Vaginal birth after 3rd degree tear?

[NewMummyJelly]

Hi
i’m trying to decide whether to have a vaginal birth after having a 3rd degree tear with my first.
I can’t make a decision.
reasons for a vaginal birth (if all goes okay this is)…. More natural, get the first cuddles, recovery is quicker, may be a quicker labour the second time round, may help with breastfeeding

reasons for a c section… no vaginal tears, planned surgery so less painful, less fear of the unknown.

what do you think? Thank you all

I wish I’d had a CS. 2nd delivery ended up with an episiotomy and forceps, and has left me with long term problems with continence.

2 years 9 months between mine. I had 3rd degree tears with the first. The second was a very quick vaginal birth. I needed an episiotomy, but so further tearing.

A friend had 3rd degree tearing first time. 2 years later have birth very very fast (had an unplanned home birth) with no tearing.

However, this is all anecdotal. Do what you're comfortable with, and speak to your midwife about your concerns. Mine was great, and I bombarded her with a LOT of questions!

Following as I am in the same position bad a third degree tear with my first. Has anyone has a anal rectal ultrasound to check their muscles down there? Then due to speak to consultant

I am in the same situation as you an opting for a caesarean. My consultant says the risk of the baby needing oxygen is 1 in 100 at 39 weeks. It is 1 in 50 at 38 weeks and 1in 10 at 37 weeks. If babies need to be born earlier than 39 weeks they will offer steroids to help mature the babies lungs ( I know someone who was given this for an induction so not just caesareans).

I would obviously be very upset if my baby did end up needing oxygen but it is quite a low chance. DS needed some help with breathing after a natural birth where we did not have the care we needed and he was born covered in meconium and that has been a big influence on my decision.

I think it is a difficult decision to make as you are not choosing between a caesarean or one of those births where you breathe the baby out in a birthing pool and are home by tea time. There is an element of risk with all options.

I had a third degree tear with my first, 14 months after had my second son vaginally and 3 years 4 months had my daughter vaginally.

My C section recovery was miles easier than my 3rd degree tear recovery.

I'd vote c section every time. Planned sections are so nice and calm.

I had a third degree with my first. Not a scratch with my second 2 years later.

My second birth was beautiful. I wonderfully calm and quick water birth. Baby had her first feed 45 mins after birth and I was home 3 hours later. Would have been sooner but I needed to do a bigger wee.

I wasn't offered a section, but wouldn't have had one even if I was.

Oh and no one ever said I couldn't have the birth centre, or a water birth.

I wouldn't even consider a vaginal birth, when an elective c section is far more controlled, safe and predictable. I had very little pain or issue with mine. Recovery a doddle.

Sadly the NHS is so underfunded that maternity services are pushing women regardless into natural births, which regularly (more often than it doesnt) end in tears or an emergency c section where recovery is 10 times worse than elective.

@Treacletoots I wouldn't consider a c section when a vaginal birth is on offer. I had totally controlled pain with mine and no additional pain after. With both I had a great experience and no last effects. No scars that I can see. No need for an over night stay in hospital or catheter.

Every one is an individual and c sections aren't right for everyone. I'm very pleased to live in a country where women have a choice and aren't forced to have major abdominal surgery because doctors, hospitals or insurance companies want to get the most money out of you.

@haloangel I had one of these 4 months after my first delivery, it was absolutely fine, I'm not sure if they'll want to do another one to check everything is still fine I'm still waiting to hear from the consultant.

@NewMummyJelly I had my ds three weeks ago and I had this dilemma my whole pregnancy. The hospital was incredibly supportive and I was given scans to see if things had healed well after my 3rd degree tear. Thankfully they had! Have you been offered this? Definitely push for it. The lovely consultant put a medical birth plan in place to limit the chances of it happening again. I still felt very wobbly about having a vaginal birth regardless as being whisked off to theatre etc was a horrible experience. I actually was booked in for a csection but cancelled the morning of as I felt I was making the wrong decision. I didn't want to put myself through major surgery if not necessary. Plus i knew id be looking after my toddler/newborn solo when my dh went back to work. I went into labour the week after my section was booked in and I'm pleased to say all was fine. I had an episiotomy to stop any further tears. My labour was half the time of my first - I only pushed for 25 mins compared to 2.5 hours the first time! 3 weeks pp now and all fine☺️Only you can make the choice! Generally though, second deliveries are easier🤞

Hi - you should have a chat with your midwife. How did you heal after your first baby? If you healed up well and have no issues 'downstairs', then I'd go for a vaginal birth.
I had the same experience with my first DD. Third degree tear, as her hand was up by her head when she was born vaginally. Midwife pushed her hand down away from her face, before she was born, but she moved her hand back up to her head (the little rascal!).
I don't remember a lot of what was going on once she was born! I was rushed straight to theatre to be stitched up. I didn't want an epidural for the birth, but was given one for the surgery. Daddy had first cuddles with DD. Spend next four days in hospital in a noisy, busy, hot ward. Had morphine post-surgery and catheter. Tried in vain to get DD1 to latch on. Had plenty of milk to express. Managed to express some colostrum with an understanding midwife. Had to formula feed in the end. All healed up nicely 'downstairs'. I had no problems at all.
When I had second DD, I was set against having a c-section, unless it was an emergency. I didn't want to be left with recovering with a newborn DD2, 3-yr old DD1 and not being able to drive for 6 weeks! Never even gave it a thought to NOT have DD2 vaginally, as I'd healed up so well and had no complications.
When I had DD2, contractions started at home. DH drove us to hospital and we just made it in time. I was being booked in with a midwife, but DD2 couldn't wait and decided to make her appearance into the world! Labour was approx 2-3 hours (from first contractions to birth) with just gas and air for pain relief at the hospital (did nothing for me, made me want to vom). She was born vaginally and came out very quickly. I had no tears or complications vaginally afterwards. I remember poor DH was near to passing out (poor little lamb 🙄😂) as the birth was so quick compared to DD1. Plus, the drama of the sac still being intact and bursting open when she was born with all the fluid gushing out and a light sprinkling of meconium! I didn't see any of this! It was what DH told me afterwards.
DD2 latched on straight away and we had no issues with breastfeeding. No two births or babies are the same.
Good luck and hope things go well for you xx

Hello, I’m not sure when you were due or if you’ve already had baby, I’m interested to know the outcome!

I had 3rd degree tear with first daughter 2019. I was on all fours but she had her hand on her face so presumed that is why I tore so bad. Also apparently I have a short perineum…

My second daughter was born 2021, 17 months later. I had no complications from first tear and was advised it’s extremely rare to tear badly a second time. Birthed on all fours (again helps reduce tearing) midwives tried to apply compression but baby was already crowning when we arrived at the hospital so not much time to do that, 3a tear again, didn’t even get to feed baby before being taken to theatre for repair, very sad being whisked away from baby again, was quite disappointed as everyone had said how uncommon it is to tear that bad a second time. Didn’t help me feel sorry for myself.

Im pregnant with my third baby now, still no complications from tears, but now weighing up my options more seriously this time. I’d rather not have c-section but if I had a seriously bad tear again and end up with major incontinance issues chances are I will regret not having a c-section every day for the rest of my life. I know you can still get issues with c-section, but it’s weighing up the risk and what suits you…

For you, and for me, there is no right or wrong choice, just go with what gives you the most peace. I am interested to know if anyone has had TWO third degree years before and now having a third baby?? It’s so uncommon I think most people don’t tear the second time or had already opted for CS. I can’t find any research on it anywhere online! And no one seems to have experienced it…

Hi there
congratulations on having number 3 on the way.

so after a lot of consideration, and even with the c section date in the diary, I went for the vaginal birth with the epidural. The epidural was fantastic and brought total pain relief.

I had a second degree tear this time, the midwives knew about the third degree last time and did their best to guide this delivery, hold the head and get me to pant instead of push at tthe right moments. they stitched me up in ten minutes while I held baby straight after the birth, it was magical to have those cuddles. As for the tear it’s healed well and I feel my pelvic floor is slowly strengthening as I do the exercises.

it’s so hard to decide what to do, and you never know what will happen which makes it even harder

I’m also in the same position; due in May so feel like I don’t have much time.
i had an emergency c section with my first, and then have gone on to have 2 vbacs, my first vbac I suffered a 2nd degree tear and then my 2nd vbac I suffered a 3rd degree tear.
this time I am really struggling to make a decision on what my best option is, my consultant has advised c section due to possibility of long term complications if I were to tear badly again.
family members think I should go for the section but the thought of being awake and going through the procedure terrifies me. (I was asleep for my emergency)
recovery wise, I struggled more after my 2nd degree tear than I did after my 3rd degree tear. I was unable to walk for quite a while after my second birth, resulting in me having a blood clot in my leg a week after delivery. It’s nice to read successful vaginal delivery stories after a third degree tear as the midwives Iv spoke to say they’ve never known a woman go on to have another vaginal birth after that level of tear and instead opt for the section

I’m also in the same position; due in May so feel like I don’t have much time.
i had an emergency c section with my first, and then have gone on to have 2 vbacs, my first vbac I suffered a 2nd degree tear and then my 2nd vbac I suffered a 3rd degree tear.

this time I am really struggling to make a decision on what my best option is, my consultant has advised c section due to possibility of long term complications if I were to tear badly again.

family members think I should go for the section but the thought of being awake and going through the procedure terrifies me. (I was asleep for my emergency)
recovery wise, I struggled more after my 2nd degree tear than I did after my 3rd degree tear. I was unable to walk for quite a while after my second birth, resulting in me having a blood clot in my leg a week after delivery. It’s nice to read successful vaginal delivery stories after a third degree tear as the midwives Iv spoke to say they’ve never known a woman go on to have another vaginal birth after that level of tear and instead opt for the section

This is so interesting because I’m in this position right now deciding what to do and the high risk midwife I spoke to said that most women she’s seen go on to have vaginal delivery. It’s so confusing because I can’t seem to find any information that is evidence based and helpful and all the anecdotal information from professionals seems contradictory. It is helpful reading on here but it’s such a hard decision to make!

Hi there
yes a very difficult decision to make without a crystal ball.
I found the RCOG to be the most useful for me. Have a look at:

www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/care-of-a-third-or-fourth-degree-tear-that-occurred-during-childbirth-also-known-as-obstetric-anal-sphincter-injury-oasi/

and good luck with the rest of your pregnancy and birth 🤗

@Rlandcb1 I think at end of day you can only go on gut. Do your research and get opinions. But everyone will have a different opinion. Ie consultant and midwives etc. midwives see more births so they tend to think go vaginal. Consultants see the worst outcomes and have to repair them and tend to say go c section to be safe.

how long have you got left? Have you seen a consultant yet?

I am due next month. And waivered a little on trying a natural delivery. But I really did have so many complications from delivery. Also a difficult delivery. Forceps. Terrible bruising. Episiotomy. 3rd degree tear. Bladder retention issues. And took a long to feel comfy to sit and sex to be okay. Took a full year to feel recovered with no issues tbh.

so for me the 1/10 chance of having another severe tear as it sits at about 10% statistically when you’ve had a previous when I fell in the 3-4% for the first time stats. Felt like wasn’t great stats as I tend to sit on the bad luck side. Most will be okay BUT there will always be ones with repeat injury.
second repairs can never usually be as successful. Likely to fail later in life.

my consultant basically said even with no repeat severe tear. The extra pressure on the perineum and spincter during another vaginal delivery still could do irreparable damage to the repair. It can weaken it further.

So I have gone for elective c section. I’d of loved a natural straight forward delivery to get that experience.
but ultimately for me. My mental health won’t copy with anxiety about complication from another vaginal delivery and incontinence and prolapse etc etc.
For me 6 week cs recovery was the better allernative. Controlled. And tbh it took longer than that with my vaginal.

It is SO hard though. No answer is right or wrong. It’s just what’s right for you. And the risk your prepared to take.

@Indianna2006 Yep I think you’re right. I saw the colorectal surgeon after tear with 1st birth and he said c-section for everyone and the midwives are more like your choice.

I’ve got until Aug but it’s on my mind because I’m terrified of c section. But then the risks of vaginal birth are also scary but then I think it might be amazing this time and might not even tear!

I was meant to have a call with a consultant but instead it was a high risk midwife. She was lovely but won’t give specific advice as to what to do.

The reality is I would love a vaginal birth and do it differently. I.e not induction and not being shouted out to push so DD shot out and I got the 3b tear! But you can’t predict the future can you 😆

What you say about the 10% stats is exactly what my partner has said too. He feels they aren’t good odds so I get where you are coming from!

Interesting about the difficulties with repairs for a second time tear too. So when I read your full post I’m like yep I can’t bear the anxiety re risk of about incontinence and prolapse either and worry it would actually affect how a vaginal birth progressed if I couldn’t relax or trust my body!

It’s so complicated isn’t it!!

@NewMummyJelly thanks for this link going to have a look!

@Rlandcb1 it really is complicated. And people will feel different towards it for different reasons. Some ppl wouldn’t even consider a c section and just do vaginal. But it depends on the delivery mode they had I think etc and whether it was traumatic etc.
Others wouldn’t get pregnant without a C-section as an option. Both are valid.

Same. I’ve toyed backwards and forwards a fair bit. As mine I laboured spontaneously but back to back baby very slow progression so was put on drip ended up with forceps. Forced out of me in wrong positon. Hence episiotomy and 3b tear too. So two scars ultimately 🙈🙈 it was horrendous and traumatic.
I would also love a much shorter happy ending push the baby out labour in a peaceful environment. But…will they tissue hold up at the end. I’m just not sure.

90% women being fine sounds like good stats but 1/10 is fairly high. Someone has to be that 1 person..and not sure I want to take that chance. I would regret it for the rest of my life I think if it made me have terrible symptoms. And where the tears don’t heal properly and people get fistulas between their vagina and anus. It’s just not worth bearing thinking about.

it was a long recovery but I got a good repair. It worked. I’ve had no issues. Minus dealing with the scar and sex issues which resolved years ago. I am happy with down there. And would quite like to keep it tbh😂😂

the anxiety about it would just smash my mental health I think. A not sure I could relax for the birth to go well. I’m sure deep down inside there is still trauma and it would affect it.

midwives are very good at selling you a lovely birth story. Cos I almost fell for it. A then realised ppl told me that before my last birth and look where I ended up…lol. My DH was very pro surgery. Calm. Controlled. No pain prior. Relaxed meeting our baby hopefully. I was separated from my DD for 5 hours initially. All those things have affected my decision. Wanting a different experience. Needing one actually.

if it’s any consolation, my consultant said he wouldn’t recommend I have a vaginal delivery. He was recommending c section. Even without any continence issues. He said to me medically it isn’t worth the risk. First opinion any one has ever given me. And the second consultant I saw who booked my date agreed and said he felt it was the best decision.

the only other opinion I’ve ever had about it was off the women’s health physio I saw on nhs for the tear 6 weeks pp and until 10pmonth pp due to scar tissue issues and painful sex. And she said I had two planned c sections for my children. Because I do this job everyday. And deal with prolapse and ppls awful issues after hideous births. A she said if you ever want another. Have a c section. Don’t risk making any long term matters worse as you age and gravity will drag it all down. Cos it isn’t now neccesarily. It’s when we age. What happens then. Another birth even a good one. Can still affect it she said. So I bore all that in mind.

Am due in September and had a 3c tear with my second vbac after a 2nd degree and episiotomy birth. am also swaying between the two and glad to have found this thread. Please update ladies and i hope everyone has a healing birth this time whatever it may be.

Hi @Mrsherdington ive actually made a decision to go for vaginal birth and planning to do this I’m at home. After looking at a lot more research I believe my tear was caused by the interventions in hospital so hoping a home birth will provide the right environment for me this time, fingers crossed! Hope you’re able to make a decision!