Advice for a friend vb or c/s?

[~clover~]

A young friend of mine suffered third degree tearing when she gave birth to her DS 18 months ago. Because of this she was told all future births would have to be c/s because of the risk of tearing again.
She's just had an appointment where she was told the hospital were talking crap basically. There is no reason for a c/s at all.
Now she's confused. She's not sure what she wants. She would prefer a vb, but is scared the same thing will happen.

Can someone tell me the chances of a 3rd degree tear happening again??

[meow]

How did she give birth last time? Position? Coached pushing?

I don't think tearing oncemeans tearing again.

[Just Me]

I also have a friend that this has happened to - 3rd degree tear with her first birth in a public hospital and spent hours in surgery being repaired. This time she has got a private obsetrician who has looked at her case and said the reason for the tearing was that the baby's arm came out beside it's face and the tear probably shouldn't have happened in the first place but it just stretched too far. He gave her an ultrasound to look at the damage and scar tissue but said that he is quite happy that she can birth naturally this time and doesn't think she will tear as badly this time.

I had a second degree tear with my first labour - not a severe as a third - but I thought I would tear again and I didn't have any tearing whatsoever with my second labour.

I would say it is possible to birth vaginally after a third degree tear and not tear as badly. I understand why your friend is worried though.

[~mamaspice~]

I'm sorry I don't know what the chances of tearing again are but I CAN tell you that my nan suffered a 4th degree tear when she had my dad (needing emergency surgery cause she tore right through the anal sphincter) her Dr had advised her not to get pregnant again for at least 2 years afterwards. She did go on to have 2 more babies vaginally with no tears. So I guess it definately IS possible to birth vaginally after a major tear without tearing severely again.

[onthefly]

I think there's often a contributing reason why women tear badly - malposition/presentation, coaching, mother's position, etc, etc - which may not be repeated so it doesn't really ring true to me.
I can totally understand your friend's fears It would be so much better if staff at the hospital worked to address those, rather than giving her even more stress

[~clover~]

I thought more about this last night & came to the conclusion that the way she birthed would be a major reason or the tearing.
They gave her an induction (the drip) for no reason, she was already in labour, then I'm pretty sure she had an epi. She also heomerraged (sp?)
She was in surgery for about 2 hours.
I'll go write her a long pm explaining it all to her.
Thanks guys

[Persephone1]

I've only just seen this. I had third-degree tearing (due to vacuum, on my back in stirrups) and have since been told that there's no reason why I shouldn't have a VB next time. The chances of tearing again are only minimally higher than normal - about 4%, rather than 2-3%. I did have one gynae tell me to "consider c-section" next time but everyone else (doula, GP, physio, Midwife) has said there's no reason to. My sister tore with her DS1 (third-degree), but not at all with DS2.

I think sometimes the hospitals might offer a c-section in such circumstances and for some women this is the path they want to take, particularly if the first birth and healing was traumatic. But statistically there's no real reason to fear tearing again. GL to your friend.

[~clover~]

thanks guys. Pm'ed her, with links to BB info on the main page.
Will let you know what happens, she only has 9 weeks to go I think

[onthefly]

I hope all goes well for your friend

[Little Chicken]

I had a third degree tear with DD2 (my fault apparantly cause she came so fast and I wouldn't stop pushing to slow her down, ah well another story), I actually asked my OB whether I would need a C/S if I had another baby, she said as long as the tear heals properly she couldn't see a reason to have a c/s just because of the tear.

[helle]

I had a third degree tear with DD2 (my fault apparantly cause she came so fast and I wouldn't stop pushing to slow her down, ah well another story), I actually asked my OB whether I would need a C/S if I had another baby, she said as long as the tear heals properly she couldn't see a reason to have a c/s just because of the tear.

I was going to say pushing quick can cause a tear too. I had amazing middies who told me "how to push" so I stretched rather than tore. Short quick pushes and long ones.

Aah, they were such amazing midwives!

[~clover~]

Thats something I pointed out to her. To either stop pushing, or ease up on the pushing as much as you can while crowning.
Turns out there was no epi (dunno why I thought there was). Not sure what position she was in though.

I've invited her to come join herself so she can ask any questions she wants & see for herself there are people who've been there.
(I'm sharing my sanctuary, lol)