Advice previous 3rd degree tear , pregnant again

[sophie95x]

Hi , not sure if anyone has been in the same situation before but just want abit of advice , I had my daughter nearly 6 years ago via forceps . With that I had to have an episiotomy and to top it all off I tore Aswell which was 3rd degree 😬

It was very painful and took around 6 months to fully heal , I also had some incontinence issues which lasted around a month after birth .

Fast forward to now and I'm pregnant again I'm due nov , and have seen a consultant who basically said I'm young and wouldnt see why I couldn't give birth natural , as I would heal quick with me been young 🤷🏼‍♀️ he also gave me a 1 in 20 chance of it happening again or worse worse case been fully incontinent which he said isn't a high percentage ( to me that is)

During the app he couldn't find my previous records wasn't sure what and why it happened last time and I had to explain , he seemed to brush off what happened last time as though that's just what happens , and said he has to offer me a c section but really he doesn't see the need to have one . But like I said kept mentioning how young I am and that I shouldn't take long to heal (the 6 months it took last time was very very long for me and I really don't think he understood that )

I'd love a natural birth , but the risks just don't sit well with me the thought of it been worse or even having the same as last time worry's me , I know a c section wouldn't be a walk in the park either but I know it's roughly a 6 week recovery time compared to 6 months 🤷🏼‍♀️ my family and friends have all advised with the c section ,

Could anyone tell me there story's please if they have had to make the same decision as me or what you would do in my situation

Thankyou sorry about the long post 😬

Hi, I’m sorry no advice but am currently in a very similar situation, due my second in November after a 3c tear 5 years ago with my first. I think mine took about 9 months to be pain free and a year to feel how it does now. I also had incontinence following birth so know just how tough the recovery can be.

I have a consultant appointment booked for when I am 34 weeks to discuss delivery and I will be pushing for a c section. I’m actually fairly terrified of the surgery and well aware that it is major surgery with it’s own set of risks but I just cannot face the prospect of a repeat 3rd or 4th degree tear and the real risk of ending up permanently incontinent if it does happen again.

Hoping I won’t have to fight for it... but feeling a bit worried that I will.

Hope you get some more useful advice from experienced ladies here and that your consultant will accept whatever you decide.

@IncyWincySpiderOnRepeat Thankyou for your reply . really sorry to hear you had a similar situation to mine , it's horrible isn't it , I just feel like to them they would rather take the risk of tearing again than have major surgery , which I do understand but they don't realise how much of an impact it has on your life to suffer how bad we have , it really did take it's toll on my mental health as well as physical.

I saw my consultant around 20 weeks and then booked in to see him again at 36 , to hopefully come up with some what of a plan !

You seem to have the same concerns as me so would be nice to hear from others who have been through same , I would want to avoid major surgery but like you said the thought of it possibly being the same or worse than last time I just cant bare with

My DD was a big baby and I ended up with an episiotomy and 3rd degree tear. Both healed well though, and when DS was born three years later, I literally needed two stitches. I was up and about the next day, it was much better than the first time. I was in my 30’s both times so no spring chicken!

So,it didn’t prevent me from having a straightforward vaginal birth the second time around. It might be different for others- I hope more people share their experiences with you.

I had a tear and a haemorrhage with my first after a ventouse birth. Was so worried about it happening again and being anemia and losing so much blood. Other than being a bit shocked with how fast my second delivery was when I was induced, it was a better experience. I had a drink for two hours after birth to prevent the heavy bleeding. But as for a tear, I didn't have one at all. They used a process called STOMP, I think they called it. Basically it was to delivery the head and a warm compress against me to help reduce any tears :)

I had a 3rd degree tear and opted for the ELCS for baby 2. It was very smooth, calm and much easier to recover from than the tear which was very painful and had caused further complications. I think it's very very easy for a consultant to sit there and say it's fine to risk incontinence because it's not likely to happen - as a man he will never ever have to risk it at all. If you would feel happier with a c section then please say! Also I would recommend joining the Facebook group Birth Tear Support (Severe Birth Tears) for some help and advice from a great bunch of women who really know their stuff when it comes to birth choices. You will also read a wide range of experiences on there - lots of them do go on to deliver vaginally again and manage to avoid further damage. Good luck with whatever you decide.

Completely valid to ask for a CS this time, if that’s what you want.
Did he talk to you about the fact that it’s likely the forceps that caused the 3rd degree (something like 4-7x the risk), and you have the option of declining forceps/ventouse this time to reduce/remove that risk? It obviously doesn’t take it back to zero but would be much lower. You also have the option of askingfor a scan at around 36 weeks if that would help your decision - some women in your situation are happy with a planned vaginal birth if they know that the baby isn’t bigger than the last one, and that there will be no forceps/ventouse. There are extra things that can help also - warm compresses and “hands on” the perineum as well.
Not to try and talk you out of CS - also a good option if you prefer it - but just to let you know you do have options. You’re much MUCH less likely to have any need for forceps/assisted delivery of any kind the second time round.
Hopefully you’ll get lots of comments with what different people have done - no right answer really, just what’s right for you. I’m sorry the doctor didn’t handle the discussion better with you.

@AmICrazyorWhat2 Thankyou for your reply :)

That's great , so nice to hear you had a better experience the second time around ,

did they give you the option of a c section ? And did you see a consultant the second time around ?

@Raindancer411 Thankyou , so lovely to hear that u had a better time the second time around , it defo helps hearing everyone's story's

@SelmaB Thankyou so much will defo have a look at that on fb , and that's exactly what I was saying I think he just didn't really care or have any compassion what so ever 🤷🏼‍♀️

@TenThousandSpoons0 Thankyou for your reply , he never actually said any of that which makes a lot of sense and helped actually , I also had a epidural and really do think that didn't help matters as I couldn't feel a thing or when to push , I was going to ask the midwife for a scan to check on growth and how big baby is looking at but wasn't sure if I would sound silly , or just sound like I wanted a scan for the sake of it , but knowing that this baby isn't a giant would help my decision

It's such a hard decision to make , I think every day about it and change my mind by the hour , I wish they could just tell me what to do for the Best haha

I had a similar experience, episiotomy during first birth which never healed well due to infection and lost stitches. I was offered a c section By my consultant but went for natural birth - DD 2 was small, I don’t know if that had something to do with it but it actually improved the scar as stretched and rehealed more smoothly and neatly if that makes sense. No stitches just a small graze.... then along case DD 2, 9lb and I’ve never known pain like the crowning... Never been the same again down there - prolapse the works.

I’m in the US so saw an Ob/Gyn throughout my pregnancy- one “advantage” of expensive health insurance.😂 She suggested induction at 39 weeks so he wouldn’t be so large, rather than a C-section. That’s what we did and he was 2lb smaller than DD ( still a healthy 7lb 12oz). It was DD’s big head that caused the issues, she got stuck!

Another poster suggested a scan at 36 weeks, that might help you decide what to do.

Following your thread with interest. So sorry you had a rough time with your first delivery.

I suffered a 3a tear with my first baby and my consultant has recommended a c-section which is interesting given yours said the opposite. I still have issues though and sometimes have to rush to the loo if I need a poo (sorry if TMI.) I also have hypermobility syndrome which increases the risk of tearing and also a rapid labour. With all those factors I’m struggling to make a decision. I’m 27 weeks and due to see consultant at 36 to make a final decision.

I hope it becomes clearer later on. You have every right to request a c-section. Push for it if that’s what you want.

I had a 3rd degree tear with my first, mine healed fairly quickly so not exactly the same as you. In my next pregnancy I the consultant recommended a natural delivery but didn't say I couldn't have a cs. I went for a natural delivery, I didn't tear at all in my second labour. 3rd labour I had a 1st degree tear.

@Goodebe oooo I bet that was painful 😫 that's what I want to try avoid if possible

@AmICrazyorWhat2 aaaah I see , my first had a large head too 😂😂😂 she got stuck but with me having the epidural not sure if that didn't help matters , I always wondered if I hadn't have had that would it have been the same outcome 🤷🏼‍♀️

I'm hoping my midwife would be open to me having a scan I'm due to see her this fri , which I will be 31 weeks

@Foreverbaffled Thankyou for your reply , such a tough decision isn't it , I bet that is awful for you :/ really sorry to hear that , it's just weighing up the pros and cons to both , in which there are risks with both .
But the thought of being incontinent for the rest of my life is a major con for me 1 thing my midwife seemed to agree on , but the there is chance that it could be straight forward and a nice birth it's just so hard to make a decision. Defo let us know on your decision

@Bluebelltulip glad to Hear your positive outcomes with your 2nd and 3rd pregnancy, was you worried about tearing again on the 2nd ?

Yes I did worry about it but after looking into it myself decided to go for natural. I was more comfortable with the risks of a VB than a CS and wanted to avoid a spinal again if I could.

I had the same with my first but my second baby 2 years later was absolutely fine, no tear or stitches, nothing.
However I was very worried about it. Please push for what you want, these things are so easily dismissed. Having read all of this I'm almost glad I didn't know the risks of having another natural birth but I'm also shocked no one told me.

Couple of extra things that sometimes change what the consultants say - the usual professional guidelines state that CS should definitely be offered and even recommended if there was a 3c or 4th degree year last time, or if there are ongoing symptoms (so the grey area is women who have recovered well with no ongoing symptoms).
Also epidural shouldn’t really affect things hugely OP - so by all means if you plan for vaginal delivery and want to feel more in control then look into hypnobirthing or active birthing methods (recommend Juju Sundin Birth Skills, e book) - but please don’t feel like you can’t have an epidural if you feel you need it!

I had a vaginal delivery with my first son following a very long labour and ended up with a third degree tear ( which I think at least in part was due to an inexperienced midwife). Immediately after the birth I was whisked off to theatre to be stitched up and subsequently had a long and painful recovery.

I became pregnant again 3 years later and was terrified of the same ( or worse) thing happening again. When I met with the doctor whilst pregnant I felt she was trying to convince me to have another vaginal birth ( same as you - that I would be fine etc) and felt that my fears were somewhat dismissed. I then spoke to another friend who had been through something similar and she had taken advice (from a family member who was a consultant) that as she had already torn once, there was a higher risk that she could again, as there was already a weakness / scar tissue there. She decided to have a c section.

I gave it a lot of thought, and ultimately decided I would rather have the controlled, planned, elective c section rather than run the risk of ultimately being incontinent. For me, this removed a lot of the worry from the rest of my pregnancy as it would have constantly played on my mind. My c section went as planned and I found the recovery from the section easier that from the tear.

I know the c section is a significant surgery, but for me the benefits of having peace of mind, a more controlled approach and the fact that elective sections are extremely safe, helped me decide. I also felt that the care and follow up after my tear was poor / non existent and didn't feel it was given due consideration or understanding.
Of course, I will never know if a vaginal birth would have been ok, but I feel I definitely made the right choice for me.

Good luck with whatever you choose. X

I had a similar first birth and although I went on to make a full recovery from my third degree tear, I found the forceps procedure and the idea that I might develop incontinence deeply traumatic. I had to have several appointments and examinations to check everything was okay afterwards.
I couldn't go through it again and was firm in my decision to have a c-section second time round. I found the procedure and recovery a walk in the park compared to my forceps delivery and tear. I was very happy with it and it was a lovely birth experience which really healed by previous trauma.
I know a few mom's in my social circle who have gone on to have a smooth second delivery after a forceps with their first so that is also an option but personally for me I really didn't want any risk of incontinence.
Good luck coming to a decision and I just wanted you to know you are perfectly within your rights to ask for a different consultant.

I had a 3C tear, recovery was lengthy and awful. With second pregnancy they suggested risk of same injury was 4%, I decided that was too risky so opted for a CS. I went into labour before that and they did an EMCS. The only complication was that I had a catheter in for 2 weeks as I couldn't wee. Recovery was months quicker! Surgery was unpleasant in a slightly medieval way, but I'd definitely choose a CS again. For me it wasn't just the risk of immediate incontinence, but it happening at menopause and potentially needing surgery then, and not healing so well because of being older. Growth scans are not very accurate so personally I wouldn't make a decision based on that.

@Bluebelltulip completely understand we're your coming from Thankyou :)

@Lovelymonkeyninetynine lovely to hear you had nice experience the second time Thankyou really helps a lot !!

@TenThousandSpoons0 I was defo wanting to try the hypno birthing if I was to do vb, Thankyou that really helps

@reegee Thankyou for your reply , you defo seem to have thought the exact same to how I'm thinking atm , i has physio last time and quite a lot of apps but it's things like holding for a wee I havnt been able to do since and even exercising or laughing and sneezing I do tend to leak which I can cope with but if it was to be anything worse than it already is I don't know what I'd do , it really helps hearing your story's and what u decided on doing for second births !!

@IrishMamaMia Thankyou so much for your reply , that's exactly what I'm wanting a calm experience which I know it's labour it's not going to be relaxing haha but compared to last time with the rushing around in theatre I found the whole thing really traumatic and would hate for it to happen again .... I was really debating asking to see a different consultant, I might mention it this week

I had an episiotomy and 3rd degree tear with first, over 100 stitches! It never healed well. Wasn't offered Cs with dc2 and was very worried about vaginal birth but it was fine, a small tear and it seemed to fix my down below 🤣 dc3 was big but I didn't tear or anything.

I had a CS with my little girl, who Will be 10 weeks tomorrow. It was an emergency as she was breach. The delivery was quick and calm (once the spinal kicked it) and she was out within 10 minutes. The recovery from the c-section was hard for the first week, especially the first time standing up! But I soon felt like myself again after 2 weeks. C-sections really aren't that scary

I had a third degree tear with my first....took a long time to recover and needed silver nitrate to get it to heal. 22 months later had my second by vaginal delivery and it was fine second degree tear that healed really quickly.

I had a 3a tear first birth, consultant said 10% risk of reoccurring (why all the different % to others!), I wanted another water birth so was released for midwife led care, and did suffer another 3a tear. I healed well from both though, but took longer the second time.

For me it was due to both having a large head, both water birth with no intervention, and also I think I can't control the force of pushing as the pain of contractions/crowning just made me push hell for leather so it was over. I don't think I could have tolerated any controlled pushing.

I think the incontinence would be the deciding factor in your position - I don't think I'd want to risk it. But having said that there's probably a good chance of avoiding it if you could avoid epidural/forceps.

I have the same decision to make. 3rd degree with DS and now expecting again. I hate that HCPs seem to have this agenda to discourage c sections. It must be down to money, surely. I have a consultant appointment booked but I'm not sure I would trust what he/she says as I'd be constantly suspicious that underlying the whole conversation is the intention to put me off a section rather than listening genuinely to my concerns and doing what's best for me. Really hope I'm wrong, but from what I've read from other women in the same position, I'm not so sure.