after 4th degree tear and anal repair op, what you you think is the best way for next birth cs or vaginal birth?

[carriedababi]

anyone been there?

had a 4th degree tear with dd, calm fairly easy labour no pain relief, no problems.
ended up getting a 4th degree tear
had to have the anal sphincter repair op.

now thinking about having baby number two and feel caught between a rock and aa hard place.
risk another vaginal birth and the possible damage that can come with that, or risk having a cs.

I too had a 4th degree tear(fast del /shoulder dystocia / hand to face presentation)and NO WAY would I have a vaginal birth again. Thank God no long lasting damage I know of. Perineum specialist already sent letter to GP advising CS if ever I were to get pregnant again. So there would be no questions asked!! I think the risk is too great and after experiencing A colostomy bag (my late father couldn't change his own) I would take the CS without a doubt.

Some good advice here. I saw a consultant to discuss birth options after a third degree tear first time around. The advice was that if I had any kind of 'symptoms' currently, then ELCS would be the way forward; if I had healed up fine and felt back to 'normal' then VB would be fine. I think you're in a different position - if you have had surgery to repair sphincter damage, even if you feel fine, I doubt that it is a good idea to go the VB route. If you have a nice GP, maybe talk to him first, before pregnancy, and see if you can get something sorted out in advance so that you know what you are heading for.
I would also second what the others say about the longterm consequences of tearing badly. The consultant said the same. What appears to be a live-able with diminution in bowel function at the moment, then a further tear and repair, could lead to problems at menopause.