incontinence after third/ fourth degree tears in pregnancy

[Mumofonexo]

Hi all, I had a 3b tear 2 years ago.
just thinking ahead and if it ever happens that’s another matter.
if you got pregnant again after a third or fourth degree tear did you experience fecal incontinence during pregnancy? I’m so lucky to not have this currently and the thought of it puts me off.

Second pregnancy, no incontinence, even after another vaginal birth.
Good luck and try not to worry if you've not had any issues so far thats a really good sign.

Not what you asked but I had a 3A tear and I had a planned C section for my second. Another vaginal birth probably would have been fine but I didn’t want to take the risk. The consultant said there was something like a 6% chance of having another third degree tear but I’d be in real trouble if it happened.

For what it’s worth I had no issues during pregnancy or now

That’s good to know. Do you know what grade tear you had?

I think the doctor has just really scared me.

How did you find your c section?

Yes I was told the same thing about another vaginal birth but I think she said 5% ? Chance I wouldn’t. but I think there was a 3% chance of it happening the first time so why would I go through it again at a higher risk.

C Section was great! Very calm and not chaotic like the first. I felt a lot more in control. Of course I do have the overhang stomach situation but I honestly don’t think my stomach would have looked hugely different had I had a vaginal brith.
If I had a third child (absolutely no plans!!) I would choose a C section every day of the week

Often feels like all medical care around birth is set up to scare!
i also had a third degree tear. I, eventually, had internal ultrasounds to check the healing everywhere which helped with my confidence to birth vaginally again. I’ve never heard it suggested that you will become foe ally in continent during pregnancy due to a tear, especially if you haven’t suffered any such symptoms since.

I had a third degree tear and had a caesarean for my second. I was too worried about it happening again. The caesarean was a walk in the park compared to the first birth!

DC1 3b tear ( stitched in theatre)
DC2 episiotomy and small tear (stitched back under local).
16 years later, no incontinence but jumping is quite a high risk activity.

Can you remember what they said during the scan? I was told the circle is still complete but you can see the scar tissue. I have no gaps in the muscle but the colorectal doctor said c section next time.

Can I ask was your second pregnancy more difficult? And did you have any symptoms come up from your tear?

both of my pregnancies were totally straightforward; I was very worried about becoming doubly incontinent hence the caesarian. My DCs are 21 and 23 now and to be honest all has been fine untul now. I had to do lots of pelvic floor exercises (after the first birth) and I got a Kegel machine and that helped. It’s got a bit worse again now - due to menopause I guess. So am using the kegel8 machine again!

Oh I’m sorry to hear that 🥺 I’ve got that machine too.
have you found using the kegel machine is helping?
I know this is really personal but is it wee or the other end that causes problems?

I had a grade 3a tear with my first. No incontinence problems- had great aftercare including women's physio at UCH.

Had vaginal birth with my second. As others have said, there's only about a 6-8 percent chance of it happening again, so I figured over 90 percent chance of everything being fine. I had a textbook vaginal delivery and it was just amazing - I felt so great afterwards. Like night and day. Really glad I did that. I did go in to see the matron and discussed birth plan etc with her so they were aware. To answer your question, no issues during pregnancy. I think if all has healed well it should be fine.

Honestly that’s amazing!

Im just so traumatised from having forceps that more than likely caused the tear. And the doctor that delivered my son was awful.

I know a c section has risks but the thought of tearing again absolutely terrifies me.

I had a 3a tear with my first. A 2nd degree with my second and third births. With my fourth the worry was taken away thanks to an EMCS.

No fecal incontinence. I count myself very lucky. Wishing more was done to prevent third degree tears.

I totally understand. I was really scared too. I was dreading the birth so much. I felt better once I went in to the hospital and met the matron and talked it all through with her. She discussed how we would deliver, how she would slow it down. By chance she was there when I went in and ended up delivering my daughter.

I think I went for it because my mum likely had a grade 3 with my brother (not diagnosed back then but an awful forceps like yours) followed by a great birth with me, and my aunt had a grade 3 followed by a good birth as well.

The wonderful birth the second time was actually healing for me and I now don't view my grade 3 tear in such a negative light. After my second birth the midwife who came to do the home visit said I likely didn't tear the second time because I was repaired so well by a surgeon the first time. She said people who have a grade 2 sewn up on the ward in poor lighting by a midwife often tear again and that seemed to happen to a lot of my friends.

Not at all saying you should go for the vaginal if you don't want to. Just telling my story as I don't know if there's as many who chose what I did. It's interesting statistically, as if we were told there was a greater than 90 percent chance of tearing again we'd definitely have the section. Yet with a greater than 90 percent chance of not tearing we're still scared to not have the section. I think it's that the outcome of the section is more predictable usually.

I’ve had 2 3/4th degree tears. I didn’t have any issues in pregnancy. I tore straight over the original tear (6 years apart).

However I’ve just had a C-section because there was a higher chance of incontinence if it happened again. for us the risks outweighed the risks of a C-section. But saying that my C-section I’m 15 days post section and by far this has been the easiest recovery in comparison to my 2 births with tears.

the kegel8 machine is amazing- it really makes a big difference (and with no effort on my part!). Mainly bladder but sometimes I have a real urgency the other end- which worries me as you can imagine. I think the machine helps both as I believe it’s the same muscles.

I went through the results with an obstetrician afterwards. All I remember was that she said I’d healed well and if I wanted a vaginal birth I should do it.
If they’ve told you not to I would be nervous about going against it, at least not without a second opinion on your scans.

it sounds like you had such good support from the hospital! What a lovely matron.

i was just told point blank after my endo anal scan never to have a vaginal delivery even though the circle is still complete. But I did have really bad urgency at the start and didn’t make it to the bathroom a handful of times but it was more like liquid poop 🙈 so sorry tmi

but since then I’ve been really poorly several times and been fine?

I know this is so personal but do you know if your mum and aunt have incontinence problems?

That’s really interesting that it’s happened in your family like that. My mum was cut straight down but never got told to what degree and has been fine but her sister had a c section.

also sounds like you had a really good repair.

yeah I completely get what your saying it’s like I’ve got a high chance of it not happening again. For me it’s the mental side too? Like the thought of going into labour again scares me and I have had panic attacks before so I’m not sure if I’d be able to calm myself down. C sections just seem to be done so routinely now I just think surely they should know what they are doing 🤣 so it’s less risky?

Oh wow bless you. I’m sorry to hear you tore badly again.

congratulations on your new baby! I hope you are both doing well ❤️

Thank you, yes it’s definitely worried me. That was a colorectal surgeon who told me not too but then a gynaecologist said I could choose what I wanted.

I guess colorectal see the issues afterwards and have to fix them so maybe that’s why they said don’t do it.

I agree with you! I had prolapse symptoms even though I was told I didn’t have one. consequently purchased the kegel8 and within a few months I had no symptoms of dragging or a heavy feeling.

im sorry to hear that but hopefully it improves for you 🩷

It's tricky isn't it. I see you said the colorectal surgeon said not to have a vaginal delivery but the gynaecologist said you could choose. If the scan was early days after your delivery when you were experiencing some incontinence then I can see why he said that. Sounds like your body has recovered further since. I think though if you are feeling really anxious about the idea of labour and you did have some incontinence early days (I never did) then it could be safest for your own peace of mind especially to just go for a planned caesarean.

My aunt is no blood relation so it's a coincidence but she was a midwife so her perspective on it all did really help me to decide. She and my mum both said back then there was no option you just did it again. My mum never had any incontinence that I know of and pretty sure my aunt didn't either, that they mentioned anyway. I know my mum had to have another operation to repair the scar a few months down the track.

I feel for you, I know it's a traumatic experience. I think if you go for a caesarean you'll feel calmer about the delivery and I'm sure that will be a healing experience for you like I found the second delivery.