Damaged fango from birth, pregnant again...

[BurnyHill]

My first bith, 12 months ago, was fine except that baby came out very quickly and as things hadn't really had a chance to stretch I had quite a lot of tearing. My stitches and scar tissue were still sore months afterwards but doctor assured me everything was fine but said it looked like 'a bomb went off on your perineum'.

Now 27wks pg with #2 and I have a vaginal prolapse. My midwide said I will have to have an elective episiotomy and that my birth plan should include a note for MW to protect the perineum as much as possible to reduce further damage.
She said that after baby I would see a gyno and a physio and may need re-constructive surgery

When she said this, my immediate thought was I'd rather have a c-section and try to avoid further damage, but I didn't ask if that was possible. Could I ask for one?

Of course you can ask!

Make an appointment with dr at hospital to discuss options and what is likely to lead to best long term outcome. This is not a matter for midwifes - need to discuss risks (of further VB vs CS) with consultant.

I would also be asking about possible incontinence problems if you have a VB. There is a tendency to "play down" such problems but as someone who suffers I can tell you that they do affect everyday life. Please let us know you get on. Good Luck!

I asked for and have been given a C section after traumatic birth 1st time round - so definitely ask! I thought there was no way but the consultant agreed it was a reasonable request after my experience.

you should be asking to see a gynae and a physio now

I agree. You should be offered a section IMO. I had a traumatic birth and repairs for damage, so glad I had a C/S.

Even with a CS the pregnancy could affect your continence so start doing your pelvic floors early as poss!

Good luck

Thanks guys, I am back with the mw in 2 weeks and think I need to stress to her how worried I am about the situation getting worse.
I do see a consultant at the hospital (on unrelated things) but don't see her til I'm 34 weeks so I'm guessing that is too late to leave it.

I'm not sure about how to get an appointment with the gyno, would I need my mw to refer me? Maybe I need to go via my GP to get te referral?

Feel very worried about it and think that after a very quick peek at my bits my mw may not have a realised how bad I think it is (TMI alert... its not too bad unless I have to strain at all and I wasn't straining when she looked at me so don't think she has seen it at its worst IYSWIM)

Don't leave it until 34 weeks. Go to GP for referal or perhaps in the meantime try calling the ante-natal clinic at the hospital your consultant is at and try and ask for appointment with dr. Or maybe call your consultant's secretary and try to get sooner appointment? At my hospital as well as midwife ante-natal clinics they run dr ante natal clinics - its run by registrar obstetricians but for something serious the consultant is on hand.

I think in your circumstances I would push for a c-section. You ought to be able to get one in the circumstances and I would ask to see a consultant or one of his/her registrar team at the hospital asap. When I was pregnant the ante-natal clinic has appointment times available with the consultant or a registrar on his team - you had to ask at the reception desk.

I think that you should definitely follow it up asap. I had a fourth degree tear after DD and am pregnant again - while I had a brilliant repair and no ongoing problems I've just had an elective c-section agreed and booked.

Yes a c-section is major abdominal surgery and has its own risk of complications, but it sounds like you're suffering enough without any extra problems that a VB may bring about.

You need to be supported - and given all the information on every available option - to choose the birth that is best for you in the situation that you're in. Good luck!

good advice i think they should have at least offered u to talk over options with a consultant.

cakeywakey- could i ask was it a hard decission to make about the c-sec or were u up for it?? i am going to see a consultant at some point, as i had 3 rd drgee epsi and rotational forceps, i am scared that i will do more damage giving birth natural (took ages to recover and still have few probs now) but scared of c-sec not an easy option!!
sorry to gatecrash thread burnyhill!!

sweet jesus, ask for one! poor fanjo

I've not had a fango birth (loving the word!) and the CS did hurt like hell the first 3 days. It was fun ( think aaaaaaaaargh!) getting in and out of the bath for a few weeks but I've had no long term issues and it healed beautifully. So don't be scared of a section. It sounds like you've earned one!

Hi Sophie I was told in the recovery ward after my last birth that it would be advisable to seriously consider a c-section for future births. I was also told this at my six-week check and at the follow-up to check that I had no ongoing problems from the tear.

I think that because of this, I've had time to get my head around it, do some reading on it and weigh up the pros and cons of a VB versus a CS. Neither is ideal, but the CS has won out for both me and DH. It wasn't an easy decision to make though - and I'm quite sad about it in a way. I'm looking at it as a means to an end.

I really would not be looking for a midwife to advise me on any point relating to this. I would be getting my GP to refer me to a gynae ASAP.

I had a 3rd deg tear after DD1 (diagnosed as 2nd; cheers midwife!) That would be the same mw who sutured it so badly that it needed re-cutting and re-doing under GA six months later. I also have ongoing continence issues. IMHO (and that of my colorectal surgeon), midwives have very little knowledge about the long-term effects of bad tears.

I had no problem being offered a CS (I declined, but that's another story)

Cakey - good luck with your C/S. It's a very civilised and lovely experience IME, don't be sad

thank u cakeywakey for ur advice,ur right neither is ideal but healthy mummy and baby the most important thing, good luck to u xxx

Thank you for the good lucks CityGirl - nice to hear from someone who's had a CS and is positive about it - and you Sophie - hope you're able to make the right decision for you and that all goes well.

Burnyhill hope you're able to get some more info and support too and good luck with your birth too.

No worries. More than positive,it was the best day of my life

Thanks guys, I've got an appt to see my GP this week so I'm hoping I'll get a referral and get some real advice and information. Thanks again.

If you're going to need an op to fix your fango anyway,you may as well have a vaginal birth and have any tear or episiotomy sutured by the registrar/consultant on call. A section isn't going to make your existing problems any better. Granted a vaginal birth might make those problems worse but you're going to get fixed anyway, either at the time or later. Save yourself an extra op.

I agree- you should definitely insist on seeing a consultant and discuss the benefits/downsides of a C section. We're really all lucky we have midwives and doctors to consult- and the option of a C- section. Please see

www.justgiving.com/walkingbarefoot

I am walking barefoot to raise money for restorative surgery for 14 and 15 year old girls in Ethiopia who suffer CONSTANT, PERMANENT incontinence (urine and faeces) after obstructed labours, usually resulting in stillbirth.

PLEASE sponsor me if you can. Thank you

Liz I see what you mean, but as I understand it there are different degrees of operation that depend on how bad the damage is.

I think at the moment I just need quite a minor (!) operation that will strengthen things and then with some physio I should be able to function fairly normally. I'm worried that if I have another vb then the prolapse will become a full prolapse (really afraid of being doubly incontinent) and having to live with it until can have a more serious operation with a smaller chance of longterm success.

Off topic - BurnyHill I love your name. Is it from The Smoking Room?

Great to find this thread. I'm now 36w and contemplating CS after first birth of 3 days first stage then forceps and a vaginal prolapse four years ago.

I've been under consultant care, but obs, gynae and midwife all keen for me to try VB and deal with the damage afterwards. Thing is, the more I think about it the more I would rather avoid the 12 months of misery I had after first baby. I couldn't run or do any sport, I peed myself in the Co-Op ....

It's easy to want to 'achieve' a perfect VB, but perhaps it's better to just get to parenthood in one piece? It took two years of physio to get back to OK-ish, so I want to stick up for what's left of my pelvic floor! Surely a VB will make things worse again? Today I booked an appt with the physio and obs again - will let you know what facts I discover.

But 34w isn't too late to choose a CS - when I asked today they said I could leave it to 38w. Hang in there - sometimes there isn't a perfect option. Do what's right for you.

I'm in a similar position. 31 weeks pregnant, and a previous 3rd degree tear after a 5 days labour and forceps delivery just over 2 years ago. I was lucky and recovered reasonably well physically, but I was utterly traumatised by the whole process and it took me around 5 months before I was able to start bonding with my son. My consultant has left it up to me with very little advice either way, but after a lot of research and much agonising I've decided to go for the c-section. At the very least I will book it in, as I think that it's much easier to reverse that decision at the last minute than to suddenly decide that I want one after all. I know that the odds are against having such a bad birth again, but for me the stakes are too high to take the risk. As well as the physical risks, I don't want to risk the mental trauma of those first months where I was unable to bond with my child after having such an awful time. It's very easy for obs/midwives etc. to encourage another attempted VB, but it's not them that will have to live with the consequences. Good luck with whatever you decide, it's very hard!