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

Big hugs to you, girly. What an awful experience. I think you are making absolutely the right decision, you've clearly thought about the short, medium and long-term implications and if I were in your position I'd have done the same.

I do recommend some pre-emptive mind and soul work in preparation for the birth, though; something to empower you as it appears that this is one thing which you've effectively been denied at both your births. As you probably know from all your CBT all these experiences can leave their emotional scars but they don't need to go on influencing your future.

I wish you the very, very best birth and that you have unending fun and happiness with your lovely children! xxx

Thanks for the messages traceybath and tweetle I don't have any faith in the MW's either as had horrid one's and they didn't notice I might need an episotomy ( even though before DD's head came out I lost a massive amount of bright red blood which MW has put in my notes as ''query torn back up inside already?'' ) If I knew I could get the MW I now know or indeed any of them off my team I might feel better about it although I still maintain I'm not sure what good it would do as there doesn't seem to be an logical reason why I tore in the first place.

muppet Hope you're okay, I did at least have my 6 wk post natal check back at the hospital and saw the consultant who had done the surgery. She did say I could have an elective next time and that they wouldn't expect me to go through that again! Now to me it's not like she was saying everythings healing fine and you have a good chance of not such a bad tear next time. She saw the damage and she put it right so i think I'll go with her suggestion of an section. I feel exactly the same as you about pelvic floor for the future. i don't really want a section at all but compared to the alternative it's our only choice isn't it! ( well can't afford a private MW etc)

mrsmerry Thanks for the advice - I think I have got over the trauma and nothing can be done to make the bad experience go away - I have talked through all my notes with The supervisor of midwives and was glad to hear that i did receive terrible care from the min I got in the hospital so I think it is just one of those things. I know the maternity unit at my hospital NOW has a 97% rate for one on one continuous care but they didn't back then and no amount of extra staff or funding could of changed the horrible MW's actual attitudes. Also the night I went in they had SO SO many woman in labour which I understand can not be predicted but I've since been told they should of called extra staff in and not tried to manage. I was also pigeon holed as a first timer whose waters had broken 12 hours earlier so they just kept thinking I would be ages and after 2 or 3 failed examinations ( couldn't reach my cervix ) I was actually much further on than they had thought and they literally had just left me on my own the whole time and kept flitting in and out and my screams for pain relief were ignored with comments like 'she musn't have a very high pain threshold' and one MW told my mum to 'shut her up she's just being dramatic, we've got women much further on than this' and then the same stupid bitch who finally came to see how dilated I was walked in saying 'oh having a bloody baby are we' sarcasm dripping from her voice. That soon changed when she sheepishly said 'oh Gillian you are 10cm dilated, the baby's in distress and we need to get you pushing ASAP'

They were screaming at me to get baby out but her head was born very gently and I panted her out so still think if had maybe been cut it could of prevented a worse tear, although I'd already torn before she came out but I don't know. The whole thing just stank, they couldn't get blood off me, couldn't get a canular in my hand, 3 docs had been requested to come and look at me and none came and no pain refief was ever discussed with me. I went in at 4pm and they sent me home at 1.30am saying I could carry on all night with contractions every ten mins and they were very busy, this was even though they had not manged to get blood off me ( which they have to do when your waters have gone, I now know) and my urine was showing protein in it. URGH sorry I am waffling now.

I am over the trauma of it as I know why had such bad care

-short staff
-staff that were there were strecthed and very frazzled

Funnily enough the theatre staff were so nice I would of rather had three of the men from theatre in labour with me.

I think first time round especially you need nice staff that are going to be sympathetic and have time to be with you and when faced with the prospect of giving birth again this side of it didn't worry me as much because I just thought at least I would know what to expect this time and I could do it without them anyway - it was only as I was told about how bad the tear was last week that I've completely turned my back on the idea of a normal birth, what a shame I just don't trust them hey?

Apart from the theatre staff the care was awful in hospital - my MW care ante/post natally was fantastic but it seems it's the luck of the draw who you get when you go in. My MW now has said if I have section she will make sure she works the same day and will never leave my side and she, like me, just wishes she could of been there at last birth or that we could have a magic ball and predict who would look after me if I laboured again.

oh Gillyan...that sounds awful

Sounds horrendous, how dare they talk to you like that. I know they're overworked but the sarcastic comments and attitude that some of them have make me so cross.

Yes labour is difficult and painful but it should also be a tremendous experience for you. I know that problems can arise that the medical staff have no control over but they could at least try and make it a good experience.

I remember when we called the hospital when I went onto labour with DD2, the mw asked to speak to me (I guess so they could gauge whether I needed to go in or not), the mw was very abrupt and told me that I didn't sound like I was in labour - had this been 1st time round I'd have felt very silly and said Oh OK then probably had baby at home, instead cos I knew what I was talking about replied toher her just as sarcastically well that's because I'm not have a contraction right now, give about 10 sec ooooooooohhhhhhharrrrgggghhhhhhhhh! She then conceeded maybe they could have a look at me! 3 hours later DD2 was born!

Hello Gillyan, I'm coming late to this thread (I always seem to find the most relevant threads late!) just thought I'd share my experiences with you (for what they're worth . I had a third degree tear 3 years ago. I had a "normal" delivery, no intervention at all and ds was 9lbs (quite big for a first baby I think but not enormous!) The problem was ds tore me when he came out, something to do with the position of his shoulder. I am pregnant again and am of course, worrying about the birth. I had a LOT of problems after my tear, I suffered with pain for about a year, couldn't walk properly for ages, couldn't have sex, couldn't sit down without discomfort and had a lot of hard scar tissue which pulled all the time. In short, the whole experience was a nightmare, even to this day I feel I missed out on the first few months of my precious baby's life, I was to busy being in pain and in tears all day to enjoy my ds. I had to have some scar tissue removed and when I spoke to the consultant who performed the operation he said if he had the choice, he would rather give a woman a c-section than try and repair a third degree tear, apparently it is extremely complicated (mine took 3 hrs to repair...) and with a c-section they can control the cutting rather than with a tear... I am still not 100% sure about having a c-section as I do hope (and from what I've read on here, it does seem to happen) that next time round I get away with no stitches or a milder tear. Like you though, I do worry about having bottom issues for the rest of my life and part of me thinks I was lucky to get away with not being incontinent first time round, should I risk it a second time. I think though, a controlled c-section must be better than risking a horrendous team with poor after-care (no-one in the hospital wanted to know after my tear, the care was appalling to say the least).

tweetle They can be so crap can't they. My team of midwives are so lovely though and if only you could plan what ckind of care you could get! Lucky for you that it was your second baby - thats so bad!

chocolate Thanks for your message, sorry you had such a bad time too. It is really hard trying to decide what to do isn't it. I'm still not really happy with having a section but I just know that all I will worry about for the rest of my pregnancy and a labour would be tearing again so for me I know I've made the right decision but still I dream about the possibility of getting away with a smaller tear or none! Hopefully second time round for both of us we won't be as bothered about the after care in hospital as at least we know what to expect, I just think it is so crap to get crap care when your scared and in labour for the first time. Let me know what you decided, how pregnant are you?

I'm about 11 weeks Gillyan and have been worrying obsessively about the birth ever since! I've had a scan to determine how badly the muscles in my bum are damaged, but to be honest even if I'm told the damage is minimal (which I doubt) I cannot risk the same thing happening again. I know women who've had c-section for more less and to be honest, I don't see why I should have to be put through the whole nightmare experience again. If I was confident I would receive decent medical care I might be more inclined to go for a vaginal birth but am panicing that I will get the same midwife again (would be just my luck!). I am being pressurised by my gp to go for a vaginal birth (I wonder if this has anything to do cost or their c-section figures...) but I am going to be strong and resist. At least this time round I know my rights! Are you still confident you have made the right decision?

Hi chocolate Congrats on your pregnancy!

Have you thought about asking for an appointment with a senior midwife to go over your notes from your last labour? My MW suggested it to me and I am glad we did it ( was with her for 2nhalf hrs ) Helped me get a lot of things straight in mind although I do feel that she was trying to get me to lean towards a vaginal delivery more. I don't think I am totally 100% convinced about my decision but I don't feel I have any other choice which is a shame. I just don't want to risk a worse tear or even the same again as it was horrible being seperated from DD to go to theatre. The care is a concern aswell as I think I would be totally miffed off if I got bad care again. My MW has been lovely and said that she will make sure she works the day I have the section so that'll be good.

I had a third degree tear with ds. Had follow up ultrasound with a fantastic consultant-a "bottom expert" he was unequivocal in advising an elective section for any subsequent children. I was asymptomatic at the time of examination and he pointed out that this may all change if I had another tear-which was highly possible. The words "double incontinence" as the worst case scenario made up my mind.
I struggled with the fact that I wanted to do things naturally howvere the elective was a total breeze compared with the third degree tear. It was controlled, I was expecting to be out of action for a short time, and the dsicomfort was pretty much the same. The whole experience was just wonderful. I have no regrets at all.
Good luck with your decision -it is a hard one.

Thanks for that chipkid That's really good to hear. I'm just waiting for my appoint to come through the post to see the consultant and we'll see what he says, not that I'm changing my mind mind you.

the other thing gillyan is that now 4 years down the line with dd-it matters not a jot to me how she came into the world.

did you have follow up after the fourth degree tear? Did your consultant not speak to you about subsequent births? speak to your consultant now and ask him what he/she advises.

Hi vronsky Congrats on your pregnancy!

Did you see a concultant at your post natal check? Thats when I was told I could have a section next time if I wanted.

Sounds like you could maybe try to do things differently next time such as position and pushing but if the midwife said you had a short perineum?? I would see a consultant and get his/her advice. I also found it really useful to go over the notes from the last labour.

It's a tough decision isn't it but I think you should get as much info as poss from MW's and consultant.

Lucky you that you had no further problems. I haven't had much wrong since although I have just started hetting very tender where my scar tissue is and it's feeling heavy ( 26wks now )

not read whole thread.

ds was back to back. terrible tear. stitched "inside and out" as the mw put it

he was 9lbs 15 with swollen head due to position.

i was in agony for months. stitches unravelled. were poorly done. mw when i got home commented on how awful a job they made stitching me up . very tight. and awful for going to the loo for blooming months.

dd - 9lbs 13. practically fell out. no swelling so wasn't a problem. just a slight tear. no stitches required.3 pushes and da ra out she pops.

vronskey I know what you mean about section being a big deal, it will be the biggest op I've ever had. You can have baby given to you still for skin to skin and you get time in recovery, I am not looking foreard to evening time when DP has to go and if baby is in the cot and I have to hope a MW will come and pass her to me etc, it's not going to be for long though.

I feel so much better for having decided but I reckon I'll still change my mind yet. I keep thinking I'll go into labour before my section is booked and think sod it and go for it anyway!

At least you have 7 months to go and lots of time to gather info and make a good decision.

When I had my section-I was also really worried-never even had a filling before! so a very big deal. The experience was great though-really relaxed, nice atmosphere in theatre and they don't tell you that they are now slicing you open!-that was my worry too. DD was delivered straight onto my chest-and there she stayed whilst I was being stitched up.
I was on a high dependancy ward for the first night-lots of assistance with the baby.
The recovery was a lot less troublesome than I had feared-and I had a three year old to look after too.

good luck with whatever you decide to do

He guys just thought I'd update you on. Someone had asked that I let you know how I get on with the consultant and share what his opinion is.

I'm off to see the Consultant today YEYYY!!! I've been waiting for this for ages as last time I was supposed to see him it was his locum. Today is the day where i hope to find out for definate what he thinks I should do birth wise. I am still pretty set on a section but can't wait to talk about it properly....I have heard he is a lovely guy and just hope he lives up to this...I'll report back.....

Hi all. Saw the consultant who was lovely and basically said he had no problem with me having a planned section. He said he would recommend a vaginal delivery in a birth pool to try to not tear. He was so nice though and said he undersatnds it is easy for him to say and I'm the one who has to do it. He said he knows what a bad hospital experience I had also. He said just the trauma of having a 3rd degree tear is warrant enough for a section though fear of it happening again alone.

I've decided to book the section in for 2nd July!!!!! And I can always change my mind if I go into labour beforehand. I keep thinking that I might just end up going for it if I do go into labour before. It's nice to not worry about it now for a bit anyway.

Got to go back on 11th June to have everything explained re- the section.

What a nice man - they were so so busy and sent one of his registra's in and I insisted I wanted to speak to him and they were dead nice about it. He was short of time but I didn't feel rushed and I didn't have to fight for a section at all.

I've had faceal incontinence problems since having my baby last Sept. I had a ventouse delivery following 63 hours of contractions and was not given an episiotomy. They repaired a 2nd degree tear when in fact it was far worse than that. Nearly 9 months on I'm now booked in for an extensive operation involving a plastic surgeon and colo-rectal surgeon. I will have to have a colostomy bag for 3 months and they will have to take skin and muscle from my thigh. Not only was the severity of the tear not picked up at delivery (which I can just about understand and forgive), but it was then not picked up following 5 examinations weeks later when I complained about the accidents I was having. I am angry to say the least and in shock at the gross negligence of the medical staff who were responsible.
I am so against the natural birth movement. I did the delivery on gas and air thinking that was the best way to do it. How wrong can you get. It was horrific. All other aspects of medicine have moved on but not childbirth. We're still expected to squat, bite on a stick and get the baby out naturally, RUBBISH.
Anyone else had such a rough time? It would really help me to hear from you.

p.s. I will be suing.....anyone a lawyer?!

Also, you have a choice of how you deliver which should be seen as a good thing. However, I really understand you're concerns about what to do and am at a loss to offer any advice given experiences differ so very widely. The decision has been taken out of my hands as I will have a C-section next time....if there is a next time. Hope all goes well with the birth whatever you decide. I am in complete favour of a section but then I would be!

preezal God that sounds awful, so sorry you have had such a shit time.

I am lucky in the respect that mine was picked up straight away andf I was in theatre within half an hour. I also healed well and haven't had any problems down there.

I have heard about the severity of the tear being missed before. My MW said to me it's 'almost' better to have a 3rd degree as you have to go to theatre and you get repaired 'prperly'

My labour was awful as I was left on my own, not enough staff, barely got a delivery suit, had comments like 'can you shut her up she's upsetting people that can hear her screaming' 'she must have a very low pain threshhold' 'we can't reach your cervix so don't how far you are'

By the time a MW actually came to check me they were like 'oh, you're 10cm and we need you to start pushing' I only had a MW with me once they realsied I was fully dilated.

Awful after care, after I had the op they put me on the ward and I was flat on my back from the spinal and had no feeling from boobs down. They gave me DD to hold and BF and then left me. I was on my own. Buzzer didn't work and I was paralysed. DD fell asleep asleep and I could of dropped/smothered her/fell asleep myself and had to scream untuil a tea lady came to take her off me.

What has happened to you is what I am terrifed of. I am booked in for the section on 2nd July but have since been told that as it took 9 attempts to get the spinal in last time it may be better for me to have a general, NO WAY! I'm not choosing to have a general v's I might tear as badly again.

I just still don't know what to do, I keep deciding I'll go for it and just hope that any tearing is not as bad or certainly not worse than last time. Or give up on all of it and have the section and then deal with the recovery.

It's driving me mad!

Your story is exactly why I want the section.

Consultant has been abit useless really and said yes it's up to me as he has no problem with me having it. Although I don't suppose he can say much else can he.

If only we had a crystal ball.