Pregnancy after third degree tear

[Mumofonexo]

Just after some advice please from those who have experienced a 3rd degree tear and gone on to have other children. I had a 3b tear nearly 6 months ago and I’ve now been told I have sphincter weakness. I’m really worried if I went on to have other children I could end up with bowel incontinence issues while pregnant?

tia x

What benefit would an induction have?

Induction comes with so many risks.

@ohfook
amazing! Are you mostly symptom free?

@BingoMarieHeeler
I’m thinking if we do have more to leave a similar gap to allow myself to heal from this physically and mentally. Are you mostly symptom free now too? I’m hoping with time things will get better and I will find a new “normal”

@sweetdreams23

I don’t mean to put you off induction but I was induced due to repeated loss of movement and it resulted in me having forceps and the tear 🥺

Also has anyone else been told they have sphincter weakness and or to expect bowel problems when you get older?

@Mumofonexo think is because I had such a fast birth (3 hours from start of any pain until delivery).only just made it to hospital last time So they want to be able to monitor me throughout. They also explained that labour could be 50% quicker this time… so not really linked to the tear. But yes aware of risks and weighing that all up before I make a final decision ☺️

@Mumofonexo i also have a 4.5 year gap between babies 2&3 and highly recommend that gap too! So don’t let age gaps worry you, there is no rush at all.
TBH I I’d have symptoms still in that I have a pretty weak pelvic floor - eg wee when I cough/sneeze/jump if I’m not careful! So definitely definitely work hard on your recovery now before having another one I would say!

My tear came after an induction, 40 min labour, episiotomy, forceps with no pain relief 🙃🙃 agree induction seems an odd suggestion after a tear tbh, I wouldn’t want to risk it again!

I had a 3rd degree tear following emergency forceps delivery with DS, opted for a c section with my second, as I wasn't willing to risk further damage. I'm still having some issues now even without having a second vaginal birth, and DS is 15, so I'm very glad I never went for another natural birth or it would likely be much worse. My recovery from the c section was much easier than the first birth, although my first birth was pretty traumatic.

I had a 3rd degree. I was under the care of a bowl doctor afterwards and mentioned that I was told to have a viginal delivery for second. He strongly advised against this and his exact words were ‘ easy for an obstetrician to say - it’s me that has to deal with the aftermath- they have no idea of the longer term complications’ . I have had two subsequent children- both c-section. My youngest is now older and I am peri. Initially as informed I had no issues but in last few years I have had a prolapse. If you have instrumental delivery a prolapse is almost impossible to avoid down the line. I think it’s important to hear both sides. I tried for a natural delivery with my last but for other reasons I had a c section. I know a woman who after viginal delivery was double incontinent and many others with variable degrees of issues. I would add that my sisters all had very easy, uncomplicated deliveries. I just seemed to have difficulties. All my babies had heads over 90th %. Have a look at some info on birth injury websites as these are useful. Now I am older and slightly removed I would not think it was not worth the risk to you and your health/love life and have the section . I am not a fan of c sections either - the recovery is difficult however it is not traumatic. Ultimately it is your choice and I wish you well.

@sweetdreams23 wow that was fast! Mine was 12 hours and I was knackered I don’t know how people labour longer than that. Good luck with whatever mode of delivery you choose ☺️ wishing you and baby a safe delivery x

@BingoMarieHeeler
ideally id like to wait until my little one starts school too as two lots of full time nursery fees would bankrupt us 🙈 that’s definitely good advice, I want my pelvic floor to be really strong to carry another baby. I’ve been really strict with pelvic floor exercises and no longer pee when I sneeze or cough which is amazing but I can only imagine it will get even stronger as time goes on with the exercises.

you are amazing to have had no pain relief 🥲 and they say woman are the weaker sex!

If your doctor has said you have sphincter weakness I would absolutely go for an elective section 100%. Fwiw I had a third degree tear, episiotomy, forceps, shoulder dystocia and I have now healed pretty well but it took at least a year. So you probably still have healing to do. I’m pregnant again (DS is now 26 months) and leaning strongly towards a section. I’ve been told that I’m less likely to have a bad tear again but they can be harder to repair the second time.

Yes I am. I was quite scared at first because (for want of a better expression) I kept shitting myself for about a week after and obviously they couldn't say with 100% certainty that it would stop- although they we're fairly confident. Anyway my hospital were very good at putting me in fanny physio (I think they actually called it women's health physio) I had a lot of sessions and they essentially wouldn't finish them until they were certain things were fine. It's the first and last time I've ever been told to go home and have sex. I really did have excellent care and I'd like to think it's the same across the country.

@GruffalosGirl
Do you mind me asking if your problems have gotten worse as times gone on? That’s what I’m worried about too x

I had an episiotomy as my perineum wasn't stretching enough and then a 3b tear which I believe was caused by my son's head coming out at a funny angle PLUS I had a pre-existing anal fissure which I expect contributed to it.

I was repaired in surgery and have had no lasting issues. The surgeon was so good you'd have no idea it ever happened if you looked down there 😅

Said son will be 3.5 when I give birth to our second in May and I've been cleared for another vaginal birth (providing my low-lying placenta moves out of the way). I've yet to discuss water birth with them as that's what I'd really like so will have to see what they say!

Definitely not having an induction though.

@Flyingkitten
Oh gosh I’m sorry to hear about your prolapse ☹️ again something that definitely isn’t spoken about enough after childbirth.

Exactly that! It’s us mums that have to live with the consequences so we should be informed about all the risks. I wouldn’t risk another vaginal delivery again either I’m so scared about things getting worse and or new problems arising. My heart breaks for women who end up completely incontinent after childbirth, it’s like a punishment for wanting a family it’s awful 😢 x

@Dinosaurus86

I definitely agree with the doctor about having a c section with any other pregnancies,it’s not worth risking bowel incontinence issues if it’s already weak ☹️

Bless you! I didn’t realise how common bad tears are I thought it was really rare.
i hope whatever route you choose it goes smoothly for you x

@ohfook
Ah I completely get how scary it is! I had a few accidents when I was poorly early on but thankfully I’ve had nothing since. You do worry if it’s never going to stop.
lol fanny physio 😂 I’m going to use that expression from now on.

I’m so pleased to hear all is well now though.

😁 certainly was not my choice to have no pain relief but there was no time. Indeed, females are strong as hell!

Just wondering if there are anymore mums who’ve been told they have sphincter weakness? And did it get better x

3C tear with my first forcep delivery... was referred for physio.

Found out I was pregnant again 9 months later. Pregnancy was fine and had a natural delivery another tear but generally all good.

I had problems initially and wasn't consistently continent for the first couple of months, but I had a scan and they said I had healed properly. But I have had a couple of minor tears since. One was a year later following constipation, which was really painful but healed with some cream from the doctor and a few weeks on lactulose, and I have one now 15 years on. It is a minor tear and not really painful but it bleeds fairly regularly, but as it hasn't healed with the cream they have said that I'm going to have to have surgery to repair it. It seems that the muscle from the deep tear hasn't been the problem, but (I'm sorry, this is pretty gross) a really hard poo from bad constipation seems to cause a tear again

@justmyluck1234
Oh gosh I’m sorry to hear you tore again ☹️ was it another 3rd degree and are you ok?

@GruffalosGirl
oh bless you I’m so sorry your having problems 😞 I hope when you have the surgery everything is ok for you.

I’m definitely going to to try and avoid constipation at all costs then

@Mumofonexo - it was a second degree tear this time. But the midwives were honestly amazing. No pain or discomfort after. For me it was the best decision and I would make the same again.

No long term issues at all. My bladder is of course weaker than before I got pregnant at all but no accidents or anything ect.

I had a 3a tear and went on to have another 3a tear 3 years later (both water births, babies with large heads and lack of control over speed of actual delivery).

I had no follow up issues though and found the 1st birth relatively easy (though agonising due to back to back) and good outcome so was happy to repeat the experience - despite needing ambulance transfer for the repair as I was in a midwife led unit at a separate hospital both times.

if there’d been any after affects I’d have made the same decision as you for a c-section though 100% (and if I’d had a third, I’d also have opted for a c section due to risk being now much higher in my mind!)

No bowel issues, quite weak pelvic floor but I don’t think this is the tear, for instance I wouldn’t jump on a trampoline but think this is more likely age!

As you have bowel issues I would wonder if it was in fact an undiagnosed 4th degree tear? I think that affects the sphincter doesn’t it? I think these are quite difficult to diagnose as the midwife was not sure if mine was 2nd degree or 3a but sent me to hospital anyway and it was 3a.