Fanjo surgery needed but want another baby & would love some friendly advice

[consideringalloptions]

Have name changed for this as its a sensitive subject for me.

I'm wondering if anyone can let me know of their experience of a second pregnancy before having perennial repair surgery.

I had a very bad tear & extended episiotomy and spent over an hour in theatre being stitched back up after the birth of my first DC 16 months ago. I've been offered surgery to 'fix' the scar tissue and am waiting to see another gynae consultant for another opinion (have suspected prolapse which is getting worse) which will be in a few weeks.

My DH and I have decided that we want another baby, and sooner rather than later. We are thinking of ttc April/May onwards so hopefully I'll have had anything done that needs to be done by then, but want to consider all my options, i.e. is it worth waiting until I've had a second baby (which will be by elcs) and then fixing things, in case it gets worse during the pregnancy.

I'm wondering if anyone can tell me honestly what a second pregnancy is actually like when things down below are not good.

Hi,
Have no advice to give you, but wanted to give you a hug. I sustained serious multiple birth injuries when I had DD but opted to have the surgery before thinking about a second baby - physically and psychologically I was just too messed up to consider waiting until completing my family.
I think it's a really good idea that you are getting a second opinion. A sought several opinions before going with the surgeon I did - all said that it would be fine for me to have another pregnancy before getting things fixed and that that pregnancy could either be delivered vaginally or ELCS. But as I didn't go for that option, I can't say anything helpful!
Try posting on the birth injuries thread here:
www.mumsnet.com/Talk/general_health/1688913-Pt-7-Feb13-Any-old-prolapse-Uterus-womb-prolapse-rectocele-cystocele-enterocele-urethrocele-incontinence-pelvic-floor-anterior-and-posterior-repair-TVT-etc
There's lots of lovely and helpful people there who have had a range of experiences.
XX

My advice would probably be go ahead with the preg before repair if you want a vaginal birth. If you want an elcs you could get the repair job in before hand.

I can give you my experience with a rectocele in 2nd pregnancy. I didn't really realise I had a rectocele before I got pregnant with no 2 as I think I'd done enough pelvic floor exercises to keep it fairly under control. However the instant I had the pregnancy hormones back in my body the rectocele became very apparent. I saw the gp at 10 weeks pg who diagnosed it and my midwife referred me to physio. The gp gave me laxatives throughout preg as I also became quite constipated.
Physio advised no lifting, ha! Fun with a toddler! So we moved dd into a bed, and I got her walking a bit more, got her to get out of the buggy before dragging it into the house etc.
Saw a dr at 30 weeks who said no problems for a vag birth but to make sure I got a referral to the gynae clinic for prolapse follow up at 6 weeks pp. Pregnancy was ok with a bit of spd, a few wee leaks with sneezing and terrible piles in the last week but nothing major.
Had my gorgeous ds on his due date at home in water with no tears or stitches. Yey.
Unfortunately my prolapse was worse after the birth than during pregnancy. Duly saw gynae at about 10 weeks pp, having done my PFEs religiously. He scheduled me for a repair op 8 weeks later.
That was in November. The prolapse repair seems reasonable, it's maybe 80% better. Still have to support my perineum if I have to strain, but the drs say it should get better with increased muscle strength. However the wound hasn't healed brilliantly and I just went back today to have scar tissue cauterised as it is still too painful to have sex properly.

They say it will settle down and I hope so.

I guess it depends how you are feeling about operations and c sections. If you are already facing an operation anyway, you could potentially avoid having two by having a vaginal birth, take the risk prolapse gets worse and just have one repair op when your family is done.
Or you could get the operation done soon but after that I wouldn't risk a vaginal birth again as it could undo the repair, so you would face more surgery for delivering the next baby. To be honest, I felt my pelvic floor was under more pressure just from the pregnancy second time round, and am glad I wasn't worrying about the stress on a repair job at the time. But for some people the symptoms are so bad they need to get the repair done NOW and not have to live with it any more, only you can know how you feel.

Im Such an idiot. Just read in your op you will be having a elcs for second baby.
Yes pregnancy can make things worse down there. Having been through it I am glad I waited till after the last pregnancy for the repair op. as I said, i had a bit of stress incontinence, piles etc and prolapse much worse during the second pregnancy. All resolved on their own afterwards, apart from the prolapse but I had a second vb.

Sounds like a tough choice.... But if it helps, my second pregnancy was better than I'd hoped (had episiotomy, several tears and cystocele after birth 1).
A consultant urogynae told me at some point that second pregnancies and births are generally easier on the body, certainly not true for everyone but definitely for me.
My feelings were to avoid too many surgeries/interventions until i was finished having children and I'm still happy with this decision, particularly as pregnancy and Breastfeeding seem to alter your body so much.... I think in my case I'd rather wait until my body is completely back to some semblance of "normal" before any more surgery.
Hope that helps....
Good luck!

Have been thinking about this a bit more in relation to my own situation and in light of what thing wrote.

In my case, the full extent of the birth injuries only became apparent over time and after my operations (I've had 3 lots of surgery now) - to cut a long story short, as one prolapse was fixed, another came to light and needed to be fixed. This can often be the case with prolapse - hopefully your situation is not that complicated, but there is no guarantee that repair surgery won't show up further problems that have so far been hidden. Hopefully for you, it will just be one relatively simple procedure. I'm really not trying to scare you, just to point out that the sum total of the procedures you might need might be more than you currently think, so for that reason it might be better to wait IYSWIM.

I've now had so much work done and have found the whole experience so distressing (both the surgery and the process of discovering the full extent of my injuries) that I really don't think I can risk or face another pregnancy. I can't bear the idea of going through all the surgery again and, as thing says, I would be a complete nervous wreck during the pregnancy and for a good while afterwards as I waited to see if problems would reveal themselves. Even with my surgeon's promise of an early ELCS (i.e. before the head starts to descend).

I don't regret having the repairs when I did - I was in such a mess that I couldn't have delayed. But if I had been in the situation when I could have delayed surgery and I was positive I did want another child, I think I would have waited.

Thank you everyone for your experiences, it is really helpful. And don't worry about scaring me, my poor body (and mind) has been to hell and back so while I'm hopeful it will be straightforward I'd rather be prepared for the worst scenario.