Hoping for positive birth stories after previous 3rd degree tear

[Sgj91]

Hi Ladies, I’m wondering if anyone has any positive stories of having a second vaginal birth after a 3rd degree tear.
I had a 3b tear in 2022 and it didn’t heal well. It’s left me with pelvic floor issues and painful sex, I’ve done 10 months of physio and had steroid injections etc but haven’t had much improvement. I’m pregnant again (by home insemination due to sex being too painful) and my midwife has suggested that another vaginal birth could fix these issues for me. I know it could go either way but I don’t feel it could really get much worse anyway so I’m thinking I’ll give it a try.
Reluctant to have a c section as I had a huge PPH shortly after giving birth and I’ve been advised that my chances of a PPH are increased with a section. I know all circumstances are different but I lost my mum to a haemorrhage so I really don’t want to increase my chances of another PPH.

Hoping to hear some positive stories if anyone has any to try to ease my anxiety 🤞🏻 xx

@Silverfoxlady Thanks for sharing, really promising to read stories like yours, especially that you’ve gone on to have 3 more vaginal births. Thank you xxx

Just say you want a phone call with consultant asap or you'll look into changing hospitals as you don't feel supported.

@Jessb2021a & @Sgj91 thank you for replying. Its reassuring to know there was improvement. Even though I knew this was a risk, it's upsetting nonetheless. Sorry you both experienced this as well and glad you're doing better.

@Sgj91 good luck for your next birth. I may be back for advice if I can brave another pregnancy in future! For what it's worth, my gut would say a planned section (my first went extremely well), but I don't have this recovery to compare yet.

@Itdjgsurchg That’s interesting, I’ve not heard of a vaginal scan before. Was that on the NHS? I had the endoanal scan at 12 months PP to check the muscle had repaired but haven’t been told a vaginal one is an option. Glad to hear you had a more positive 2nd delivery xxx

@Jessb2021a Sorry to hear you went through the same! I’m starting to doubt that midwife advice, would have been nice if it was true! Are you expecting again too? If so, do you have a plan for the birth? Lots of people are telling me to have a planned section but I’m just not sure that’s right for me xx

3rd degree tear 20 years ago from a fast birth of a tiny baby. I had continence issues after for about a year, but was told it was nerve rather than muscle damage. I booked a c section with my 2nd , then changed my mind. Normal sized baby, normal delivery, no stitches.

Hi OP,
I had a 3a tear after first delivery followed by a big PPH so in a similar boat. I had a follow up appointment with an Obstetrician when I was 6m post partum and she quoted me an 8%recurrence risk of 3rd degree tear which I thought was not too bad. She also recommended endoanal USS which I decided to defer until I was pregnant again in case it didn't happen so I've got that to look forward to!

I'm now 16 weeks with baby number 2,
I'm still hoping to have a second vaginal birth but my midwife was happy to book me in to see a consultant to talk about delivery options at 24/25 weeks so it may be worth seeing if you get a different answer in a couple of weeks, or if you talk to a different midwife.

Can you cut the gatekeeping midwife out of the process and request the consultant apt directly from the hospital?

The other thing I'm putting more effort into this time is perineal massage and paying special attention to the area of my previous scar, so that tissue is as flexible as it can be when the time comes!
I find it a bit weird to do and I don't know that there's any evidence that it helps, but it makes sense to me, and I've started now since it's easier to reach for now!

Thanks for the thread. Had a 3a/3b tear (notes different to my discharge docs so who knows) 4 years ago and endoanal scan came back as OK. I'm now 34 weeks and still can't decide how this baby is coming out. Consultant said that natural birth would be a quicker recovery and gynae said that I could leak more after a 2nd natural birth. I was hoping someone would just say oh with your medical history then its a c-section but nope. Did get booked a growth scan at 36 weeks in case it's a big baby or a big head as that might swing it for me. Was told by consultant that you lose more blood in a c-section and having haemorrhaged with a mmc before this scared me a bit.

@SouthwestSis Congratulations on your pregnancy! 8% chance is reassuring, assuming that’s the same for everyone I think I’d take my chances and have a 2nd vaginal too. I did lots of perineal massage with my first, twice a day for the last 2 months and it obviously didn’t work for me but there must be evidence that it works or they wouldn’t recommend it 🤷🏻‍♀️ best of luck!xx x

@DoloresOnTheDottedLine Thanks for sharing and congratulations on your 2nd, not long now! Do you think you’ll take the induction at 39 weeks? Makes sense to come to that decision and I’m glad to hear you’ve not had any long term issues from your first. I’m only on week 18 but it’s planing on my mind a lot already. Do let me know how you get on 2nd time around! Best of luck 🥰 Xxx

I had a 3b tear 2 years ago, was referred to gynecology. I have done lots of physio to improve my continence and prolapse symptoms, I still have some urgency and heaviness occasionally but it's improved massively. No other issues.

I'm now 36 weeks pregnant and asked the gynecologist what I should do for the birth, he said it was my call to know what would be best for me but did say although the odds are in my favour he'd probably suggest a c section. His rational was that I've put in all this effort and not got back to 100%, another tear could mean I don't get back to where I am now, let alone 100%. I suspect he sees the worst case scenarios more than the success stories though.

I'd love a vaginal delivery but am booked in for a section, I said to the consultant I was nervous about the scar tissue holding up and she said instantly booked me in despite me still being on the fence.

Part of me is still hoping the decision is taken out of my hands and I go into spontaneous labour and end up with barely any injury this time (or another reason for a c section is found!), but I just don't think I'd forgive myself if had to go through that recovery again with a baby and toddler to look after.

Hope you settle on what's right for you, ultimately you know your body and what matters most to you.

I had a birth choices appointment when pregnant with my second as had a 3C tear with the first. I had already requested a section at my booking appt but still interesting to see what they said. She took into account lots of factors and gave me my chances of tearing again. Might be something to look into (sorry haven’t read all the replies!).

I far preferred my c section recovery to my tear recovery. I lost 6 pints of blood during my ELCS but the environment is so controlled that they were pumping blood into me as it was coming out. It did trigger an autoimmune condition though as quite physically traumatic 😄 I really don’t say this to piss on your chips, just to show that c section is not a walk in the park either. Whatever you choose it’s going to come with recovery. My tear was 9 years ago and I’m still not ‘recovered’ (I won’t recover if not already!) and my c section recovery was far far far easier and more comfortable (if you take out the autoimmune aspect!). I had an ELCS with my 3rd which was completely heavenly and quite healing actually and I think that’s far more normal.

The worst option of all if you ask me is to try and labour then get exhausted and end up with an EMCS anyway. Hence I went straight for nice calm organised ELCS.

Yes, very early days for me though - I'm only 4 weeks. It's definitely preying on my mind a lot though. My thoughts on delivery depend on the day. Sometimes I'm adamant I want a planned CS, others I want a vaginal delivery. I'd also like to talk to a consultant about it when the time comes. I'm a little worried because I was told that a second vaginal delivery would be recommended in my case but that was after a consultation via Zoom. No doctor has actually looked at the scar and how it's healed since I was in the hospital post delivery.

@Sgj91 I've restarted my pelvic floor exercises seriously again and doing regular perineal massage so hopefully I'll be in better shape either way

@Sgj91 I am not surprised it’s playing on your mind - it does on mine too. You’ve had a much tougher time than me and i’m sorry you’re still experiencing ongoing problems.

It’s such a lottery. I was part of an NCT group of 6 mums and every single one of us had a third degree tear or something worse (undiagnosed breach, emergency csec with PPH, broken pelvic bone, one poor girl got sepsis!) and then my sister gave birth the following year - every single person in her NCT class had a dream birth (she herself literally had the equivalent of a graze in her vagina). She also had a very big baby so there’s no rhyme or reason to it - just rotten luck.

im very surprised they haven’t seen you to discuss your options already though and I have to say (with the caveat that I have no medical training whatsoever), what that midwife told you sounds like absolute junk science. I hope you can talk to someone sensible soon.

Good luck and I’ll be thinking of you and rooting for the best outcome. I’ll let you know how it goes - if my perineum explodes again, you’ve still got time to opt for a c-section!!! 😉

@Sgj91 just realised that I didn’t answer your question in my long ramble above. Yes, I’m planning to go for the induction. I like the idea of having a less gigantic baby and I also think it will make it easier to get my mitts on an epidural which I am absolutely DETERMINED I will have this time (after being told it was too early, too early, too early and then woops! too late! first time around)

I had a 3rd degree tear from an episiotomy and forceps birth...it took them a while to be certain it wasn't a 4th degree tear. I was so worried about my second birth first labour had been long and arduous with a large back to back baby. I too had pain afterwards until I stopped bf and then the pain went. Second birth was really quick, baby just came out without me actively pushing. I couldn't stop myself pushing when the baby was crowning so I did get a small first degree tear at the side but it was nothing compared to before where it felt like I was ripped in half.

Should add for the second I was on all 4's which might have helped avoid ripping the original scar open.

I hear this a lot – seriously, is it a money-saving strategy?

I've had pretty much the same experience. 4th degree tear and pph first time round. Months and months of recovery, loads of physio, also told it was miraculous that I've not had continence issues. I had a c-section about 7 months ago and the recovery was fine. I feel better this time round as even though my body has been through another pregnancy, all the physio work hasn't been lost by putting my pelvic floor through another birth.

@BamBamHam Good question!! They were incredibly stingy with with the good drugs in general when I was giving birth - for the second time round, I’m answering every single question or comment with “epidural please” until I get one!

I’ve always had this vibe around birth! – that you need to be incredibly firm or else you’ll somehow find yourself with gas and air and it’s too late for proper pain relief. (No first hand experience myself!)

I think I remember reading something along these lines in Zoe Williams’ column and book about having a baby, and the way MTB are constantly patronised and fobbed off.

I guess the first time you don’t know what to expect and you place all your trust in them to do what’s needed at the right time – once bitten twice shy!!

Congrats on the second :) 💐

Hi @sarahc336 ,
Congratulations on your pregnancy .

I have had 3 kids and tore with all of them .

1st baby had a 3rd degree tear and epsiotomy and needed stitches .
Was an absolute nightmare to sit and healed poorly and needed antibiotics/physio etc

Second was not as bad as there was no episiotomy but still tore badly but I don't recall it being a horror show like the first .

Third baby , born within minutes of me arriving in hospital, tiny skin tear . No issues after .

I hope you have an easy delivery. Definitely don't get pushed into a C section if that is not what you want .

Also pelvic floor exercises if not done correctly can make matters worse so make sure you are referred to gynea physiotherapy who can actually check that you are exercising the right muscles .

I remember after my first baby I also had an internal scan which measured that my muscles were working correctly as they were worried I may end up with incontinence .