Am I better off having a 3rd degree tear or a c/s?

[ChocFudgeCake]

The midwife said so. I had a 3rd degree 2 labours ago, then had a forceps delivery and now worrying because perineum feels sore and all muscles there weakish. I'll have an app. in a couple of weeks with the consultant to speak about it. I do remember that after that tear I thought that I'd rather have a c/s than going throught that again, but of course I don't know how bad a c/s is. I'm very worried

Thanks thanks everyone! I'm really very grateful for all your posts. I feel very overwhelmed because I never talk to people about this, I just worry on my own.
I have booked and app with a consultant in 2 weeks time. I hope it goes well and feel reassured about whatever decision I take. Also because I have suffered from postnatal depression, I wonder if a c/s would help me feel more in control and not isolated as before (I couldn't bring myself to speak about my physical symptoms to people and just try to put a brave face). Maybe I'm just being silly, because it is a major operation... Still, after reading the posts, I'm def. feeling more inclined to have one!
I'm going to read the link, thanks Sawyer.

for me, i had 2 sections and it was fine! cant imagine 3rd degree tearing! sounds dreadful. not to mention risking being incontinent etc.

so question about it: choose CS

My section was great and I was back to my active self very quickly, it was elective for personal choice and I don't think I would have recovered from a vaginal birth as well (even if it had gone well as it was definitely not what I wanted to experience however I know some people really find sections tough either emotionally or physically. On the other hand nearly 6 months on 2 of my friends swear they would never have a natural birth again and both reckon things are still not right 'down there'. Think there are pros and cons whichever way you go though so ultimately you just need to read up on all you can and make an informed choice.

Your choice is not a third degree tear or a cs, you are slightly more likely to have a third degree tear than someone who has never had one, but far far more likely not to have one. Your third degree tear was probably caused by forceps which you probably won't need again.

It is true that for most women having 2 cs won't be a problem, but they always have a consultant there for a third as they anticipate problems, it is not a simple procedure and should not be taken lightly. Some people even have major problems after one cs. Your best bet is to talk to your mw and consultant who can look at your notes and see what the chance of a recurrence is and advise you accordingly.

Hope it works out well for you

People go on about the risk of being incontinent after a third degree tear (which is still a small risk, although obviously a major concern). No one ever mentions the risks of becoming incontinent if they accidently nick your bladder when they are doing a cs. It can cause major worries and trauma, although obviously much less likely to happen with an elective than an emergency.

But quite often we're talking about being faecally incontinent here with a tear - for those of us who have had even a taste of this, urinary incontinence would still be preferable...

BTW, Choc, the control issue was exactly the problem with me as well - I definitely felt with the cs that I had made that decision so I felt better.

You run a risk of becoming incontinent just from being pregnant alone. There was a push awhile back, that was fostered by some urologists, for all women to have elective c-sections in order to save their vagina and pelvic floor. However, it was short lived because the level of risk, and who was at risk, were not equal.

Obviously you can have worst case scenerios with any birth, but it comes down to risks versus benefits. Which has the potential for the greater risks? The risks for mother and baby associated with another third degree tear....which may or may not happen, or the risks for mother and baby associated with a c-section...which would be a given. Which has the most potential benefits to mother and baby? Will you be one of the few that has problems with either choice?....no one can say.

Do the research on both possibilities and the likelihood of poor outcomes, discuss it with your consultant, think about what risks you are and aren't comfortable with, and then decide. Obviously either way could go very well and there could be no problems....and if you do have problems you will be second guessing yourself about how would things have been if I went the other way...so you will have to make the decision you are most comfortable with.

That is one thing in childbirth....you don't get "do-overs"....you can't go back and see if you would have had a different outcome if you did it a different way....no two births are the same.

Maxbear, I tore because baby was big. The forceps delivery was in the subsequent birth and there was only an episiotomy, baby was one kilo less than the previous one. I did panic when in this pregnancy they told me in 2 separate scans that the baby was going to be big again.
I'm grateful that you are all pointing out the risks to both options.
I know of someone whose baby was accidentally cut during the c/s . He needed some stitches and recovered well, but one does remember these things. Argggh.

Pretty unusual though CFC,unfortunately "Birth Trauma" isn't.Alot less spoken about however.

Never had a natural birth, so no tearing, but I have had 1 emergency CS and 2 elective CS. Given the choice I would go for the elective CS every time. So much more relaxed!

Helloooo. Welcome to my world!!! I have been deliberating the same as you for ther last 9 months!!! have a search on my name and you will probably find lots of helpful comments off people.

I am 37 +1 and have finally decided on the c/s.

I had a 3rd degree tear last time 3 nhalf yrs ago. Like you I remember thinking never again and was told at my post natal check up I would be allowed an elective c/s next time.

When I got PG this time though I really couldn't decided what to do as for me it seemed hard to turn my back on it all and opt for the c/s.

My tear is un-explained. I had a 7.5 baby, no weird presentation, no insturments, no fast labour etc...they think it just the way my body is that I tore.

I have taken SO much advice from people and as I had no incontinece problems they do suggest a vaginal delivery but consultant aslo said it was down to me and he was more than happy for me to have a elec c/s. I have had so much conflicting advice form different docs and MWs.

Some said they would recommend I have and elective medio - lateral episiotomy to prevent any tearing goingnear my bum while the consultant totally disagreed with this. He recommended maybe a water birth then MW said she though water can make your tissues more likey to tear!???

I went into early labour at 34wks and so have spent the last few weeks in and out of the ante-natal ward..it was good as got to speak to lots of different docs and MWs. I actually saw the MW who delivered DD and she said she just would never of thought I would of torn.

To cut a long story short i finally had a few MWs tell me straight they thought I was mad to attempt a vaginal delivery in light of my circumstances - ie the no massive baby factor or fast delivery etc. They all said it sounds like I just have 'friable' tissue and am destined to tear. I think they have to be quite inpartial with their advice but they got to know me and then said what they felt.

At my 36 wk check they found baby was bloody breech anyway!!!! She turned again though but I am still having the c/s.

My tear was described as half a cm away from leaving me with a colostomy bag and there doesn't seem like there is anything I could try to do differently this time so I am happy with my decision. I may have to a have general as it took 9 times to site the spinal last time for the repair job, I also know of someone who's babies head was cut but baby was fine.

I eneded up thinking that it would not be the end of the world to have a general but it would be the end of my world to have a colostomy bag.

Hope you come to a decision, best of luck xx

And..I'm having my section on Monday 29th June so I'll let you know how it goes.

Ohh thanks! After reading "colostomy bag" a few times, it is becoming easier to make up my mind! I think I now want only the green light form the consultant, for extra reassurance.
Yesterday I saw a great midwife, she was very understanding and didn't dismissed my worries like the last one. I start to feel that I might be in good hands
All the best for the delivery, Gillyan.

Have an elCS! Seriously, pain is very manageable, and recovery is quite unbelievably quick, especially re all you read on MN referring to "major surgery".

I had one of those mediolateral episiotomies, and it was honestly the worst pain I ever suffered, which lasted for weeks.

I had an elCS last month because consultant said I had 50% chance of needing another episiotomy (big baby and previous epi scar), and I was fine on Day 3. Pain was very manageable throughout.

Try not to worry. It will be a quick and calm birth, and you will wonder what all the fear mongering is about

More reassurance, thanks, CoteDAzur . If you were candidate for an elective c/s. They'll def tell me that I need one. I even started thinking about childcare, as I'll be in hospital for a little longer, right?

I had a third degree tear 3 years ago and still have problems. Am expecting again too and cannot bear the thought of going through that again. Took a good year to get over.

Anyway what I have recently discovered is that the Royal College of Obst. and Gyn has produced recommendations for treating women who have 3rd or 4th degree tears. One of them is 'Offering a caesarean delivery for future pregnancies as a recommendation - an offer not an order'.

I am seeing my consultant Monday to discuss. Since the start of my pregancy I have said that I wanted an elective CS, but everyone has ignored me. I have had to demand this appointment with the consultant.

Good luck and hope you get what you want.

When are you due Mudmaid? Let me know what happens on Monday. I'm seeing a consultant on Monday too!

I had a 10lb baby last time, and 3rd degree tear due to size. no episiotomy. no incontinence (know people with worse problems from lesser tears - but then not realised that coudl afect me post-menopause).
Been offered el-cs this time, not sure what to do. been told not really any more likely to have 3rd degree or worse than if not had it last time.
going to wait and see how big it is looking at scans. mind you last time the scans showed a very big head - off the chart - but dismissed by consultant as error! (head awas 38cm at birth) and midwives at delivery did not seem to take much notice of scans or think he was that big based on feeling him.
anyway - after reading a few posts on here finding it hard to find real downsides for el-cs???

I had a ventouse delivery and episiotomy with my first baby, I could not move without wincing for weeks.

I had 2 elective cs subsequently and had NO pain, and I was up and walking about the next morning.

If I have another baby I would not even consider anything other than a cs.