3c degree tear last time...WWYD

[sianyb83]

6 years ago I had my DS, it was a long labour (31hours), he was back to back and I ended up with a cervical lip due to pushing to early and then in theatre for a instrumental delivery. They tried ventouse, which didn't work, so they then used forceps which finally did the trick - but just when I thought we were out of the woods I had a large haemorage (2.1litres). The aftermath was a 3c tear - which I only found out about at my booking in appointment (with current pregnancy - I thought it was a second degree episiotomy).

I'm now 27 weeks, and had a consultant app a few weeks ago. I was surprised she wasn't worried about the haemorrage at all - but was worried that I may tear again, and it could cause bladder or bowel incontinence. Her advice was to consider a c-section, which is pretty much my greatest fear.

I had a few issues with my bowels last time, nothing too major and it seemed to resolve itself within about 6 months.

Half of me is optimistic next time will be easier, or at least quicker - I'll be calmer and less chance of baby being back to back second time (I think!) I know I'll likely tear again - which I don't mind, I just hope it won't be as bad.

I'm afraid of a c-section, but know it would be a more controlled option - what would you do?

I had a 3rd degree tear with my first 10 years ago, I was referred to a consultant to discuss it when pregnant with my now 8 week old and weighing up the risks, I had no bowel/urinary problems from the first and it had been a long time ago so she and I was happy to do it again naturally.
I did the perineum massage not as often as advised during pregnancy but I made a little effort. In the end I had a second degree tear with my second (verging on a 3rd, the surgeon made the decision it was only a second) and luckily again I seem to have healed with no side effects.
I think both my tears happened because I dilated quickly and gave birth in such a short space of time, second child was a 30 min labour 😳.
I also made my decision to give birth naturally again due to not wanting a cesarean. I am 100% complete with my family but if by some complete miracle I had a third I would opt for a cesarean, the risk of bowel/bladder issues is too much of a risk to take and I feel I was very lucky to have recovered in the way I have.
In your position I would opt for a cesarean, I know it comes with its own risks, but it's what I would do.

Thank you Blinkingblimey

minniethemooch that sounds horrendous

I've had two sections emergency first time and planned second so I can't relate to your experience I just wanted to say that there is nothing 'princess' like about opting for the section. You deserve to be safe, care for your body and do the best thing for you.m & baby. You've been through an ordeal first time and that stays with you. I think you owe it to yourself to think about your body and your future. Planned section was great and recovery super quick. Good luck.

I had a 3rd degree tear 6 years ago and was also offered a c-section this time round.

I thought about what to do for the best for my whole pregnancy and in the end opted to go for a natural delivery but with some conditions and a lot of breathing preparation for the pushing stage. I had recovered really well from the tear and the c-section recovery was very much of an unknown for me which was a big factor in my decision.

I knew I was likely to be induced so the main condition was that if I did not progress into labour with a pessary then I would have a section instead of going on the drip as I was concerned that I would not have enough control over the pushing stage on the drip.

In terms of preparation I practised down breathing from the positive birth company hypnobirthing course. This is a technique where you inhale and send your breath ‘down’ and the advice is to practice when you do a poo!! So instead of straining to push you use your breathe to push your baby out. This makes you less likely to tear but is not synonymous with a pain free delivery. I was convinced that my tear was the result of straining to hard to push, so for me this felt like a good way to avoid it happening again.

It also meant that I knew exactly what the midwife meant when she told me to breath and not push when she coached me through my 2nd stage and it really helped me to stay in control during what turned out to be quite a quick delivery.

In the end I did end up with a 2nd degree tear but only because he put his arm up by his shoulder and got a bit stuck. I gave birth just under a month ago and I’ve recovered well so far.

Overall I’m glad it turned out the way it did. It’s a really personal choice though and you’ll probably just need to trust your instinct on what will be the right option for you.

Sounds identical to my first labor lol with my second I had a natural birth no tears, no blood loss. They wouldn't even consider a c section 🤷‍♀️

I'd definitely opt for the csection OP. In fact I have this time around. My body has proven in 2 other pregnancies that it can't handle natural birth. 1st pregnancy resulted in a few bad tears and a haemorrhage that almost killed me. My 2nd I chose to ignore advice for csection and tried natural again only to labour for 36 hours and then need a csection (my 1st ever surgery) due to lack of progression. I was terrified at first but it was honestly the best thing for me and DS. This time I've opted for ELCS as the risk just isn't worth it to me for anything to go wrong again. Good luck hope all goes well for you.

Hello all, I know this is a few years later but what did you opt for? I'd be keen to understand if anyone else has gone for VB following 3c tear. Thanks in advance.

I had a planned csection after my 3B tear.

@Newuser9 i had a VB after my original 3b and ended up with a 3a (he was even faster birth wise so there wasn't time for guided delivery). I had much better aftercare with women's physio and don't feel I've had any additional issues bar what I already had.

Thank you @Littleguggi and @Frizzy1986 it's interesting how variable it is! There's literally no right or wrong answer is there. Reassuring that there's no additional issues @Frizzy1986 I am hoping for another VB in the future but always feel silly saying so following a 3c tear with my first. Tbh I think I'd need to see how I coped in a next pregnancy e.g. how it goes and if any symptoms surface. Thankfully other than the psychological impact of the tear, apart from the first couple of weeks I had a good physical recovery...

It is very variable and not scientific at all, I think it depends on how you feel mentally about it all and any other factors/ complications. Although I had a 3b tear, I had a very traumatic after birth and had to have my placenta manually removed, so 2+ hours in theatre after having had no pain relief for the vaginal birth. I did of course have an epidural when in theatre. I was worried about having a retained placenta again so thought a planned csection was the best option. My recovery from the csection was far easier than the VB, and that was with having to manage a toddler as well!