if you have a 3rd or 4rth degree tear can you tell me if you had a child later through caesaerean or vaginally?

[oranges]

And how you recovered, and what happened? I had a 4th degree tear and healed really well and am dithering now about whether to try again vaginally or go for a caesarean. and did it have any effect on breastfeeding?

Oranges - Will have a read of the positive thread. Am generally a pretty optimistic person - just feel like I have lost all my child birth experience. Sounds odd but I was expecting second time to be a more familiar experience and not a whole new challenge.

Will be following the thread to see what you decide.

Cyee - I do think that some issues are not addressed frequently enough post birth. A lack of continence would be life changing for me in so so many ways, from all the intimacy issues through to the fact that I would have to quit the job I love.

Wish you all the best with your CS.

Hi all
U can't believe I have stumbled across this thread now when i am 36 wks and have been looking for something like this throughout entire second pregnancy!

I had a 3rd degree with DS1 (2 yrs 8 months ago) and have had to make the same decisions as everyone on here regarding what to do this time around. i have decided to give a natural delivery a go.

The previsou 3rd degree was stitched in theatre under spinal anesthetic and although was painful for inital 2 weeks or so, it wasn't so bad after that. But............the stitches did not dissolve and consequently the scar tissue healed over them and all the tissue got bunched up (sorry TMI) and when DS1 was 16 weeks I went private and had a subsequent perineal repair under general anesthetic, which involved having all the stitches dug out, being re-cut and then re-stitched with vicryl (a softer stitch)! It was truely hideous having to go through it all over again but it did solve the problem and I have been very comfortable ever since. I don't think I have any continence issues, to speak of which is why I have decided to go with a natural delivery. Apparently DS1s hand was up by his face making it harder to push him out and I don't remember being told not to push as his head was crowning - which apprently should happen to slow down the delviery of the head. So I am hoping that I am more informed about the pushing stage this time and can try and avoid a fast second stage (DS1's delivery was only 4 hours in total).

I must admit it is such a hard decision, i have agonised over it and still not sure I am doing the right thing, but the decision is made now! PLus I don't fancy the thoughts of all the issues to do with CS when you have a toddler to look after as well and I wonder if it just swops one set of problems for another!

I will post here again afetr the birth to let you know how I get on!

Incidentally - does anyone think perineal massage is worht a go?

I had a 3rd degree tear with my dd, and had ds on Tuesday vaginally, with a very small second degree tear. Smarting somewhat, but nothing in the realms of the 3rd degree one.

Ive been reading this thread with interest as im in a similar posititon.

With DD I had a episotomy and 3rd degee tear after a long 27 hour labour. DD was Back to back and turned with vontouse then pulled out with forceps coming out superman styly with her hand up by her face. Almost an ECS.. All in all a nightmare! (17mths ago)

Im now 22 weeks with number 2.

I think id like to do it vaginally again but the whole continence issue does worry me slightly. Thankfully things seem to be generally OK although not quite what they were.

When/who bought up the decision between CS and normal? Nothing has been said to me having the choice yet. At what stage would this become an issue?
Is it in your notes in your second pregnancy?

Pigley - sounds like you had a tough first labour!

I never mentioned my continence issues after my 6 week check with DS as the Dr was pretty blasé and just advised me it was to be expected. My continence issues seemed minor and I was too embarrassed to mention them again.

Urinary incontinence was a minor problem for the first few months but improved hugely after using aquaflex and pelvic floor exercises. The biggest other symptom I have had has not really bothered me - I just don't really feel the urge to poo anymore and I struggle a bit to hold in wind.

My brother is a Dr - he asked me originally if I had considered a CS. He knew I had a third degree tear and my DS was a good size.

I asked my MW what complications I might incur and she asked me about my bowel function etc. She was overwhelmingly supportive and I spoke to my consultant ( who I have been seeing due to other complications) and he was also very supportive. He advised that he felt it was essential to prevent me from developing faecal incontinence.

I think your MW might be a good start point?

Pigleychez, my mw referred me at booking in at about 9weeks and I saw the consultant at 14weeks but you can be referred at any time. The decisive factor for the consultant in advising a elective she said is a tear connected with incontinence, especially bowel or if their was a surgical repair. But she also said that she now likes to send ppl for scans so that the extent of the damage can be seen and what that reveals can make the decision much more clear cut.

their/there

I would bring it up as early as possible pigleychez. I'm nearly 15 weeks and seeing a consultant next week about this stuff. The earlier you bring it up, the more time you have to discuss with the consultant your worries and ask him/her loads of questions about mode of delivery. If you leave it too late, then you'll end up panicking yourself.

I imagine since I don't have any continence issues from the first birth/delivery that the consultant will steer me away from the idea of an elective CS. But surely it's justifiable to want to consider this option even if you've not been incontinent? Worse case scenario could be left incontinent after second delivery. It's such a difficult decision.

I hope people who are immiment to their second birth will come back on this thread and let us know how you all got on. I'm watching with great interest..

Hello all, I saw my midwife for booking in today, and she said that she would recommend an elective CS for a fourth degree tear, but warned me that a CS should not be taken lightly (not that I would!). She did also say though that elective sections can be quite a positive experience.

I'll be seeing a consultant at some point apparently to talk about it further. Will have to wait and see. I'll be interested to see if they suggest a scan Heated. Pigley congrats on number 2 - I agree with Momdeguerre that bringing it up with your midwife is probably the best starting point if you need more info, hopefully they would refer you to a consultant. May be good timing-wise for you to bring it up now. Good luck.

scienceteacher - sorry, not read your whole post but wanted to respond to the bit I saw about perry massage - from what I hear (from top class midwives), perineal massage is a really good thing, but I think it's useful to learn how to do it properly. I'm not convinced that I did it properly, or regularly enough 1st time around.

In fact, thanks for the reminder - that's another thing to add to my baby prep checklist!

Hi scienceteachermum. Have you had a chance to look at this site, I linked earlier? It's very good on how mws can help manage the birth to avoid tearing and is something you could talk over with your own mw.

Heated - oo no, not seen that site before, thanks for the link I will have a look now!

also this one too