What did you do after a 3rd/4th degree tear?

[ealey]

I'm currently 34 weeks pregnant, and need to decide this week whether to book an elective c-section this week after suffering a 3rd degree tear during my last birth. I'm tending towards the c-section, as I feel that the consequences of a repeat performance would be too difficult to deal with, even if this is relatively unlikely. What I would like to know is what those mums who have been in this situation have done, and how you felt afterwards about your decision? I know these kinds of threads can easily end up as v-birth vs c-section battles, and I hope it doesn't because that really wouldn't be helpful! But I would love to hear about peoples' first hand experiences who have actually been in this situation. Thanking you for any contributions!

I woke up this morning thinking of all the things I should have said in the appointment but didn't, such was my shock at the time! So I plan on being a bit better prepared next time. I know that NICE say that you have a right to a second opinion, and I'm concerned that she spent more time talking about their c-section rate than the evidence base for my problem. Anyway, I was hoping for a favour! I've done a bit of research myself, and know of at least one paper stating that a significant proportion of women suffering 3rd degree tears have sustained damage that would preclude another vaginal birth even if they're asymptomatic (www.bmj.com/cgi/content/full/308/6933/887). I was wondering if anyone else had come across any other references like this in their research, as it would be good to go in armed to my next appointment? I'm determined not to at least go down without a fight!

Good for you! I'll see what I can dig up though I might have deleted a lot of links due to my happiness at making a decision!

Thanks lovethesea, I'd really appreciate it if you still have anything knocking around. I actually feel a lot better about it today. I have been very lucky to be asymptomatic, and if it's genuinely the case that I'd be better served by attempting another birth then I'm happy to consider it - I just want to really push her to make sure that she's making the decision in my best interests and in the light of all available evidence and not just to lower the c-section rate of the trust. Still hope this baby doesn't shift though, I'm constantly slumping on sofas - the exact opposite of everything I did last time!

There's this Canadian medical journal review:

ukpmc.ac.uk/articlerender.cgi?artid=1191750

And another from the same journal

ukpmc.ac.uk/articlerender.cgi?artid=1194277

I had a third degree tear with ds1 who was a very fast labour ( 2 hours start to finish), got his head caught and twisted and ended up with a cut and ventouse. I tore beyond the cut they made.
I have so far been lucky enough not to have had any issues since.. And gave birth vaginally to two further dc's. Although they did a 36 week scan with dd as she was a big baby.. Determining that if she went full term she would be over ten pounds, they booked me in for a csection.
As it happens dd decided to make her own way out 3 days after the scan.. Beating the c section and being 8 lb 3oz. She was also back to back and turned when being delivered, all I ended up with was a graze.

Totally understand your concerns, I was really worried about it.
Do what you are most comfortable with and what is best for baby.

I had a 3rd degreetear with DS1. Nobody ever mentioned the possibility of needing a CS next time around.

As it was I had DS2 at home and ended up with a 2nd degree tear, which was not a problem for me.

Thanks so much for the references, and for the positive birth stories!

I know this was an old post but was wondering how you had got on? I had a 4th degree tear with my first son in 2010, and an elected section last year with my 2nd. The consultant was brilliant, although as I had no symptoms he said I would probably be ok but that at the end of the day ' if that's what the lady wants that's what the lady gets!' and I have to say that the section recovery was far less painful and a lot quicker than the recovery from the 4th degree tear!