Forceps delivery and 3rd degree tear in first birth experience. Am I safe to have a vaginal delivery second time round?

[mrsm22]

Hi all,

I am 21 weeks pregnant with my second baby and have been thinking about birth. When I had my first baby, the birth was a bit long and traumatic. I was in labour for a long time and ended up with forceps and a 3rd degree tear. I was stitched up and two years later I am fine and have had no problems. My midwife seemed to dismiss this when i mentioned to her about my experience first time and said i was fine to have a vaginal birth next time. The thing is (and without sounding nasty), I have only seen my midwife this time a couple of times and she isn't very friendly or easy to speak to. Obviouslt i will have to speak to her about this, but I wondered if anyone had had a similar birth experience and then gone on to have another natural/vaginal delivery? I don't really fancy a C-section and have heard that second time births are usually easier, so hopefully it would be ok to risk but it would be nice to hear from those with experience. Many thanks in advance

I presume it's ok. I was cut in two places, had a ventouse delivery then was stitched quite a lot! I asked my midwife and at the hospital if I was ok fir natural vaginal birth and she said no problem at all, everything will be well healed and all ok now x

I had a 3rd degree tear and this time I want a section and I'm having a proper battle trying to get one. Consensus seems to be that it would be fine to have another vaginal birth. I still want a section but if you want to have a vaginal birth then I'm sure it will be OK x

hiya. i had 3rd degree tear, episiostomy and forceps last time and do have some perinneal damage not to mention the emotional trauma. fully expected to want c section this time, but actually, my consultant has been wonderful in re-assuring me that worsening of damage is extremely unlikely, and that back to back instrumental delivery is very unlikely for a second labour. we have a tight plan which will involve reverting to a section if things dont look good. im due on 4th feb and being induced on 9th please feel free to pm me and i can share the details afterwards?

I had a third degree tear last time, having a section for dd2 in April, consultant was totally supportive of my decision.

I had a 3rd degree tear with ds 1. I was super worried about having ds2 and spent a LOT of time talking about my fears with the MWs. I had a very very controlled calm labour with ds2, where I was told not to push at all.I still ended up with a 3rd degree tear, and the damage afterwards was much worse than with ds1. DC3 was an elective c section.
You can never tell what will happen.

I had a forceps delivery with 3rd degree cut/tear and stitching.

Went on to have two normal vaginal deliveries.

I had a forceps delivery with 2nd/3rd degree tear (doctors argued over it and couldn't decide) and episiotomy 1st time. Was 'guaranteed' by midwives/consultants that NOBODY has 2 forceps deliveries, and a vaginal birth would be fine for DC2.

Ended up with kiellands forceps, tear (not sure of degree), episiotomy, and 20 months on a prolapse and general urinary incontinence. And absolutely not having any further DC because of this. But if I were, I would be loudly demanding a c-section from my first appointment!!

had 3rd degree tear face 1st back to back with dd1...then retained placenta so further surgery, then 10 days later another operation for yet more retained products
had a section with ds2 - every medical person I talked to agreed with my choice
31 weeks with ds3 - and booked in for section again, although small part of me wonders if to try and do v birth again.....

gad Kveta section it is. 100%

I had a 4th degree tear during labour with DS.

I umm'd and ahhh'd about a natural delivery with second child but eventually went for c-section as I really didn't want to be panicking whilst pushing.

When I had my consultant appointment before birth I was surprised that they offered me a c-section as their preferred birth plan, as I thought that I would have to 'fight' for it.

You can ask for a consultant appt to discuss options.

If you've had a previous third degree tear then you're 4x more likely to have another. Different studies put the risk of a third degree tear for the base population at between 1-3% depending on the study. So worst case it means you have a 12% risk of a third degree tear but it could be as low as 4%.

Also those figures don't take into account the reason for the first third degree tear. So your risk could well be lower if you don't have a forceps this time.

You are less likely to need a forceps with second and subsequent births but it can't be guaranteed.

I would want to know whether it was a 3a, 3b or 3c tear as this would tell you how much of your sphincter was involved. Personally I'd be more likely to got for a vaginal birth if it had been a 3a, less likely if it was a 3b or 3c. But it very much depends on your personal perception of risks and how against (or not) a section you are and how worried (or not) you'd be about having another third degree tear.

Thank you to everyone who has responded.
Ilovekitty - thank you is much. Would you mind me contacting you to find out how you get on second time? Your first birth sounds exactly the same as mine, episiotomy, forceps and 3rd degree tear. I was quite traumatised by it all for a while after so the thought of doing it again is very frightening. Good luck to you, it's not long until your due date so I hope it all goes well x

I had 3rd degree tears first time. A normal birth second time round, in a birthing pool with no tears or grazing! I am 21 weeks now and likely to be having a home birth, in a pool again.

Also, I spoke to a midwife yesterday, who said I suggested I have a scan to check how it has all healed. This was a midwife at a home birth workshop, but she does work with my midwife and consultant so will follow that up when I see the consultant. It might be worth enquiring about a scan to put your mind at rest.

mrsm of course, im happy to share. as viva says there are a range of possible outcomes and its about what you are comfortable with. i actually had no idea the tear was graded a, b or c and dont know what mine was. for me my confort lies in the fact that theres a tight plan and im hopeful for a less traumatic experience.......

Thanks Ilovekitty - I also have no idea what grade mine was, just know it was called 3rd degree.
Yummystepford - your experience really gives me hope. Thanks for sharing.

Mine was a 3a, "the best kind of severe tear" :-/ but still, csection in April 100%!

I had a very similar birth to you first time round and developed tsd and was terrified for my second birth, I asked for a c section and my consultant agreed, it was the best decision I ever made, with my first baby I was in agony for a good two
weeks and very weak despite a blood transfusion, with my second I was walking round a garden centre 4 days after my section.

I had a continues, ventouse episiotomy hemorrage with two blood transfusions 2nd degree tear to boot with ds 1, ds two on the other hand was plain sailing two hours tears again but re stitched with just gas and air, it was 2nd degree again but the option of not going to theatre was preferable for me. As I'd not had anything other than gas and air with him so would have needed an episiotomy.

I'm not too sure how bad a third degree tear is in comparison but I was scared stiff completely and utterly, ESP as with ds2 my waters broke mid contraction all over the floor with no m.w present. But my second birth was so much more positive, I think the key things were

Ds1 epidural at 5 cm, laid down didn't move couldn't feel a thing. Very nervous stressed anxious bleeding everywhere.

Ds2 calm relaxed but nervous still. Basically listened to my body and did what it wanted, stayed up right the whole time, he was born with me squatting (highly un dignified I must say) but no transfusions, stitches yes but I figure that's just my body.

I had a third degree tear after both kiellands and standard forceps during my first birth and had faecal incontinence for the first sixth months after the birth. I got to choose as the consultant said he couldn't say it wouldn't happen again and went for a section.

Much better recovery from a section than the first birth. And dd was breech in the end so I would've ended up with a section anyway!