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?

Shaz Yes, I was trying to think of a way of getting Mount Etna into the name but it was getting too long. LOVE the smoking room, wish there was another series.

Again, thanks for the replies. I really want to make the decision that will be best for all, I will be a rubbish mum to my DCs if I spend the next year miserable about the after effects of a vb and my lovely DH could probably do without the grief too!

I am also planning an elective after a lot of bladder and vaginal damage from rotational forceps done when DD was in distress - emergency in theatre.

I would love a 'normal' vb but am more worried by risks of double incontinence given how weak my pelvic floor is, how the bladder is already dodgy and how long the tears and episiotomy took to heal.

My first weeks and months with DD were shadowed by extreme pain below, intermittant catherterisation, horrific pain when bf that lead to me stopping at 5 weeks (breast tissue thrush that wouldn't heal despite 2 x 10 days of treatments).

I know a c-section is major surgery but I feel it is a better option for me longterm. It is no longer about the birth for me, it is about healing afterwards to a place where I can be a great mum and wife and feel myself again. I would have enormous regret if I tried a vb and worse damage occurred. It is trying enough to live with the damage from DD's birth.

Lovethesea When your DD was found to be in distress was a emergency CS suggested as an alternative to rotational forceps. I can empathise with your bladder problems as I have probs since a myomectomy for fibroids several years ago when suffering a botched catherterisation. I did not have tears of epis to cope with as you have done. I get so upset when others do not consider incontinence to be much of a problem! All I am grateful for is that I am not incontinent of feaces.

I had 4th degree tearing with a ventouse delivery at the beginning of the year. I've had some urinary problems and the obstetrition I spoke to was adament that if I have a 3rd pregnancy I must have a vaginal delivery because c-sections risk damaging the bladder.

He told me that you "can sew" the vagina back up again but problems with the bladder are more difficult to solve. His view came purely from his specialisation in urology.

A friend who suffered 4th degree tears had her perineum and bum checked out and was advised that if she went for a natural birth she would risk faecal incontinence. She had her second child by c-section.

DS no1 was delivered by emergency c-section and although it took several weeks to heal I recovered well. At the moment (touch wood) I am healing reasonably well from the birth of DS no2. I understand the risks in respect of c-sections but I'm afraid that I wouldn't risk another "natural" birth and incontinence.

I asked my new consultant recently why forceps were done and not a c-section - I was rushed to theatre and prepped for an emcs, given a spinal and then rotational forceps were tried once and got her out. I wasn't given any choice on method as DD was in distress and oxygen deprived.

The consultant said that it would have been more risky to do a c-section as I had been 10cm dilated for a few hours and DD had come down past the spines of the pelvis - her head was sideways so she was never going to come further without help. A c-section would mean pulling her up again to get her out. It helps me a lot to think the choice was better for DD as for ages I have been upset I was torn up so badly by the forceps - and read up a lot on how this level of damage from rotational forceps is common.

I have read up quite a lot on vb/c-section to protect the bladder as that is my major dodgy area. What I read (in online medical journals from UK, Canada etc) did show a risk of bladder damage from a c-section (the bladder has to be moved out the way to get the baby out), BUT much much more protection from bowel damage. A c-section also had the same kind of stress incontinence issues for some women, but these healed up quite quickly. It causes a lot LESS urge incontinence (my kind) than forceps and also protects the pelvic floor from the giant birth stretch to get the baby through.

When my bladder is trying to empty without warning my pelvic floor is my only hope of some control until I can get to a loo. My physio said she would go for an elective in my case. As have a number of mw and the consultants involved have not tried to talk me out of the plan either.

I know I might not need forceps second time - but I could do. I could also tear badly and have bowel problems from that. I also think incontinence is no small thing and affects my life daily. I am spending a fortune on Tena pads at the moment - and it affects your confidence and relationship with partner too.

I also had dyspareunia after the forceps - very painful when we tried to have sex 5 months after the birth. Had to go back to gynae as the physio thought I might have an undissolved stitch as she could feel scarring prominently. That resolved (hence next pregnancy!) but it was not totally sorted. I want to have this second child and then get my body back to ok working order so I can get on with life.