How common is tearing/complications with first baby?

[Butterflies12]

On Friday, at my 16 week appointment, I told my midwife I want an elective C section with my first. Pretty much everyone I've told about this has reacted with horror that it's something I would choose. From what I've read, at my age, 37, it is unlikely I will have an unassisted birth and that tearing is also likely. My mum and sisters all had labours ending in emergency c sections after days with no dilation and/or undiagnosed breech babies. The thought of tearing and being left with long term health problems and incontinence terrifies me. In fact, the whole thought of giving birth scares me, I can't read the sections of the baby books without crying. To me, a calm and planned c section seems preferable. I dont know a single woman in real life that has had an uncomplicated labour with no massive tearing, ending up in surgery, having various other serious and traumatic complications... So I'm wondering if this is normal or if I just know unlucky people?

Depends on what degree of tearing you mean.

First and second degree tears are very common, but in essence are only skin and muscle deep, and recovery is minimal. I had a second degree with my first. It was sore for a couple of weeks, but healed up beautifully. Third and fourth tears which impact the anal sphincter are much less common. RCOG reports 6% of FTM have a third or fourth degree tear. 2% for STM+ having a second+ vaginal birth. So if going purely by tearing, if they were all third/fourth degree, then you know some very unfortunate women.

I didn’t tear with my first or my second. And my second was over 8lb. Both unassisted births too.

I think you’ve just heard too many horror stories.

I had a second degree tear with DD1, was deep but small, and didn't bother me at all post birth, no issues with going to the toilet or anything like that, and the birth itself was on the birthing unit with an unassisted delivery.

DD2 I had at 41, managed to avoid the forceps, they were there ready, but the midwives kept asking for a little more time and I was able to deliver again unassisted and no tear.

People who have had straightforward births are possibly less likely to share their experiences as there is nothing much to share, so you do tend to hear about more traumatic births.

I had a third degree tear, really no big deal. You don't feel it at the time and it healed very well.

I was annoyed I had to go in to hospital to get sewn up as I had given birth at home - which gives you a 40% reduced chance of tearing fyi! My first birth was incredibly quick and I probably gave it a bit too much welly at the end so that's why the tear happened.

There's no actual reason why you would have an instrumental birth or any kind of serious birth injury at 37.

Do lots of research, a hypnobirthing course, look at lots of the lovely birthworkers on Instagram. And then make your choice. There's nothing wrong with wanting a C-section but don't make the choice out of fear.

You are more than capable of birthing your baby!

I should have also said, tearing is the least memorable thing about my birth - it was an incredible experience. I was 35, which lets be honest is no different from 37. I'm giving birth again at 36 and can't wait.

I have babies very quickly - dilate and get them out quickly! 20 minutes with my first and 6 with my second.
Both times I’ve had a second degree tear but think this was due to the speed and strength of my pushing. First time recovery was sore but DH didn’t get any paternity leave so I was having to be up straight away doing everything.
This time, touch wood, recovery has been much nicer and I’ve barely felt it past the first few days.
Honestly the worst bit was being stitched but sitting looking at your baby takes away some of that.

I'm 38 years old and gave birth 5 days ago and only got a first degree tear with 2 stitches that I only feel when washing in the shower. It stopped hurting in just couple of days.
Labour was long (25 hours) and unpleasant but not traumatic and no complications or interventions, even though I had gestational diabetes.
There are things you can do to reduce the risks of tearing. I encourage you to watch those videos:

I had a second degree tear with my first. No biggie, I was stitched up on the MLU and was home within 12 hours (I was only kept in that long due to DD being born more than 24 hours after my waters went). No issues afterwards.

I only had labial lacerations (required some stitching but very minor, not even 1st degree) after an induction. Mind you baby was just under 6lbs. Overall a positive experience that I would be ideal if I could replicate it for baby 2!

I tore with my first but, from memory, it wasn't a bad tear and just needed a few stitches. Recovery from that wasn't bad at all (far easier than a C section which is major surgery IMO).

I'm planning a 'natural' birth again with my second due soon.

In the kindest way, maybe you shouldn't listen to other peoples horror stories, and when people start to tell you their birth stories you should politely decline.

I’d really recommend the positive birth company’s book ‘practical ways to make your birth better’ or their online video programme that you can purchase online if you’re feeling scared about birth. It’s great at giving the facts, evidence and dispelling myths. It may really help you to make a decision that’s informed and right for you rather than based on fear and other people’s (negative) experiences.

Do you know what reason your sister and mother had c-sections? If there’s something genetic like having babies with large heads or having narrow hips etc then it might be the case for you too.

I think there are plenty of women who have uncomplicated natural births. So you do seem unlucky if everyone you know has issues. Sadly I was not one and neither was my mum so I think like you that there can be genetic issues. I had an emergency c-section and will hopefully have a planned c-section with next one.

Tearing is quite normal with vaginal birth, I had it in both my pregnancies, 2nd degree, stitched well and had no problems afterwards. As long as it doesn't involve muscles recovery is fast no long lasting side effects. To ask for cesarian to avoid tear is a bit over the top in my opinion. I'm now 42 with my third pregnancy and will only have c section if absolutely necessary.

My experience (although it probably depends on your hospital more than anything), is that midwives usually give you a little cut to avoid a tear. That's what happened with my first and second. Recovering/healing were minimal and all fine. I think that's pretty standard in a lot of hospitals.

@IVFbeenverylucky cut is not standard procedure. It's better to have first, second degree tear than cut which heals much slower. Cut is usually done if baby is stuck or labour is not progressing fast enough with distress to baby.

I didn't tear with mine, I don't think any woman in my immediate family has, however completely understand your worries, labour is a scary time because no one knows what will happen on the day. I've had one natural birth and one emc and I'm hoping for vbac with this one as I found recovery from section much harder than natural birth. I would only have a section again if it was absolutely necessary.

I find the Royal College of Obstetricians and Gynaecologists website very helpful at setting out facts. It says 1/3 first time mums will need an assisted vaginal delivery but only 6 in 100 will have a third or fourth degree tear. So I think it depends what your main concern is.

Please don’t let others (especially those without any medical qualifications) choose what’s right for you and your baby though, it’s your body and you can have an elective c-section if you want one

Problem with the stats about age/weight etc is they tend to intervene more the older bigger you are - so it’s hard to know if the issue is the actually the intervention in the first place!
Anyway I had suspected big baby, turned down section and induction, had my 8 pound 6 baby within 4 hours of getting to hospital, I was older and overweight, just gas and air, easy recovery minimal tearing. Laboured mainly at home. Next one I want a home birth ideally!

I had an episiotomy and ventouse delivery with my first. Honestly, it was completely fine. I healed really quickly afterwards. Planning a home birth with my second due in a few months 🤞
That said, if you want an elective caesarian, go for it. It's your choice and you should do what feels right for you. Just make sure you also educate yourself about the procedure as it carries its own risks.

I had my first 2 weeks ago and ended up with the drip induction I really wanted to avoid, and that was tough but I avoided any interventions. I had a fast pushing stage and just had internal grazes and a small labial tear so had stitches but I didn't feel them during or really whilst being stitched (with gas and air). I was really surprised that weeing after wasn't painful, had a bowel movement the next day absolutely fine and thankfully not been very sore during recovery. Now I feel almost 100% fine and today even ended up doing a couple of hours walk with lots of steps and lifting prams and am feeling fine.
I wanted to avoid a c section as didn't want it to impact breastfeeding or picking baby up after

@Butterflies12 90% of first time mums have a tear / grade of some sort but only 6% have 3rd or 4th degree tears. This was the info from my doctor recently.

I’ve also requested a c section for similar reasons I found this the best source of info for weighing up the pros and cons.

www.rcog.org.uk/media/11woxkxs/considering-a-caesarean-birth-patient-information-leaflet-large-print.pdf

Hi OP. First of all, I’m sorry you’re feeling so scared about birth. 💐 Rest assured that it’s completely normal to feel this way; it’s a huge event in your life.

One of my worst fears became realised and I ended up having to have an episiotomy (two cuts, I believe) and whilst recovery was hard (stitches tore back open somehow), I was back to normal after about a fortnight of painkillers and sitting on a doughnut cushion. Due with my second any day so it didn’t put me off having another baby OR giving birth again. :)

There’s lots of exercises and things you can do in pregnancy to prevent tearing and midwives will also coach you how to breathe during labour to reduce it happening.