Episiotomy or tear without pain relief ?!! Cause for ELCS ?

[DefNotYummyMummy]

Shit. I have had two failed epidurals with my previous two, and found gas and air to be useless. With my second I had a labial tear and some internal 'grazes' that needed stitching which was undertaken without pain relief (even the local was useless) and it was pure excrutiating hell (much worse than the birth). That baby was 6lb 3oz. (First was EMCS under GA as I could feel them cutting into me) - he was 6lb 11oz.

Now I am 28 weeks and my baby is measuring 3 weeks ahead and is estimated at 3lb already. I have another growth scan at 33 weeks, but it just dawned on me, what if I need an episiotomy or I get some tearing and I have to have it fixed without any pain relief. It terrifies me as I was pretty distressed last time.

I know they can get these scans wrong, but my consultant herself did the scan and she is the best in the hospital as I had IUGR last time (hence a smallish baby).

They don't know why epidurals or spinals don't work on me as I am small and not obese and did not have any back surgery, but I saw yet another consultant anaesthetist and she just said 'I don't know what you want me to tell you...'. So I just have to go through labour without it.

Sorry for the long ramble, but I always thought this one would be small and hoped I got a bit streched last time and was hoping that I wouldn't have any stitches etc (or at least nothing major). Optimistic, I know.

I have always been an advocate (just for myself) for another VBAC, but now I am thinking if the baby still shows exponential growth (off the charts as it is now !), that I want to ask for an elective c-secion. Do you think I have grounds to ask for one ?

Really scared as don't want to have to go through that without pain relief. Can I deliver a 10lb baby unscathed ?

Sorry I don't understand - aren't you worried that you will feel the elective CS?

For what its worth (and I haven't had a huge baby though) I only needed stitches with DC1, was stretched enough for DC2 (although did have deep grazes) and DC3, and because i was so calm with DC3 wasn't really painful - I am a big believer in endorphins to get one through a natural birth - this requires you to be calm though and not scared or terrified.

Try reading marie Mongan's hypnobirthing book - I wasn't actually in hypnosis during the birth of DC2 or DC3 but was able to remain totally calm.

Also worth reading Ina May Gaskin's book Spiritual Midwifery, lots of stories about large babies!

i went through the same as you when i had my ds i had to have the episiotomy with forceps and it still haunts me 2 years on i had to have counselling to get over it. i fell pregnant 1 year ago and was told by my gp i could definately have a c-section if i couldnt go through with a natural birth. i think it is standard practice to offer c-section to anyone who has been through that trauma. good luck and i hope everything goes well whatever you decide

I think I was at a bit of a disadvantage in a way as I recovered so well with my EMCS and was out of hospital in two days and in a week I felt fine, whereas with my VBAC I was in agony down there for two weeks and it took 6 months to have sex and I am still weeing when I sneeze on and off despite regular kegels.

Of course I will feel an ELCS, but at least I'll be under general for it.

I am worried about having to go through them slicing my fanny open and having to get the baby out (using instruments - even worse !) suffering bad tearing and having to go through them sewing me up withough pain relief.

I don't think any amount of hypnobirthing can help me through that. Although I have ordered that book yesterday on Amazon as I was hoping it would help me through the labour at least !

I tore in DDs birth, which was a water birth birth without pain relief, but I had a local (injected) anasthetic for the stitching, plus gas and air. Tearing was no big deal - wasn;t even aware it had happened - but I can't see why you would be expected to undergo a repair with no pain relief - you don't have to have an epidural for stitching to be done painlessly.

nightlark you shouldnt be expected to undergo a repair without pain relief but you do. it happened to me there just wasnt any time the baby was in distress and that is the priority. when the baby is out the injection doesnt take effect till after your nearly stitched ouch!!

Addictedtolatte - that is what I am worried about ! Poor you. I think people underestimate the women who need such aftercare and support after birth. I think I'll wait and see what the next scan reveals, but I just suddenly though OMG - what happens if I need help to deliver this baby - before it hadn't even crossed my mind.

They are real advocates for natural birth in my hospital and so I think I'll have to fight for it if I think I want one, but I think it's a fight I'm willing to take if the next scan reveals a heffer.

That's right ! The local injections didn't work either - they tried 8 times (which wasn't pleasant in itself). I just had to scream through the pain and the lovely midwife held my hand.

I had a 9 pound baby, episotomy, second degree tears and no pain relief. (anaesthist "couldn't be found" apparantly) I had an allergic reaction to gas and air and the lidocaine injections they gave me when stiching me up didn't work. I could be heard screaming at the other end of the ward apparantly

There is no way I would ever have another baby that way. I was traumatised by the whole thing. I think you are perfectly reasonable to be considering an elective cs.

why dont you book an appointment with your midwife and tell her about your concerns you will be surprised how supportive they can be. they will understand your fears completely.

OMG slug ! I am so glad I posted this question as I didn't realise how common it is for women to have suffered so much with this. It's so undignified and seems like the 18th century (How naive have I been ?). They may as well give us a piece of wood to bite down on and a mouthful of whisky.

Addicted - luckily I see my midwife today for my 28 week appt and I think I shall definitely bring it up with her.

good luck with the midwife as long as you make it clear to them how strongly you feel they will not refuse to help. they do try to discourage you but its just to see how determined you are, they give in eventually after all its your body and your choice what happens.

sorry still don't understand, are you saying you would rather have an ELCS under a general that you will feel than have a natural birth?

i guess i find this hard to understand as i just had a natural birth without pain relief (other than a little G&A but wouldn't have minded if i couldn't have had any) and it was fine.... as i said i think it was so fine as i was very calm and focused on it not hurting - used hypnobirthing/natal hypnotherapy. wouldn't say it didn't hurt at all but was very manageable.

mumnwlondon are you for real?

I tore with DD2 and had had no pain relief, the tear didn't hurt (in itself) as it was at the height of a contraction which was already very painful. Local injections were awful esp the one right next to my anus, EEEEEEOOOOOOWWWWW. Dreadful. They did work and I wasn't in pain with the stitching, even though I could feel it all and it was an awful and stomach-churning sensation.

You know you may not even tear at all, so wouldn't need any stitches. Plenty of women don't tear! (Just not me)

Perhaps if you did need stitching you could try and gas and air again?

I really feel for you and hope you have a supportive midwife and/or consultation.

duh

consultant

MumNWLondon - it's not particularly the natural birth on gas and air I am talking about (even though that in itself was a scream-fest with 4 midwifes trying to calm me down as I was hysterical with pain). What a lovely natural experience I had.
It is when they stitch you up, or indeed, need to cut you for an episiotomy and shove some instruments up your vagina to get the baby out.

That is what I am anxious about. Doing that without pain relief.

Of course it is an unknown entity as we never know how the birth will go, but I initally started this thread as I thought my first vaginal birth had a 6lb 3oz baby that tore my labia and had agonising grazes up inside that needed suturing by a surgeon. It was very distressing not to have any pain relief - the gas and air did nothing and they couldn't get the local anasthetic to work and so I was losing a lot of blood and they just had to do it.

This time they are predicting a 10lb baby. I was thinking last time I only just got a 6lb baby out of me - how on earth am I going to get a 10lber out of me without stitches.

Midwife was unhelpful really. She said talk to your consultant.

I was silly and thought I was the only one that suffered ! I thought surely no one else goes through this agony - they wouldn't let it happen.

Def sorry your midwife wasnt helpful when i think back now it was my gp who had influence on my birth plan. i got referred by her to a consultant within the birthing hospital who deals with cases like yours. maybe you could speak to your gp and see what she could do to help you. hope you get it sorted. you should be enjoying your pregnancy not

I had an episiotomy repair with DD1 (8lb+) done under local- worst part of the birth hands down. Excruciating pain. I totally understand what you are talking about.

I had 2 tears that needed repairing with DD2 (10 lb+), they tried (once) to give me the local and stich it up in the delivery room but I couldn't bear it so went to theatre for spinal and repair there. (almost) Best part of the birth that time around.

If spinals don't work on you, perhaps you could ask for a general if you need any repair. I know it seems extreme, but it would be much less traumatic.

Oh, and both times I gave birth without pain relief and have to say I didn't really notice the episiotomy or tearing specifically. It was just the repair that was awful!

I tore very badly with my first baby (9lb 11oz) and had loads of stitching.

On the consultants advice I had my next baby by c-section.

It didn't feel right though and when I became pregnant again I hired a doula to help me with a VBAC. I had my big 9lb 5lb baby with only a first degree tear and on gas and air after a 7 hr labour.

4th baby was 10lb 14oz. Born on gas and air, 4 hour labour and only a graze!

All the midwives predicted every baby (all 4 of them!) to be around the 7 pound mark. All the scans showed them to be average too. What I'm trying to say is size doesn't always matter and sometimes they just don't know how the birth will be.

OP, my repair was awful too; I can still feel the suture being pulled through my skin. Why I didn't ask him to stop I'll never know.

I also had forceps and episiotomy without pain relief. They also started stitching me without using local anaesthetic.

I don't understand mummynwlondon's post either - the OP isn't talking about a straightforward natural birth without pain relief - she's talking about people shoving huge metal instruments up your vagina and cutting you open with scissors while you can feel everything.

It felt to me very much like medieval torture.

I'm having a c-s this time too.

My first baby was born using Forceps with no pain relief after a failed epidural and many hours of labour/pushing. The gas and air was helping but they took it away saying I didn't need it as I'd had an epidural. The fact that I got on my own hands and knees didn't seem to show that the epidural hadn't worked.

I seriously thought I was going to break in half and was screaming (and I never scream). I felt the person cut me and like other people have said the midwife told me to stop screaming and push. I really thought I was going to die.

When my daughter was finally out and I thought everything was over they manually removed the placenta by shoving their hands up repeatedly with no care. I didn't want to hold my daughter for some time.

On the other hand, my second daughter was born at home after a very mild labour (although very quickly dilating at the end) and it was lovely. If I could guarantee a birth like hers then I would have another one :-)

OMG. I still can't believe how common this is ! Maybe I will request repair under general if they let me so thanks for that advice. I have a growth scan (33 weeks) in a week on Thursday and the consultant said she wants to see me too and so I will bring it up with her.

I do want a natural birth. My son starts school in September and The baby is due early august and I live in the middle of nowhere and have a 20 month old too.

I have been so naive. So many women seem to have suffered like this.

Thanks for all the feedback. We truly are the hardier sex. Men have no idea how lucky they are.