C-section for no 3 or go for another 'natural' delivery. Your advice needed please. (anyone with previous 3rd degree tears really wlecome!)

[babyno3]

Hi

I had ds 1 after awful induction. He was 11 days late, I had the pessary, the drip it was awful. I had G & A, then pethadine which made me very sick then epidural. After 27 hours ds 1 was distressed and he was delivered by ventouse. I had an episiotomy but tore anyway. I am 5" 2, size 8 and ds 1 was 9lb 1oz. I was traumatised and in shock after the birth.

I then had terrible pnd where I saw a psychologist for a year.

Ds 2 was spontaneous labour and I knew he was a big baby as I'd had growth scans as he was always at least 3-4 weeks ahead of dates. I was terrified of giving birth but went into labour keen to not be induced. I had another epidural which wore off down 1 side so I had G & A also. They knew he was stuck at 10pm yet I was asked to push. I had the most amazing pressure in my bottom which was unrelenting. A couple of hours later I asked for help as I was in agony and he wasn't coming down the birth canal. ( He wasn?t delivered till 2.24am) They said they could use forceps, I was worried about tissue damage but the obs said it would be okay. I had a spinal in theatre (as emer c-section would take place if forceps didn't work) Dh was ashen as I disappeared behind the theatre doors (he was able to join later) Our son was born after 3 tugs where I sustained a 3rd degree tear with no episiotomy. He was 9lb 15 1/2 oz. His shoulder were enormous hence he was stuck! I have had complications from the tear and still have severe pain when I need to empty my bowels.

I am prgt with dc 3 and are considering a c-section as I am worried about re-opening the tear (it will be 21 months between births) I am worried about having another birth that 'goes wrong'. I have lost all confidence in my body to deliver babies and just want a more calmer, plannable birth. I have been told by my Dr that 3rd baby's are bigger which worries me. I do understand the risks involved from a c-section and have had 2 births so def not too posh to push. A section would place difficulties for my 2 boys I already have.

I am so confused as to what to do. I can't guarantee am instrumental free 3rd birth and are wanting a major operation instead which seems crazy. I feel my body grows baby's that are too big for me to deliver -opposite to what the consultant told me with ds 2 'You can deliver a 12lb baby Mrs babyno3!!'
I feel I've lost trust in the professionals as I expressed concern about ds 2 being a big baby, I didn?t like forceps and expressed this but was told it would be fine yet it turned out exactly how I though it would be.

Any thought/opinions gratefully received?

[Jacksmama]

I well remember not getting my knickers down fast enough and looking at the mess and wanting to die with embarrassment. It was horrible beyond description.

[Jacksmama]

When is your booking app't? Because I'll watch this thread and will want to know how it went.
xxx

[babyno3]

Thanks all
x

I suppose I am saying I do want a c-section just a little hesitant about asking for one as I feel belittled by the consultants in the past both with ds 2's prgcy and the subsequent problems with the tear. I need a bit of girl power and everything written out so I can hand it to them when I see them as I've a feeling I'll just burst into tears! (This happened a lot after ds 1's awful birth I was left with a sort of phobia where I would shake at the sight of the hospital, daft I know but there you go!)

[babyno3]

Next friday, I'll do an update to let you know
xxx

Specialoffer - I feel I'm missing out on a positive birth experience too. A very lovely friend on mine just had a fab homebirth. Got up, twinges, contractions, G & A by 3pm, baby born at 5.40pm. I am so pleased for her but sooooooo jealous...

In fact I'm jealous when anyone has a good birth. That sounds really awful and I don't mean it a nastily as it sounds. It's just all panic, panic, panic with me.

[Heated]

A deciding factor might be that if you have suffered incontinence in pg it makes you more prone to it as you get older.

If you have fecal incontinence at any point in your pg (as sometimes happens if there is a pre-existing weakness/ligaments relax) or have suffered from it after giving birth, consultants generally advise an elective.

[babyno3]

Yep with bladder incontinence when prgt with ds 2. I had to wee very frequently to not let my bladder fill up. Told the midwfe and she said that this was a consequence of pregnancy...

[Jacksmama]

Do please let us know - big hugs!! Must go for a bit and take some books back to the library (I'm in the Pacific time zone so it's only 2:15 pm here in case you're wondering) but will check and see how you are.
XXXXXXXXXXXXXX

[Mine]

babyno3 - be firm with them, they can't make you have a birth you are not 100% comfortable with, as this will definitely affect the delivery.

If you feel anxious and scared now, you will feel one hundred times worse when you have to deliver. Surely that is neither safe for you or your precious baby.

Go with your instincts. They have got to listen to you.
xxxxx

[ThursdayNext]

Oh, what a rubbish time you've had. Much sympathy.

I had a forceps delivery and a 3rd degree tear with my first baby.
I was offered an elective CS for my second baby. The obstetrician told me that some women are so traumatised by an instrumental delivery and a bad tear that they prefer to have a CS, and it may also be advisable because of the risk of faecal incontinence later on. I'm very surprised you've been given different advice, I got the impression this it was standard practice to be able to choose a caesarian after a 3rd degree tear?

I actually had a natural birth with my second baby and it was fine, but she was early and only 5lb 10oz so quite a different situation to you. I hadn't experienced any faecal incontinence either. If I had I probably would have chosen a caesarian.

I would be surprised if the doctors weren't happy with your decision to have a cs?

[ButterflyBessie]

Wow BN3

You have had a tough time of it

I am a campaigner for vbacs, but if I were in your shoes I would be booking in for a section, sometimes the end justifies the means and from what I have just read your body has already taken loads of abuse through natural childbirth.

From what I have read there can be really lovely and special elective sections, I think you deserve one of those.

Good luck with whatever you decide - and you do need to make that decision, not the cons on your behalf

[bosch]

Interesting that it sounds as if advice may have changed since I had ds3 by planned c/s. I had ds1 by em c/s because he got distressed, ds2 was natural birth but 3rd degree tear followed by some months of faecal urgency and incontinence. In spite of this, I really wanted to try for another natural birth with ds3 and had tests before I got pg to establish extent of damage from tear. It was this that persuaded the consultant that I should have a c/s and when he said that, I knew that dh wouldnt' let me have natural birth. Don't mean to sound wet, dh argument was that he had a healthy wife and two healthy children and another natural birth was risking his healthy wife too much. So consultants very clear advice to have a c/s was what swung it for us.

I wouldn't stress out too much about your booking appt. Tell M/W that you want to talk it over with consultant. You may have to wait (I knew before I was pg that I'd have a c/s but didn't speak to the consultant once pg until 20 week scan) but given your history it seems highly unlikely that they'd not agree. Tests I had to establish the extent of damage might be worth pressing for if you want to make your best case - was a type of pressure test of your bottom basically, would inform you and medics if you feel MW not supportive of your decision, but not down to MW how you deliver.

[alicet]

Can't add much to the fantastic advice on here.

You know my story but in case you've forgotten I'm going to tell you to give you some confidence that one of the most medicalised births of all CAN be as emotional and enjoyable experience as a positive vaginal one (fwiw I have deliberately not used the word 'natural' as in your case I don't think there is anything natural in what you have experienced!)

Ds1 was born by an emergency c-section for foetal distress. When I was expecting ds2 I was advised that it was entirely my choice as to whether I went for vbac or elective section as with 1 section under my belt the risks were equal although different depending on my choice. In the end after much prevarication I went for the section - gut reaction told me it was the right decision.

Ds2's birth was magical. I asked for a number of things in my birth plan to make it more personal to me and the team on duty really listened. Dh watched the operation (not for everyone I know but he really enjoyed it). I asked that they lower the screen so I could watch my son be born and they did - it was amazing to see and such a contrast to the first time when I was so scared I didn't care what happened. (Couldn't see any gory bits by the way - this would have been too much information!) They passed him out to a midwife who then put him straight on my chest for skin to skin. All in all a complete contrast to the first time. I'll send you my birth plan as I've already promised - feel free to email me with any questions.

I'm thinking this is what you need too. A positive experience that will go some way towards lessening the awful memories of the first 2 deliveries. With your history I reckon the chances of getting that with a vaginal delivery while not impossible are small and I have to say I would be very very surprised if they refused this very reasonable request for a section. You know that a section is major surgery and not without it's risks but most people including me sailed through without any complications.

If they refuse I would be asking for a second opinion. It is probably also worth talking to crochetdiva - for all she wanted a vbac but she was brilliant at fighting for what she wanted and got it against a lot of resistance so her approach may help you.

Good luck xxxxxxxx

[alicet]

I have a mate also who had a 3rd degree tear with her first adn was advised to have a section for her second. From what I know she didn't have anything like the symptoms you had afterwards either.

Good luck xxx

[manamana]

Having had a similar experience I would wholeheartedly recommend elective cs.

I had bad birth with ds1, bad tear, terrible stitching by MW. Suffered severe anaemia because no-one noticed I was so badly torn inside and losing too much blood (thought everyone bled that much!) Had whole perineum rebuilt 9months after ds1 born. Suffered PND as a rsult of trauma.

So, when I was pregnant with ds2 I was absolutely terriefied about repeating same experience. Was in tears at every mw appt and my mw said it would be much better to get a cs booked in early so i didn't spend whole pregnancy stressing. She wrote to the consultant to explain the situation and he saw me early. In th course of my pg I saw 3 diff registrars and consuktants to discuss cs but all were understanding of my reasons to have a cs. It still took until 35 weeks to get a date and I didn't really relax until then but I did manage to get mw to write elective cs on my notes which made me feel much better.

Anyway. CS was bliss compared to my previous birth and recovery much easier. I was very worried that I should go for a 'better' natural birth to get closure but as my mw pointed out I had no guarantee that I would get one. I still get quite emotional when I think about birth of ds1 but I don't have one second's regret about going cs for ds2 and have only happy memories of the op and recovery.

Good luck, can you take someone with you to your next mw appointment to make your case very clearly and ask for an early referral to consultant - not that i am suggesting you can't do it yourself but I found it much easier to stand up for myself when I had someone with me.

Finally, sorry this is v long. My consultant for the repair had said there was no physical reason why i shouldn't be able to have a natural delivery. So strictly speaking I could have gone ahead with natural but I wasn't prepared to take the risk with either my fanjo or my mental health.

Good luck with your pg. I found great support on here.

[redflipflops]

agree with good advice on here.

My god it would be really hard to approach a vg birth feeling confident after your previous experience!

Unfortunately not all women are able to experience a 'wonderful' natural birth... I went through a period of feeling disappointed I never experienced one - but now I'm just glad the babies arrived safely with minimum damage!

I have had c/s and recovery was fine. Out of hospital after 48hrs (you're not knackered as you haven't been through a long labour). You'd need help in the first couple of weeks - but after that chances are you'll be fine. A lot of women feel fine to drive after a few weeks (tho' you need to check with insurance).

[MamaG]

Whatever you decide, here's my 2p worth. I had third baby 3 weeks ago by emcs and felt like I'd been hit by a truck. Probably more to do with 24 hour labour then emergency CS under general anaesthetic. I lost loads of blood and had a transfusion. Others on the post op ward who had elective CS were up and about much faster than me.

I definitely found it much easier to get back on my feet after 2 vaginal births, but they were relatively straightforward, if long (both inductions).

HOWEVER - we are now 3 weeks post section and I've been doing the school run all last week as well as looking after newborn, pottering about doing housework etc. I am SLOWLY getting back on my feet (prob not resting as much as I should !) and I think I'd have been much stronger much sooner had it been an elective CS.

I firmly believe you should listen to your body. I thought my baby was big (I'm 5' 3) and when they scanned me at 38 weeks to check for breech, they said he was about 7.5lbs and would gain half a pound a week at MOST. He was 10lb 9oz just under 3 weeks later

Does that help at all, or am I just waffling?

[minxi]

Oh my goodness how horrific - definitely go for the c-sec...
I had an awful birth with my ds1 which after how ever many hours in labour resulted in EMCS under GA, recovery was about 2 weeks as I had eclampsia and was all very traumatic....
With DS2 I had elective c-sec and although I was terrified I was out 3 days later - and on my hands and knees 4 days post birth cleaning floor for when midwife arrived - I was driving at the end of three weeks - far easier smoother and I am expecting DC3 in 14 weeks and am going in for another elective... I would not put myself through the kind of hurt and pain you went through again! Good luck

[orangehead]

Like you I have planned to go for a planned section 3rd time round, not preggers yet though. With ds1 had a long hard labour when he went into distress and had a emergency section under a GA it was very traumatic and I was very upset that I missed the birth and did see my son for his first few hours. With ds2 I had a vbac but after another long horrible labour I lost a lot of blood and passed out as they pulled him out with forceps. So I missed his birth also. I feel very lucky that despite both births going wrong that we were all ok in the end. I feel it would be silly to push that luck as I take the hint that me and vaginal births just dont work. Plus I really want to be awake for the birth for my next and last baby. So I feel a planned section is the sensible choice for me. Good luck in whatever you decide and have confidence in your decision

[LisaLessLumpy]

Go for the c-section.

I had a full episiotomy and forceps delivery with my first who was 8lb 5oz, I had a c-section with my second as he was found to be breech at 3 days overdue and 8lb 11oz I must say I recovered quicker from the c-section. I luckily healed very quickly and had no complications. I worried about how I was going to cope not being able to drive/lift/deal with kids etc but reality isn't as bad, you deal with it. I was driving at 3 weeks and my DH went back to work 2 weeks after and I managed fine with a toddler and baby, although I recognise that it will be harder with two already. Go for the c-section and enjoy your pregnancy in the knowledge you will have a relaxed, planned birth and worry about recovery afterwards, if all goes well you will be amazed at how quickly you will feel ok.

[luckymoray]

for what it's worth, i would chose a c-section for you. i was up and about the same day after mine, even though it was an emergency one. after 24 hours + of labour, it was divine! i am currently considering vbac or elective c/s for number 2, due christmas day. to be honest, i think i'm going for a c/s again. yes, it's surgery, but for me, it's a way of knowing exactly what will happen to me and when.

[mabanana]

Blimey, in your case I'd have the cs. It's the bowel thing that would be the decider for me. Poor you.

[turtledove23]

I have only skimmed over the posts, but just wondered whether you'd had any counselling to help you deal with previous births? It can be really useful to at least have a debriefing to put your mind at rest.
You are the only person who knows what is best for your body, and with your history you should have no problem with being given an elective c/s if that is what you truly want.
Is there anyone who could go with you to help you stand your ground and to ask all the right questions when you go? Also, remember that you have the right to change your mind whenever you want. It is YOUR birth.
Have you got anyone to help after the birth?

[tinkisahugexmaspudding]

i would definetly have a csection
i had only 2nd degree tear and was considering a c section i am hoping for a water birth just praying and hoping i dont tear again

[munteria]

Hi

If I were you i would go for a c-setion. I was induced at 40 + 12 and ended up with an emergency c-section after 24 hours in labour due to distress (of the baby). It was brilliant - i healed really well and was up and about in no time at all.

I always felt a little guilty that maybe i "copped out" by having the c-section, even though the birth was still magical i,e, skin to skin straight away etc. However,I spoke to my yoga teacher the other day and found out that she was in the same situation as me i.e. induced and in labour for 24 hrs. However, she was stubborn and insisted on a "natural" birth (maybe because she was a yoga teacher). She ended up with a forceps delivery and rectal and uteral (?) prolapse. she really regrets not going for the c-section.

I am considering a natural birth for baby no.2 due in Feb. However, it would be great to know that if things got bad and they suggested a forceps delivery whether I could insist on a emergency c-section? It sounds silly but i am mored scared on tearing down below than i am being cut across the stomach!

Does anyone know?

[Jackaroo]

I think there are two ways you could approach this - depending on how pg. you are, and depending on where you are. If you're not too far along, and have time and inclination, you could explore something like Hypnobirthing (rubbish name)which seems to have a great track record for getting mummies who've had horrific experiences into a better place to approach a calmer birth next time... and see where you get with that. It maybe that the combination of the size of your babies and all the medical stuff is the problem, a relaxing, different approach might make all the difference.

On the other hand, if don't have time/resources/inclination etc etc for that, I think you need to just "insist". My bestF had two awful births, and was told the 3rd would just pop right out.. she just lost it and blubbed. This was enough, the Dr could obviously cope with everything except a crying woman. She got her CS and said she should have done it before! She was happy, calm, loved her children, and admittedly had lots of help from friends and family, but if you can get around that bit... she said she felt awful as she was supposed to be the NCT rep. on the patient board at the hospital and now she was advocating CS.....Her 3rd baby was large too.

BTW, if you still have BM problems like that, they really need to take that seriously, both in terms of your next delivery, and doing something about it. Maybe after the next you could get a referral to a specialist? I went to one and it made a huge difference.