Homebirth after 3rd deg tear. Should it (g*d forbid) happen again... a midwife will be able to tell won't they?

[hopingforahomebirth]

... that's it really. Is a 3rd degree tear obvious after childbirth and would a home environment (i.e. no strong examination lights etc) mean it could be more difficult to see?

DD was ventouse delivery, with an episiotomy and a 3rd degree tear. It was picked up within minutes of delivery and I went straight to theatre to have it repaired. I've often wondered if the speed with which it was dealt contributed to the fact that I haven't ever had any pain and healed very quickly (I realise I'm fortunate.)

I've raised this with my midwife (who seems great) and she said she would be able to see if it had happened and that if it did, I would transfer to hospital to have it repaired in theatre.

Does this sound right? Are midwives trained to recognise severe, internal tears that will need surgery?

She's an independent midwife, so will be working alone. She says she's never had a 3rd degree happen during one of her homebirths and this includes a woman who had one previously. She said I'd be more likely to tear on the epis scar.

I hope I don't sound distrustful, I'm not. I suppose having had this happen to me once has made me very, very aware that it can happen...

Thanks v much in advance for any opinions.

Your midwife is exactly right - we are trained to recognise third and fourth degree tears.

Mears, thank you very much for the quick reply. I suppose it's obvious that a midwife would be trained in recognising a 3rd/4th deg tear, but it's reassuring to hear it from another MW.

DDs birth is a bit of a blur really, I didn't ask any questions and was completely passive - I want it to be very different this time!

It is most likely that your third degree tear was associated with your ventouse delivery. The fact that i
t healed with no problems means that it is fine to go for a vaginal birth. A homebirth will be such a different experience for you and your IM will refere you in if there are any problems with a tear. It is likely that everything will be fine. Best of luck.

my midwife missed my 3rd degree tear and it needed redoing under ga 3 months later and has left me sometimes incontinent. This is why l prefer a registrar/consultant to assess my perineum.

I had had 2 previous tears (not 3rd degree) and when having dc3 I was asked if I wanted a homebirth- I certainly did not. I spoke to the consultant about the chances of tearing again and he said it was highly likely. I opted for an episiotomy at the first possible opportunity and it was a million time better- still needed a few stitches but not in the same league.

A third degree is much less likely to happen at home for many reasons and all midwives are trained to assess tears. Midwives (and doctors you won't be amazed to learn!) do miss problems occassionally, but your midwife is aware of your history and will act accordingly I'm sure.

I had a home birth for my third child - the first two pregnancies being in hospital, both induced and both with complications - bad tearing and grazing after first (did not need surgery but was in hospital for four days), and manual removal of placenta under GA after second hospital birth.

Firstly, despite bad tearing during first delivery, I did not tear during my other two labours, despite giving birth again within a year and despite my third child being bigger than my first.

Secondly the homebirth was a completely different experience - completely different. I was in my own space and felt free to move constantly throughout the labour and evenutally delivered in a position that I wanted to assume for my first delivery, but was told by the hospital midwife I wasn't allowed (curled up on my side.)

The community midwives were FANTASTIC, lovely ladies and very capable. I had one with me throughout, and a second arrived during the second stage to look after the baby.

I don't know your midwife. But if you trust her, then I would go so far as to say giving birth at home actually lessens the chances of a tear.

Good luck.

I had a section for twins followed by planned HB. Transferred in as dd was stuckin odd position.

I delivered in hosp with a 3rd degree tear.

Ds3 was HB and 2nd degree tear that needed a trip to hops the next day for a few stitches (was fine)

Ds4 HB in 40 minutes, 2nd degree tear,few stitches at home. All ok

Ds5 hosp induction and 2nd degree tear again.

Dd2 HB and no stitches!

Good luck and stand your ground about it all. Read around on the subjec.