the tear which was a bit of a suprise as my friends with c-section scars had them checked each m/w h/v visit. Just after delivering ds 2 I was told I would be checked at the hospital at 6 weeks, the day later it was 12 weeks and on discharge the m/w said they don't check you at the hospital anymore as they figure you'll come back if you have a problem. (I was soooo embarrased to talk to anyone about it and eventually did at my 6 week check which was at 8 weeks) This time round the consultant was [shocked] that I wasn't seen at the hospital.

I suppose I don't trust the hospital to see me though, safely, another vaginal birth.

Muppetgirl - i must say that when deciding what to do with ds2, ie, vbac or elective c-section my decision was very influenced by the fact that i didn't believe that there would necessarily be the midwifes available to monitor me closely enough if i went down the vbac route and it wasn't working.

For me an elective was the best choice. Of course there are drawbacks but recovering from a bad tear is clearly no picnic and i know i was on my feet quicker than friends who had babies at the same time and had nasty tears.

Muppetgirl, what an awful experience you've had. You do sound as though you might need some emotional support, at least to give you confidence about your approaching birth. Have you had any counselling for your birth experiences? I was terrified of labour but listened to a Natal Hypnotherapy CD, which had a massive impact and made me incredibly confident by the end (along with other things such as preg yoga with active birth training). Maggie Howells, whose CD I used, does one for Caesarean births: here. I highly recommend it, but also I think both you and Gillyan should contact the Birth Trauma Association if you haven't already, as I understand they're very good about supporting women in your situations.

Tweetle Beetle - aha, so that's what panting's for. I was instructed by male OB to push my DS out as he was 'in distress' - not bloody surprising since they'd got me sitting on the hosp bed. Hence delightful 3rd degree tear. Next time I will kick anyone who tries to get me to sit on the bed, and then blame it on the hormones .

Thanks MrsMerryHenry yep, I had severe pnd after ds 1 (when I said I was getting stressed about ds2's birth I was told that a bad birth does not mean a woman will get pnd returning personally I think being terrified, feeling out of control and shell shocked after birth is enough of an emotional event to certainly trigger off pnd but heyho, what do I know?) I was referred first to counselling and then onto psychology/cbt. This I had for over a year. It didn't concentrate on the birth but it was covered iyswim.

It's awful to know that the choices I made could?ve made the situation worse (I do know that ds 2 could have got stuck anyway, CBT's great for making you look at all possibilities!) but being induced the first time really made me lose any trust I had in my body to deliver a baby and ds2's birth made me lose any trust I had with the consultants. (The midwives were fab btw) I remember even shouting at the consultant 'This is exactly what I said would happen!!?, when he was just about to use the forceps. He just said -keep on pushing whilst I get the pack ready (I had been pushing for ages and had HUGE pressure in my lower tummy/bottom where ds was stuck and was just in agony, no break from the contractions as the pressure was constant. I told him no, I wouldn't push anymore and that I needed help! One of the midwives visited me the following day and said that she knew ds 2 was stuck around 10pm and said this during her handover to the next set of midwives. Ds 2 wasn?t delivered till 2am -4hrs later. It was agony. I said that if they knew he was stuck why not help? Why was I in that position when they knew he was large? She said they like to assume all will go okay (as it can be) but mop up anything afterwards. In other words they won?t prevent anything despite having evidence that would lead them to assume a certain situation would be more probable. They would rather take a chance and mop up/stitch up afterwards if it doesn?t. The trouble with this is I am the one left with the emotional fallout which doesn?t seem to be even considered when giving birth.

Anyway, with this prgcy I knew I wanted a c-section. Well, I actually don't want a c-section and would love to do this is I said earlier, at home with dh and a lovely midwife (friends have and I am so jealous) but I know that just isn't going to happen so c-section is the least daunting possibility for me. I have my mental health to consider (the consultants don?t consider this when making decisions so I need too!!) and I also have 2 children at home already who need a working, capable mummy. But most of all I know my lovely boys will leave and go their own way in life and I will have 30? 40? years of living with the consequences of birth. I want to protect my dignity as far as possible as I already have issues resulting from ds 2's birth that are still with me today. (not as bad as they were but still not right iyswim)

...and I was on a bed also so no chance of finding a position where ds 2 could free himself. They just kept asking me to push.