Damage to perinium from previous births

[MegaBloxRoxx]

To mums who have had 2 or more deliveries with bad tearing and /or episiotomy, did you find you were able to stretch to give birth with subsequent deliveries? I am a little worried as first delivery I had an episiotomy and second I tore badly in multiple directions (I didn't even know you could rip upwards!). So I have a lot of scar tissue which doesn't cause me any issues day to day, but I noticed it when I had a smear recently.

Am I going to be able to stretch to deliver the baby with all the scar tissue or am I going to tear in multiple locations again?! Would I be better to ask for an episiotomy? I will ask my midwife once I have one, but just curious as to others experience.

Bump

If you're worried about further damage you could request a c-section on the nhs due to previous damage. I've had two and would highly recommend!

I have wondered about that but then worry about how I will look after a newborn and my other 2 as husband work away a lot. Something to think about though.

I torn quite badly delivering my first. Within 3 years I had another two vaginal births and had no other tears with either delivery x

It is worth asking your midwife to assess the previous damage and extent of the scarring. Scar tissue does not stretch like normal perineal skin and you may therefore tear again. There are things you can do, including perineal massage to break down adhesions, but ultimately the extent of my scarring was a primary reason why I requested, and was granted, an ELCS for DC2.

It might also be worth asking to be referred to a physio who specialises in pelvic injuries for an honest assessment of the potential consequences of future damage. I was really lucky that despite extensive damage I wasn’t left with any continence issues after my first birth and I wasn’t prepared to risk it.

I am not keen on a c section but to be honest with the episiotomy scar one way and 5 or 6 different tears in other directions (nearly lost my labia) , i am now wondering if it might be a more sensible option. How painful is the recovery?

It is really hard for me to give you an impartial answer to that because my recovery from my first birth was so awful that I could have recovered from my ELCS multiple times over in the same period. With DC1 my episiotomy wound became badly infected and I had to be readmitted to hospital. The stitches fell out but rather than attempt a repair the open wound was left to heal by itself. I had a series of further infections and granulation tissue which meant that I couldn't walk more than a mile or so without significant pain for the first six months of DC1's life. In comparison I was up and about quickly after the ELCS and driving (with medical approval) at 4 weeks. I should say, however, that my older child was 5 by the time I had DC2 so well past the stage when I would need to pick up or care for a toddler.

I think you need to get an honest medical opinion about your options.

Thanks, yes I know, just helpful to get others opinions and experiences.

With DC1 it hurt badly for a good couple of weeks and I felt like I had been booted in the fanny with a steel toe capped boot for about 2 months (prob the forceps not the episiotomy to be fair). DC2 the repair work with gas and air was excruciating and hurt so badly for weeks. It turned that some internal tissue was still external and I had to have it burnt off

I have been induced with both, so the idea of a c section does appeal in many ways. I am just a wimp who has never had any surgery. Also the 'will never learn' part of me hopes I may yet get the calm water birth I have always wanted!

Based on what you have described I would think that a straightforward ELCS recovery would be easier than DC2 but it does depend on the ages of your older children and how demanding they are to care for.

Do you have any continence issues? That would be my primary concern.

They are 5 and 3, so not too bad, but a certain amount of dragging around, help with dressing, toys to pick up etc but I am planning to work on that a lot over the next 7 or 8 months

No major continence issues as such. I wear a panty liner every day as I usually have a small dribble of wee come out when I stand up after a wee and stress incontinence if I need to go and do a big sneeze (only happens if I have a full bladder and a very big sneeze!). I had fecal incontinence after DC1 for about 8 weeks. That was a delight, but fortunately was temporary.

I would honestly op for a section in your shoes. Recovery from a c section can be easier than Recovery from a bad tear/ episiotomy.

TBH OP you have a lot more damage than I had after DC1 and my ELCS was granted pretty easily.

If you can afford it then in your position I would find a pelvic physiotherapist who specialises in childbirth injuries to see privately for a full assessment of the existing situation, including a vaginal and rectal examination (sorry). They will be able to give you an honest prognosis of the likely outcomes of your various birth options and will also be able to treat your existing stress incontinence. Pelvic aftercare is generally pretty awful in the UK unless you go private but the symptoms that you describe are treatable and you don't have to live with them.

Thanks. It doesnt feel that bad to me day to day (i suppose I am just used imto it now). I definitely don't want it getting worse though. Maybe ELCS is the way to go

I don't know how effective this might be with all your scar tissue, but you could try using an Epi-No or similar in the lead up to your birth. You can use it for both stretching/perineal massage before and pelvic floor exercises after.

Mmm with multiple tears in different places I think there is defo a rational for discussing elective c section for sure, good luck xx