Had two 3rd degree tears with DS1&2, have opted for a c-section, but contemplating another vaginal delivery - HELP AND ADVICE NEEDED

[YoureInMySystemBaby]

Ok, so here's a brief overview of my birthing history..

DS1 born in 2003 after a 12 1/2 labour. He got stuck as he presented awkwardly and after 3 hours of trying to push him out he went into fetal distress and they performed an emergency episiotomy and I had a forceps delivery. This is what did the original damage and created the 'fault line' so to speak.

They cut me in the wrong place, but it was an emergency situation and he needed to come out. The forceps then extended the tear to the 3rd degree.

He was 8lb 10ozs born. I had a very successful repair job - no symptoms or side effects.

DS2 born is April 2009 after a 1 hour 10 minute labour, no pain medication, normal presentation and weighing 8lb 5ozs. I originally declined a c-section as I was quoted a 90% chance of NOT tearing to the 3rd degree or worse.. I ran with my majority chance as it was a heck of a lot more favourable than a c-section - MAJOR abdominal surgery.

Due to extremely fast delivery there was no time for me to stretch properly, as well as the obvious scarring from the first dedlivery.

Luckily had another decent repair job - no obvious symptoms or side effects HOWEVER (sorry if TMI) I now find that I can never properly clean or sipe the area after a bowel movement. No matter how much I wipe the area, when I go to the toilet subequent times, I always wipe and there is more crap on the toilet paper - I presume this is a side effect of weakened anal muscles?

Now comes my dilemma. I currently 22+1 with my third and final child, a daughter. Whilst I have verbally opted and agreed to go for a c-section, I just can't accept it.

I suffer from panic attacks and anxiety attacks regarding my breathing. I have heard MANY MANY stories of women being numbed so much, up to their chest, that they cannot feel themselves breathing. This is LITERALLY my worst nightmare come true, this is my ULTIMATE phobia.. I am SO scared at this prospect I feel like I would rather chance and deal with anal incontinence..

Does anyone have any GOOD c-section stories? Is this the case in majority of c-sections? It seems everyone is all to eager to tell me thier own personal horror stpry, but noone is half as willing to share a GOOD experience.

Has anyone went fully under for a c-section? How did you find that?

Has anybody suffered a THIRD 3rd degree tear and what was the outcome?

I am going to mention to my midwife and hopefully consultant, about the possibility of a control induction. I'd hopefully have an epidural, which would slow down my progression and they could give me an episiotomy in the right place and hopefully I'll be given enough time to deliver the head softly and slowly - hopefully incurring a lesser tear, or at least avoiding the anal muscles at the very least. Has anybody had this as an option?

I'm not sure my hospital would agree to this as they have a very very very very strict policy of NOT inducing before the 42nd week if the pregnancy is otherwise healthy (though have no qualms about a c-section at 39 weeks, go figure!)...

My hospital is the RVI in Newcastle-upon-Tyne - anyone have any experience with this hospital and a section?

I am SO scared. The birth is 5 months away but it's all I can think of... I wish I had never gotten pregnant or at least never read the stories other women felt the need to share with me about not being able to feel oneself breathing - my anxiety has gone through the roof, possibly to the detriment of my bowels at the tender age of 25..

I really don't know what to do. My community midwife is very unhelpfula nd says I need to discuss with my consultant. However, when I had my 20 week scan I also was scheduled to meet with the consultant - however, I got the consultant's ASSISTANT who was every bit as unhelpful and impersonal as my midwife (who I can't change, you get who your given - good old NHS) and after getting to my appointment 60 minutes late, just as I threatened to leave as I had other things to do, told me my chances of tearing were 50/50 - no guarantee of a good repair job and section was the best way to go, have a nice day.

And off home I went. I don't meet with 'someone' again until my 36 week appointment - whether I'll meet the organ grinder or have to deal with the monkey again is anyones guess.

Sorry for such a long post :[ It;s driving me mad though..

Many thanks in advance for any information or advice anyone can impart and send my way.

Sounds like you are driving yourself around the bend! 1st of all take a minute to calm down. I have only had 1 c-section (emergency) followed by a natural with 3rd degree tearing. In my experience the natural delivery was far better. However... I have since spoken to a lot of women who have had planned sections who say they are completely different to emergency ones.
I think you need to speak to your consultant asap and find out what they have to say, you still have plenty of time to decide. Lets face it, as much as we would like to plan a natural delivery, anything can happen and if you delivered in 1 hour last time, chances are you will be fast again. Can't believe how pro-section I'm sounding as usually I'm not but in some instances they can be the best option.
My advice would be to make a list of questions for your consultant and go and see them soon. Hope this helps

No, no, you CAN change your mw/dr. ASk again, follow it up in writing, the squeaky wheel does get the oil.

I haven't been in your situation as such as I have only had one 3rd degree tear but with significant continence isuues as a result. I have had two subsequent VB as I also have a phobia of CS. I would strongly recommend you ask for a referral to colorectal surgeon as they, IMHO, are well informed to help you make the decision that is right for you.

Incidentally, I requested a GA, should I go for a CS, and after a discussion with an anaesthetist it was agreed to (get it documented.) There are excellent reasons why they don't like doing it though. Good luck.

I dont want to change my doctors surgery, but the midwives are community midwives and there are 4 - so you never know who you're gooing to get.. as for the consultants at hospital - again, pot luck - if youre even lucky enough to see your allocated consultant and not just her assistand registrar!

I agree with LittleSilver - the best place to start would be with a colorectal specialist who can advise on what the best birthing method might be in terms of avoiding damage to that area. As for your phobia about CS - well I had an elective for various reasons and even though I wanted one I was certainly nervous - but it was absolutely fine and I went on to have another one. And yes, being a Geordie I know people who have had sections at the RVI (not me, I moved away) without any problems whatsoever. On the other hand I never try and persuade people to have particular birth methods so, if the colorectal advice is that a VB would be fine then if you prefer I would go for that. But if the medical advice is for a section please don't worry - you can certainly breathe, even chat...

Best wishes whatever you decide.

I can appreciate your fear, it was mine too. I googled caesarians when I found out I needed one and read about this not being able to feel myself breathing, and panicked big time.

There was no way I could avoid a caesarian without significant risk to my child (I had Gestational diabetes, and had gone undiagnosed until I was 34 weeks, by which time my baby was very large and I had a tiny frame).

So the run up to the day and the day itself was pretty frightening, as you can imagine.

This is my experience of the not being able to breathe sensation....

I had the spinal, laid back down on the table thing, slowly felt numb..the numbness reached my chest. The sensation was a slight heaviness on my chest, like a weight (not very heavy) was on it, it didn't interfere with my breathing, which I was anxiously waiting for. It felt strange, but not particularly frightening. This sensation lasted a few minutes..I expected it to last for ages, it didn't. When baby was born I forgot all about any sensations and focused on my baby. In recovery I felt fine. The whole caesarian itself lasted about 10 mins.

I had a second cs 2 years later, again I was anxious about breathing, had the same experience. I was calm pretty much throughout as I knew what to expect.

I hope this makes you feel a little less anxious about the process, I appreciate it's a huge fear for you. The actual event is often a lot less frightening than the anticipation! It certainly was for me

I had similar traumatic birth with DS and had to have corrective surgery, 5 months later and still have issues. I have opted for a C-section ( I am 31 wks) - like you I am beyond scared, feel panic, sweating at all my appointments, as well as other emotional baggage. I have finally started sorting these feelings out through getting professional therapy through my GP, (and through discussing here). The therapy is really helping me put my fears in perspective, deal with the trust issues I have with healthcare professionals, and generally help me feel more in control of the CS that is planned. Doing visualisation of what would happen if you couldn't feel your breathing, and how the team caring for you would help you, will help. I would really recommend getting some help in dealing with these thoughts so that the delivery date doesn't feel like a dreaded looming disaster (which it has for me) and becomes a date we can look forward to. Good luck! x

Thanks everyone - there's some REALLY great advice here.

I have my 25 week appointment on Feb 9th so I'm going to make sure my midwife (whomever I get) takes my fears seriously - as they're very real and vivid to me..

I'm also going to take advantage of the elective c-section class they run at my hospital at 34 weeks, as there's an anaesthentist who partakes..

I have actually had an epidural AND a spinal and not had these breathing issues people speak of - however, I thought maybe they had to administer much more local anaesthetic with a c-section..

Either way, I'll undergo ANYTHING necessary to get my baby here safely, just another sacrafice you have to make as a mother - and any discomfort will be temporary.. and if I do feel my breathing go weird or funny - hospital is certainly the best place to be!

I guess it's a question of making sure my medical team dealing with me are all aware of my apprehension and fears so they can deal with whatever situation arises.

Thanks :]

Hi There
I have supported a couple of women after previous third degree tears (as a doula).
Have you considered birthing in the pool. THis can be a much slower and gentler delivery, could also help resolve any malpresentation issies (e.g posterior position) and rather than valsalval pushing (holding your breath and pushing hard) breathing your baby out.
Both pisiotomies and epidurals can increase the chance of third degree tears occuring.
There is some info here that could be helpful-
www.radmid.demon.co.uk/thirddeg.htm#cs
Selina x

Thank you for the link I will be watching with interest, for your info I had 1 3rd degree (prob pushed too hard as in labour a long time and bit confused towards end with lack of sleep and pushed when she said pant - semi lying on back, baby 7-12. 2nd birth baby 6-14 (same head circ as first_ 1st degree tear) laboured in pool but told to get out for birth as they couldn't monitor the birth in pool..on birthing stool. 3rd baby 3rd degree laboured on all fours bum in air think this may have been caused because body didn't come out at first, head out had to pull because cord trapped and baby going blue.

Expecting no 4 as have no incontinence issues am so far going for VB but advised its 50/50 my secision to have a csection.

Sorry cannot advise you in your situation but if you search the threads in here under 3rd degree you may find some helpful info as I did for last birth - Im just as scared of making the wrong decision of going for VB and being incontinent