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  1. #1
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    Question Help - anyone have a second child after a 3rd or 4th degree tear with first bub?

    G'Day all,

    I REALLY need to hear from women who had a third or 4th degree tear (specifically) during a natural birth please. I had a technically '4th' tear (written under 3rd degree but the worst of the 2 types of 3rd degree you can get) with our first child. It took almost a year to heal and I still feel the scar ache from time to time even though DD is now just over 3. I am 30 weeks pregnant with child no 2.

    Anyway, due to my difficult/traumatic first birth and long recovery, the Dr's have now given me the option of having a c-section for the second bub. I have to give them my answer soon.

    I know the majority of you will say DON'T get a c-section due to the pain, recovery, etc etc. Which is why I REALLY need to hear from women who have had a third degree tear specifically, as much as possible please, esp if you have had another child after the first. Did your tear re-open (if you had it naturally of course)? Did you go the c-section option? Are you glad you did? Anything like that would help me please. Dr said there is no guarantee my first tear won't re-open Thanks in advance. I look forward to hearing of your experiences ASAP so I can add them to my decision making process. (Of course, I'd still prefer a magic, third option hehe ).

  2. #2
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    I had an episiotomy with DD1, so if it had been a tear it would've been classified as 4th degree. I was cut along my entire perineum. A year after DD was born my scar was still aching occasionally, especially when DTD and I was terrified of what it would be like to give birth again. Once DD was about 18 months old it began to feel so much more normal, with nearly no pain, and we fell pregnant I was still terrified of tearing along my scar. We planned a homebirth and my midwife helped me work through so many of my fears. DD2 was born 6 weeks ago - she was 4.02kg (a huge baby for a woman of my size and a whole half a kilo larger than DD1), and her head circumference was 36cm (huge!!). I had one minor graze that I never even noticed, and one tiny first degree tear that didn't need stitching I felt back to normal about a week after DD2 was born.
    It was stories of second births like mine that helped to alleviate some of the fear I felt about tearing, so hopefully mine has helped you

  3. #3
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    I had a 3rd degree tear with my first baby (induced, epidural, vacuum). I was fortunate that it healed very well and I've had no ongoing issues with it. I did, however, have to chose between elective cs or the risk of another severe tear or complications from the original tear. I chose to have a natural birth where I would not have an epi so I would be free to have an active labour and not be confined to lying on my back whilst birthing (as we all know is a bad position for birthing). I spent a lot of time getting myself in the right headspace and I achieved the birth I wanted. I did, however, have a very quick 2nd stage and ended up with a 2nd degree tear with DD but it was no where near as bad as it was the first time around. Once again I've healed all up with no ongoing issues.

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    I had a 3a tear first time around, but healed up ok. I was very worried about a 4th degree tear the 2nd time around, but my Ob said the risk of that degree (or worse) tear again was not really that high. C-sections aren't without risks and it was his opinion that a natural delivery was still a better option.

    My first bub was 3.95kg, induced and vacuum extraction. He was twisting and turning during the birth, and I had a really strong epidural due to other issues, so I thought that all played a role. But, probably not.

    My second bub was induced, 4.4kg (yep, I make big bubbas), and forceps delivery for shoulder dystocia. I had a light epidural (tried to survive without it, but couldn't - the pain was horrid!) and I had much more feeling than my first delivery ... not that it helped cause she was stuck at the shoulders. Thankfully I had a small episiotomy, but no tear at the end of it. Amazing! Very happy about that!

    I'm not going back for #3 (well, not planned anyway), but probably next time they will induce me earlier to avoid such big bubbas and I might just avoid a tear or epi at all .

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    I had a an episiotomy that led to a 4th degree tear with my first DD (natural birth). The Dr. that delivered her said I would probably have to have a C-section if I had another baby. When I fell pregnant with my 2nd, my new Dr. thought that was nonsense. She said there were ways to prevent a second tear and also suggested that I be induced a few days before my due date. (I was having weekly ultrasounds by that time for other reasons, so both Dr.s knew they weren't inducing too early.) I went that route and I was quite happy with my decision. I suffered a small second degree tear, but it was NOTHING compared to the 4th degree tear; I felt normal by day two. An excellent OB who listens and is sympathetic is priceless. I hope you have a great Dr. and an easy delivery!

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    With my first I had an episiotomy that would have been the equivalent of about a 3rd degree tear (DS needed vacuum assistance as he was a bit stuck, plus he was 4.4kg).

    With my second I tore naturally, 2nd degree, but interestingly the tear is in a different place to my epi scar. DD was 4.2kg and came out with her hand on the side of her head, so I think I did pretty well to only have 2nd degree tearing with her.

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    My sister had 3rd degree episiotomy with her first baby (internal scar tissue that wasnt found til he was crowning )

    Then she had 2nd degree episiotomy with her second, she would not have encountered a problem most likely but her daughter was damn near ripped out as her heart rate dropped, she had her cord around her neck.

    Her third she got a graze and her fourth nothing.

    All were 8p8oz + and had huge heads (cant remember the size)

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    my bestie had a forceps delivery with her first and a rather long traumatic labour with a 3rd degree tear (plus episiotomy). she just had her second bub (4 years after her first) and opted for a c-section. she recovered pretty quickly and she did say that if she was to have another (which she isn't planning to) she would go another c-section.

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    I had a third degree tear (boarding on 4th) with dd1. She was a big baby at over 4kg. It was a natural tear and was repaired with a spinal block after the birth. Didn't have too many ongoing problems from it.

    Second baby was 2 pound smaller and another natural birth but third degree tear again. I went in expecting to tear again so it wasn't a huge shock.

    I think how you healed the first time would affect your decision?

    I am still deciding if we will have number three but i know i will opt for a cs as i don't think i can cope with three third degree tears. Might end up incontinent!

    Good luck with whatever you decide

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    Yep, i sure did

    I had a 4th degree tear with DS1. It was a full midline episiotomy that tore to 4th degree.
    I was told when the dr was doing prelim stitches (ready to send me to theatre for a repair under GA) that i wouldnt have a natural birth again. DS1 was 4.41kg with a 36.5cm head. My next baby was going to over 10pds apparently.

    I was fully healed with no lasting effects within 8wks of birth.

    When i went into the hospital for hyperemesis treatment at 15wks preg with my second child (first child was 2.5yo) the dr instantly recognised me and wanted to book me for a csec then and there! I declined, left in tears and didnt get any treatment for the hyperemesis.

    Fast forward a few weeks, i started my antenatal appointments. Every Dr i saw had been told of my tears and they all wanted to book me for a csec, the midwives agreed. I asked for proof of the risks. The Drs tried to scare me into a csec by saying that its not a risk if i tear, its the actual baby going through the canal that weakens it (but then wouldnt this be true for every woman?) I was told that if i try a VB if have a colostomy bag for the rest of my life. The Dr printed me out a handout trying to prove his point. The printout from the Victorian college of OBs and Gyno said "If there has been no lasting effect from the 4th deg tear in birth the mother should be able to have a straightforward birth with subsequent children".

    So i told them to stick it. Every appt. they tried to bully and scare me into a csec, sometimes it worked.

    In the end i just researched the hell out of ways to reduce tearing. I armed myself with knowledge and told every midwife i saw during antenatal my birth plan, so they knew my plan, and they couldnt turn around and say they didnt.

    My birth plan was:
    No intervention
    I stayed at home as long as possible
    No constant monitoring.
    I wouldnt lay on my back at any time.
    I dont want drugs (except gas) and i did NOT want to me asked after i refused, i didnt want them to bully me into taking drug.
    I didnt want any internals except for one when i first got to hospital.
    I didnt want to be put on their timeline. I told them that as long as baby was doing ok, id labour as long as it took.
    100% NO EPISIOTOMY
    And the most important thing, I didnt want to be coached into pushing. I had to breathe my baby out to avoid tear.

    I went into labour at 8pm sunday night and laboured at home for 90min when i felt like throwing up. I thought it was transition so i went to hospital. I got one internal (4cm and 50% effaced). They asked if i wanted drugs, i declined and said no, do not ask me again (and they didnt). The midwife left the room and left me to do my thing. After an hour on the gas my waters broke. The midwife came back in the room and i kneeled on the bed. I started breathing. I felt DS2 descend. I just breathed (it helped having DP breathe with me). I stayed as relaxed as i could. DS2 started crowning, (mdwife was supporting his head) this was the tricky part. He got over his nose and i till hadnt torn (i was doing it!!). Then as his mouth was born the midwife realised he was compound presentation (hand to head) Usually they tuck the elbow in. But DS2 had his hand to his mouth, with his palm out. There was no way to tuck his elbow in.

    I tore to second degree (8 stitches with local). DS2 was 9pd 9.5oz (4.35kg, so not the predicted 10pd) and he had a bigger head circ (37cm).

    Just do your research and stick to your guns Best of Luck.


 

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