2nd labours after 3rd degree tears, HELP so scared

[sam1983]

Hi just wanted to know other peoples experiences. My 1st labour ended up with an epi and a 3rd degree tear. it took about 5 months for the pain to go and bout 3 months for my boweld to return to normal. I am now 34 weeks with number 2. I have seen my consultant and he said to go for a natural birth which i was happy with at the time, as i was only 12 weeks at that point, labour seemed a long way off!!!the scar has never been looked at since 2 weeks post birth. I am now so scared to give birth incase this happens again. Has anyone else gone throught this?? how do u feel about giving birth again, did u have a section of natural birth and what were the outomes???

Hi, I'm 36 weeks with DC2, I had a bad 3rd degree tear with DD. Until a couple of weeks ago I thought I would deliver naturally, but having discussed with the obstetrician have now decided to go for an elective C section. There is a good chance I would not tear so badly this time round, but if another bad tear did occur there's evidence it would be less likely to heal well & could lead to long-term continence problems. I don't think a C section is an easy option but personally I'm not willing to risk another tear like last time, so for me it's the lesser of 2 evils!

My hospital have been very supportive in saying it's up to me to make a personal decision on this. Under recent NICE guidance you are entitled to ask for a CS if you think it's a better option for you, but they will obviously talk you through the risks & benefits to make sure you make an informed decision. I'm not saying you should necessarily have a CS, just that you can discuss it further if you wish. There is a good chance a natural birth would be fine this time, but I've decided not to risk it myself. Good luck with whatever happens, I completely understand why you're worried!

Hello,

I had exactly the same thing with my first, bad 3rd degree tear which took 45 minutes of stitching in theatre to fix so was worried about second birth, but I ended up having a perfect home birth with only the tiniest tear that needed no stitches.
My advice would be to chat through with your midwife but what mine said and did was to make sure you have midwife support at the pushing stage. Basically they said tears are often caused by an uncontrolled birth, so to prevent this in my case the midwife basically supported my perineum when it was time to push and instead of actually pushing I just breathed through it and she guided my baby out. I admit that not pushing was the most intense feeling ever but it really worked.
Other advice I was given was to give birth lying down to slow things down but I didn't do this as didn't feel comfortable.
I am four weeks away from having baby number three so I will defo be having words with my midwife when I go into labour and make sure she knows that I want plenty of help at the end.
Good luck, there are definitely lots of positive stories about giving birth post tears so don't let it preoccupy you too much, I'm sure you will be fine.

Hi, I'm 23 weeks tomorrow with twins after a third degree tear. I had decided to have a VB until I realised it was twins, now I'm not so sure (always a chance of assisted breech delivery even if both head down which they're not even now and haven't been for weeks which is more chance of tearing). I discussed it with my consultant and she said if people were likely to go on to tear again they wouldn't encourage anyone to try for another natural delivery after a big tear. However she didn't have any stats- if she had been able to day for example 90% of women don't tear again it would have been more reassuring to me. I also saw the women's health physio for pain an d she said of ladies she sees (generally older of course) with incontinence and particularly faecal incontinence almost every one had a 3rd or 4th degree tear in childbirth. she said it was far worse if there had been further trauma to the area from a subsequent birth. She did point out she has no stats either and of course doesn't see those with one tear, no other damage and no continence problems. However, she said for me I need to write a list of pros and cons of each, bear in mind the third degree tear I had and-tmi, sorry- vulval varices I've developed this pg already (the joys of a twin pg!!) Plus of course twins. So actually, I'm already leaning towards ELCS regardless of whether twin 2 turns out of breech.

Not sure if that helps.

Oops, x post

Now klinda, that's a great, positive post.

And if I wasn't having twins, I would try for natural birth, particularly as I've always wanted at least 3 children. Dh wanted 2, so we'd kind of agreed 3, and to me, not wanting more than one CS for the adhesions risk was important.

Re reading my post it sounded a bit negative. My friend had a third degree tear then elcs, and much preferred her vb for recovery reasons and the actual birth was much better naturally she said, despite the tear.

Thanks everyone for the replys. They have all helped a great deal.
I really do want a natural birth as I feel the whole planned c section might take away the magic from giving birth. There seems to be a lot of postivie stories out there on 2nd time births following 3rd degree tears, But I am still unsure as in the back of my mind I keep thinking what if i suffer incontience problems and thats what is holding me back from going for the vaginal birth. Think I need a good long chat with my midwife and consultant!

With ds1 I had a 3rd degree tear and did lots of research before ds2 was born after a chat with a fab consultant he packed me off to my local mw led unit and told me I'd have a much better prognosis there and suggested I tried for a water birth - I could have hugged him on the spot! The MW at the birth centre agreed that a water birth would be the best course of action but in the end ds2 was him normal impatient self and arrived 40 mins after we arrived at the hospital and before the pool was full. In the end I had a minor tear which the mw hummed and haaed about stitching and decided to put 2 in in the end as she could tidy up some of the mess from when ds1 was born. I just wish I'd been brave enough to have the home birth I really wanted but then I didn't know he was going to be that easy!

Hi following my first baby, I had 2x 3rd degree tears and an episiotomy and as DD got stuck crowning too, I ended up with a displaced cocyx (which resulted in pain when sitting on any hard surface/chair for the best part of a year). This was combined with fecal incontinence for about 4 months post delivery, so all in all a pretty hard recovery for me. After much research and some posting on Mumsnet, and with the support of my midwife, requested a planned CS. I didn't take the decision lightly, but wasn't willing to risk futher continence issues, and figured that the recovery from a planned section was unlikely to be as bad as from my first delivery.

I found the C section itself an incredibly positive experience. I planned and discussed with the midwives in theatre, how to get skin to skin whilst being stitched, managed to get DS feeding in recovery, had great support from the whole team in theatre who said as I was brought in 'we understand you had a pretty rough time last time, lets make this more positive for you'.
I won't lie, the recovery was hard - I wasn't one of the 'off the painkillers in 2 days and driving in 2 weeks' cases. I was hobbling about and at one point got overtaken on a pedestrian crossing by an elderly lady complete with walking stick , but I felt like I bonded with DS, much quicker than with DD, as I wasn't in shock/trauma, as I had been following my first delivery.

onehitwonder can ask how your scar is now folloing your section? did you recover giver quicker 2nd time round and was it an easier recovery?
Bert2e your story has put a smile on my face, its just a shame we cant predict how labour will go!

While we're talking about scars.....I forgot to say that after ds1 my perineum was really scarred and quite lumpy, after ds2 all the bumpy scar tissue got kind of stretched out and it's no longer lumpy.

Hi, my C-section scar is maybe 6 inches long, and just looks like a line slightly pinker than the skin around it, not puckered. I had staples, not stiches and everyone (midwives etc) that saw it even immediately post section commented on what a great job the (female) surgeon had done. I am now 2.5 years post the section and the scar is now fading to white. I don't have an 'overhang' but can see that if I put on much weight I would have.
The pain during recovery was more intense (but not unbearable) with the section, but personally this was preferable to the incontinence issue first time around. The hardest bit was the 2 nights post section in the hospital, trying to pick DS up to feed him (I ended up co-sleeping with the tacit agreement of the midwives who helped me do so safely). Also, had to really nag to get pain relief on time (crucial to manage the pain) and my cathetar got blocked, so I had to have it taken out early.
Biggest thing for me was that mentally the recovery from the C-section was so much better. I was pretty traumatised from my first delivery, not soley due to the birth, but also being left to labour on my own on the ward following the start of induction (DH sent home as visting hours finished and then no-one would believe I was in labour . So having DH with me all the way during the section was great!

So glad this has been posted! I suffered a 4th degree tear 20 months ago with DD1. I was repaired under a GA by gyne and colo-rectal and have been very lucky when it came to healing physically (not so mentally but fine now).

Am now 24 weeks with DC2- had consultant appointment yesterday where I was booked for elective c-section. I still worry if this is the right decision so hoping this thread will help!!

OP I think what ever you decide will be right for you, I know it's scary and really hope all goes well.

I had 3a tear first time and am planning home water birth this time round. Never considered CS - think the info I found said that I'm no more likely to tear than anyone else, and if I do tear there's a 17-25% chance of a 3rd degree tear occurring, which means a 75-83% chance of any tear NOT being 3rd degree.

Thank for your post flisspaps makes me feeld more confident , I really to want a natural birth this time. but as time gets closer am doubting if its the right thing. thinks its a case of mind over matter.

Just lost a long post

Have u considered hypno birthing? It's not too late to start and could allay some o your fears. I had a horrible time first time and this is what I'm planning for dc2.

This is exactly why my birth plan said I would rather have an episiotomy than a natural tear.

I would never consider CS in this kind of situation as it is a major operation and can cause other complications. Also recovery time is pretty long.

www.netdoctor.co.uk/health_advice/facts/caesarian.htm

I'm probably the minority but after a 3rd degree tear with DD1, on DD2 I didn't even have a graze. DD1 9lb 8oz and DD2 8lb 11oz with a bigger head circumference.

Sandra I had an episiotomy that extended into a 3rd degree tear. I think you're more likely to tear badly from a cut IIRC - if you test with a sheet if paper you see the result.

Pull a sheet of a4 paper by holding each short side and tugging. Then make a 1 in cut along one long edge, and pull the sides apart again - considerably more likely to tear!