2 previous third degree tears - should I push for c-section?

[icravecheese]

Wonder if anyone can give me some advice....

I'm currently 9 weeks pregnant, expecting my third baby. I have suffered 2 previous 3rd degree tears during my labours - first birth I had an episiotomy, forceps, third degree tear. 2nd labour totally natural, still tore 3rd degree.

There was some discussion at dating scan with my second pregnancy about how I was feeling 'down below' after the first 3rd deg tear. I felt it had healed fine and was happy to go for a 2nd natural birth. 2nd labour was fab, but another 3rd deg tear.

I had booking appt last week & voiced my concerns to midwfe - mainly that even though I feel like I have recovered / healed well from the tears, I sometimes have pelvic floor leakage when I do aerobics or sneeze, and I am slightly worried about the long term effects of the tears - my mum says it can all start to go wrong once you've hit menopause.

Whilst I would LOVE to give birth vaginally again, I dont want to risk my continence and be wearing tena lady when I'm 50!!

I am booked for dating scan in early april and, all going well, will discuss with a consultant afterwards the tears / birth options. Some friends say i'm crazy to risk another vaginal birth & possible tear....some say otherwise.

Anyone else suffered this and gone onto have a perfectly fine 3rd birth? Sorry for long post...I want to be all prepared when I see the consultant...

Hi cheese!

I dont know if this is of any help, but i wanted to answer you.

I had bad tears like yours with my first. She was a long labour and a episiotomy/ventouse (sink plunger) delivery.

My second baby was large, just under 10 lb, and a natural birth, and i tore a little.

3rd baby was much smaller and natural with no significant tearing.

Basicly the news is good - i think it may depend on the speed of labour and the size of baby, but don't rule out a vaginal birth. Plus, i don't think you have to decide yet - hope this was some help

Good luck x

I had a very extensive 2nd deg tear with my first (8lb10oz) a less extensive 2nd degree tear with my second (9lb3oz), and no tear at all with my third (11lb).

I think that the positions in which I laboured were significant, and also how I pushed. Essentially, with no 1 and 2 I was horizontal on a bed and pushed, whereas with no3 I was upright in water and did not push at all.

HTH

I had a c section for my 3rd. Consultant wanted to protect what's left of my pelvic floor now & into old age. Majority of incontinence issues for women in old age are related to childbirth.

oh wow, thats really helpful, thanks ladies. I know its really early to be thinking about it, but I wanted to be ready & armed if & when I see consultant (or, more likely, some poor junior Dr who doesnt quite know why they're seeing me!). Very interesting that even though both your subsequent babies got bigger, you didnt tear / or didnt tear as badly. I tried to push on all fours for both labours as was taught this is best way to let gravity help get baby out, but ended up giving birth flat on my back after midwives said my pushing on all fours was getting me nowhere.

Feeling much more positive about possibility of another vaginal birth now... thank you!

Hi there, sorry to hear you've had two 3rd degrees - you have been really unlucky. I would say if you have some symptoms from your 3rd degrees then you would be better off having a vaginal delivery and if necessary opting for a full on repair later on in life (short or long term). The risk with going for CS is that if your pelvic floor is knackered anyway then why put yourself through a major operation with its associated recovery whilst putting a scar on your uterus. I'm sure that research comparing CS against vaginal birth will says that incontinence issues in later life are related to pregnancy rather than mode of delivery. Your consultant will discuss all of this with you and probably send you for a scan of the rectal/vaginal muscles to help with the decision making. Good luck. A