Worthless ob/gyn appt (poss tmi)

[Gen35]

I had a 3rd degree tear with dc1, and the mw referred me to the ob/gyn as it bleeds a bit at the outside edge with friction. At the ob/gyn appt the dr yesterday didn't even have a look, she said they advocate a c section only if I'm already having incontinence issues, which I'm not and said I wasn't at the booking appt. I thought they'd do some sort of assessment of the location of the old tear to see what the risks would be if it tears in the same place again. But no. Anyone any experience? Bit worried about pushing now as basically got no reassurance. Ps they don't have my old notes as didn't give birth here so they really have no idea where the tear is.

That sounds really frustrating. At my hospital (St Thomas's in London) they did various tests (pretty unpleasant...rectal ultrasound, prensure tests etc) about four or five months after the birth as standard for all women who had a third degree tear. I have never had incontinence at all but the tests showed some reduced sensitivity to pressure so they recommended I have a c-section next time. They said if I did want to try a natural birth again they'd recommend I repeat the tests while pregnant to see where I was in terms of recovery. The obstetrician who specialised in the testing said that even if you don't have a second tear, you are still more likely to have some incontinence as a result of the second birth itself (ie the baby passing through, rather than an actual tear) if you've had a third degree tear in the past.They gave me a brief report stating the test results in case I needed it for future pregnancies (which I will as I'm not in the UK now).
Could you request a copy of your notes for your previous birth and see what was recorded and then see if you can see the obstetrician again to talk them through? On a more positive note, my sister is a midwife and has worked with a number of women who've had very successful natural births after a severe tear, so there is hope!

Thanks, you know I think I will get my old notes even though it'll be a faff as I can't really get to the birth and be scared to push as I don't really know what condition my under carriage is in...should have gotten them before just didn't think I'd have any more!

Contact PALS and demand a 2nd opinion. NICE recommends if the woman has good grounds (including worry after past birth- and you have a MW saying so) she should be able to request a c section.

Another Dr might well agree with you/mW- eespecially if you're a but pushy.