Birth options after a previous 3rd degree tear

[Grimbo87]

Hi there,

Background of me: I have a 2.5 year old who was forceps delivered with an episiotomy that tore into a 3c graded tear. 2L blood loss in total from the resulting wound so I had a blood transfusion and 2 hours in surgery to repair it. I lived with months of incontinence as a result however due to an amazing physio I'm happy to say no long term damage.

I'm now 25 weeks pregnant with my second and after going through the birth afterthoughts process and meetings with a couple of consultants I'm now at a loss as to which way to go for my next birth. The hospital themselves have taken the stance of it being my choice for either an elective caesarean or a vaginal birth again although when pressed the midwife said "off the record" they'd lean to an elective section. The risk of another tear have been given to me as 7% up from 2-3%.

The recovery from a section scares me as I'll have a toddler at home to consider this time but I don't think I could handle the incontinence if I tore badly again and there's no guarantees I'd heal as well as this time. I have no strong opinions either way, I just want baby and I safe and well afterwards with me in the best possible state to look after my little ones.

I guess I'm after some experience from those that have gone before me! Any similar stories and which way did you go?

[Purpledoggo29]

I'm on my second pregnancy too at 37 weeks now. I had a section the first and I am trying to avoid that at all costs as recovery is so long and incredibly hard and painful. I can't help with the tear as I haven't experienced that but it sounds really hard too. I hope it goes well for you!

[CJohns]

c-section recovery really depends upon the person. I was driving on day 12 and picking my 2 year old up on day 9-10. I have recovered extremely well from both sections, and felt the experience of both (one emergency and one elective) to be pretty calm - I actually preferred the emergency as I felt they spent so much time on the elective explaining what they were doing, when I really just wanted them to crack on.

If opting for an elective, as you have a toddler, I would just recommend ensuring your partner has at least 3 weeks off with you after, just in case you don’t recover quite as well and need help with lifting/bathtimes etc

Xx

[Sevy571]

Do you do perinearl massage to loosen up the scar tissue from last time? Also worth looking into an Epi-No.

[Grimbo87 in reply to Sevy571]

I did do some last time although I do feel more educated about the process now having recovered from last time so I'm definitely thinking that is something I'd do this time around. Thanks for the suggestion I haven't heard of Epi-No but will look into it

[Seb9]

One of my best friends had a similar tear and found the consultants did the same, offered the C-section but told her it was up to her. In the end she asked them outright if they were in her position what would they do and they said the C- section. They couldn't say what would happen with existing scarring and what the breaking process might look like. Because it was an elective, she said she felt a lot more relaxed and she could make decisions about it, like she still wanted delayed cord clamping, music playing etc

Her recovery was much better than from her tear, and I know she was very pleased with her choice in the end. From what I understood an elective is also done slightly to an unplanned so the recovery tends to be better. You can also plan your support more if you know you're going to have a C- section, if you have friends or family that can be close by to help out.

Good luck with your decision and hope whatever your choice, you have a healthy and lovely pregnancy x

[Grimbo87 in reply to Seb9]

Thank you for this. The discussion I had with the afterthoughts midwife did make me think on balance an elective was the way to go so I could have more control. My last birthing experience was complete chaos (being blunt) so choosing when and where and how is very appealing this time round! I have a month until I sit in front of the consultant again with my decision so could well sway again but feeling like elective might be right for me.

[Fowler01]

Hi I had a 3rd degree tear with my first although doesn’t sound as severe as yours as I didn’t lose that much blood and I didn’t need physio it just healed itself. I was told about the risks of it happening again so was a bit anxious but I really didn’t want a section as I was also anxious about the recovery from this. I went for a natural birth and during labour the midwives were aware of my last tear so when the baby was away to come out they applied hot towels and thankfully no damage was done. Good luck for whatever route you go down.