Elective episiotomy after 3rd degree tear

[Hayley16]

Hi

Im currently 30 weeks pregnant with my 2nd child. I gave birth to my first child 11 months ago weighing 9.7lbs and had a bad 3rd degree tear. I was in alot of pain with this for months after the birth and still dont feel i have totally healed and my perinium often feels sore. I have spoke to my midwife who has suggested i have an elective episiotomy but im starting to get very anxious that i will still tear again and make my perinium worse than it already is. Has anyone else been through this?

I had a 3rd degree tear with dd1, she was only 7.7 lbs, but I had ventouse, so tore on top of the episiotomy.

I had dd2 14 months later, and although I had talked through 'managing' the birth, the actual pushing bit happened so quickly, that there was no time for an elective episiotomy, I tore again, but not as badly as first time. I healed very quickly as well, and only had to stay in overnight.

I am due to have dc3 in July, and am already starting to feel anxious about the tearing.

Sorry probably not much help!

I had a 3rd degree tear and episiotomy when ds was born (he is 18 now!) I had 2 dd's, with a small amount of tearing but no episiotomy. DD1 was a domino delivery (20 months after ds,I still don't know how that happened!), and dd2 was a 36 hour stay as we have no midwives to visit postnatally where we live now! I dreaded dd1's birth, in case of a repeat performance, but it was fine. I hope yours go well, ladies!

Ooh, I had exactly the same experience OP! BUT I was advised that an elective epis was contraindicated as it increased the risk of repeat 3rd degree tear, and I am certain I saw that backed up by an evidence base as well when I researched it, only I don't still have the study references to hand still. How weird.

Actually I was advised to have elCS (due to ongoing continence issues associated with 3rd deg teaar). I refused, and fwiw I only had a 1st deg tear with DD2 and grazes with DD3.

Can I make a suggestion? Ask for a referral to a ob/gyn to assess your perineum if it's still causing you pain. Maybe the scar hasn't healed well? You could discuss your concerns about an episiotomy with her at the same time then.

In my unfortunately quite extensive experience midwives are NOT the best people to speak to about this. I had my repair re-done under GA six months after the birth as the mw had done such a poor job (and missed the 3rd deg tear and said it was 2nd )

Also, if you are concerned about having an epis then ask whoever suggests it for the references for evidence base supporting this recommendation. I am very interested to see this has been suggested and if they do produce them would you mind putting them on here so I can read them?