Sorry another VBAC vs ELCS thread but have a rather embarrassing question to ask...

[itsalwaysthequietones]

OK, I know there are masses of other threads on this but I have a possibly rather silly related question that I've never dared ask anyone in RL.

Had EMCS 20 months ago. Wasn't expecting it. Horrid experience resulting in me and DD stuck in hospital for a week post birth.

Am now pregnant again, admittedly v early days, only 12 weeks but am already starting to worry about the VBAC vs ELCS choice. IN some ways quite up for a VBAC but... everything 'down there' is really tight to the extent that if DH and I haven't had sex for a week it really hurts. Seems to be even more the case than before I had DD. I can't possibly imagine how I'm going to get a baby's head out without tearing really badly and am terrified of possible permanent pelvic floor damage etc which a friend had after forceps delivery.

Am I being completely daft? Does it just stretch? Last time I was equipped with massage oil for perineal massage but to be honest was never convinced it would make any difference!

What are your thoughts/experiences?

(Have to bath DD now so if I don't answer for a while I'm just away from computer)

Hello quietones, so glad you asked the question first!! Im not pregnant yet, but have been pondering on this since i had my emcs a year ago. I too am very tight down there, (cant believe im going to admit to this)but, the midwifes hand even got stuck when checking me the last time i was in labour, and she had to have another midwife to save her
When i asked the midwife through contractions how i was supposed to get a head out of there, she said that my strong pelivic floors would be great at getting the baby out and i would be less likely to suffer tears. It didnt matter in the end because of the section, but i will be interested in seeing your other replies!!

Hi mrswill - thanks for answering. That's really interesting - yes the internals were a nightmare last time, although no-one actually got their hand stuck!! Poor you.

Interesting re the strong pelvic floor thing. I'd heard the opposite from a friend who is a physio, she said physios as a rule are so conscious of looking after their pelvic floors that they can be more likely to tear, which seems quite logical to me...

Any experts out there who can help us out??

I was quite mortified at birthing a posterior baby with his elbow up by his head without a tear as I thought it must make me a little slack.
However a mw told me that the stronger the muscles are the less chance of tearing as you can control the pushing stage better of course this is not 100%.

So I made sure to do lots of pelvic exercises after ds and it seemed just as tight as before childbirth and dd was pushed out in 2 mins Yet again not a stitch.

Hope this helps the only bit of advice I give is don't be afraid to push. I pushed as hard as I could then gently slowed down holding as long as I could It worked for me twice. However can't offer advice Re csec as I have been very lucky. I hope whatever you decide it goes well for you.

it is not that great that you are too tight down below.. have you asked your doc/ gynae about it?

could it be a nervous/anxiety issue?

your vagina is stretchy.. remember it is also called the birth canal. it is designed for this

the vagina has a chance to stretch and accomodate the baby as the baby descends and your perineum should also have time to stretch. some MWs use hot towels/water against the perineum as the crowning starts to help everything stretch.

i had a VBAC with no tears ( small labial graze ) intact perineum and can trampoline with confidence

hypnobirthing might be good to help you relax and not keep things too tight

slushy - thanks v much for your thoughts. V helpful. And well done you!

Also for the record I have trouble with internals too they can hurt me alot but no ones hand ever got stuck. But sorry if tmi but I have to orgasm before I can have sex as it wont fit otherwise (that's my excuse anyway).

Hi Lulu - haven't asked doc as yet, might now pluck up the courage. I don't think it's a nervous thing but it's possible I guess.

thanks anyway for v helpful response - I guess what I was asking is, are some people more stretchy than others but it sounds from what you are saying as if they're not, which is good news

slushy - yes, I'm exactly the same re orgasms!!

Well i say hand, slight exaggeration!, it was her fingers, they had to get the gas and air and another midwife to 'help' set her free I also have same thing with sex and most of my previous partners and dp have been a little 'premature' sorry tmi again. DP says because it is very tight. I did mention it to my consultant, but i dont really think he took me seriously, so next time im going to speak up. Maybe mention it when your having a chat with the consultant about section/VBAC, and see what he/she thinks. Il be very interested in the answer!! I cant believe other people have the same problem, ive never spoken to anyone in RL about it.

mrswill - ashamed to say I had quite a chuckle about you trapping the MW's hand. But don't wish to make light of the situation and appreciate that it was prob v stressful at the time, sorry .

But yes, isn't it so interesting to hear that other people have the same issues. I suppose I've just never thought to bring it up with friends etc but who knows what I'd turn up! And BTW, exactly the same re the premature thing - sex is never a lengthy business...

I'll definitely work up the courage to ask the consultant though that's some time away.

I wonder if there are any more midwifes on here to shed more light on it before you see the consultant, although hypnobirthing sounds a good suggestion by lulamama, as tensing up probably does add to the pain.

Dont worry about being amused, we and the whole midwife team thought it was hilarious!one midwife was joking they should have thrown a bucket of water over me as they do with dogs!! i then got gas and air with two midwifes present during each check

Vaginal examinations being difficult, or even having sex, does not impact on whether a baby can pass through or not. Nature is an amazing thing and the muscles and tissues of the vagina are made to stretch and allow a baby's head to pass through. The hormones and lubricants released in labour allow this to happen.
As a midwife I commonly come across women who find vaginal examination very difficult. I overcome this by explaining what I am planning to do and why and gaining consent. I use a lot of lubricant and proceed slowly. If a woman feels very anxious and uptight about it then I offer gas and air.
Some women suffer from vaginismus, which is an involuntary spasm of the vagina during sex/examination.
Hypnobirthing is a good thing to explore.
It is worth discussing your concern with the midwife so that a note is made in your records to ensure that medival/midwifery staff are aware that you have an issue.
It is by no means uncommon.
It can feel very tight down there when there is little lubrication. It is worth getting a vaginal swab taken to rule out any infection and also do not be afraid to use lubricant such as KY jelly when having sex. HTH.

vaginismus

There are varying degrees of it.

mears - thank you, that's v helpful indeed