VB after 4th degree tear?

Hi all,

Just found out that I may need to have a c-section due to my first birth which resulted in a 3rd to 4th degree tear.

Has anyone had any stories to share? I really don't know what to do.

thanks in advance

No personal experience, but my mum tore "hole to hole" (ouch) and needed surgery for repair and still had two more children vaginally with no further tearing

It might be better to look into ways to avoid tearing this time around than to give yourself and your uterus an even bigger tear.

What were the reasons given for a c/s recommendation exactly? Is the previous tearing healed?

I am not sure actually. I was NOT expecting it, seeing that I am going public this time and thought they really supported VB.

I healed fine and have no issues with controlling my bowels and I told her that too.

The Ob said she will need to talk to my previous ob to find out more and will let me know at the next appointment.

I would also be looking into why you tore and how to prevent that happening again. As in, what (if any) interventions you had that may have contributed, what positions you were in, coached pushing etc.

oh sorry the tearing was from an ventose and DD being big for me.

M2OSB, that sounds like something that might be avoidable this time around with better positioning and good support. Have you thought about hiring a doula or a m/w to support you for this birth? Stats (and personal experience ;)) show that having either will reduce interventions and the need for an assisted delivery. It might also be good to debrief what happened in your last birth and work out how to prepare for this one.

I'm sure if you tell them you would prefer a VB they won't push for a c/s, given you are fully recovered and it's your wish to do so.

I had a 4th degree tear internally, and so I had to have a c-section second time around.

This was very difficult, emotionally for me.

I saw a perineal specialist who reviewed my hospital file from the first birth, interviewed me, had a look, etc, and then gave me a risk assessment for a repeat performance if I attempted a vaginal birth with DS2.

It was a substantial possibility that I would have another 4th degree tear, and so I had to have a c-section.

I think you just have to get the best, most accurate and straightforward information available to you, and then make a choice based on those risks, your desires, and determine what is going to be best for your family, particularly your daughter and your baby.

Would you be immobilised? Would you need a longer hospital stay? More doctors appointments afterwards? Will you be able to get to those appointments? Will you be able to drive? Will you suffer emotionally, or just physically? Will your recovery realistically be about the same as recovering from a c-section anyway? Will you suffer mentally? Might it lead to PND or PTSD? Will the stress of having a c-section be worse than the stress of getting another tear?

I talked through all of these sorts of things with my counsellor and my DH, and got the risk assessment done, and made our decision from all of that ...

HTH.


It's not an easy decision at all. Hugs.

Thank you ladies and thank you Peanutter for your personal account.

I will have to play it by the ear and see what the hossy finds from my ex-ob.

I had 3rd degree after hospital induction, then home water birth with not even a graze. 2nd baby was 500gr bigger.

Many women will have a successful VB after a 3rd or 4th degree tear but it really needs to be a decision made in conjunction with your OB and midwife. Sometimes a CS is recommended to avoid the risk of further trauma which may not heal as well as the first one, and sometimes as a routine recommendation with no thoughts to individual circumstances. I hope you have some clarity one you have your notes from your ex-ob and can make a decision that you are comfortable with.

When I was first pg they asked me to consider a c/s, i didn't have a 4th degree tear tho. I had an episiotomy and then needed surgery cos it didn't really heal properly. I declined and said I'd rather try a vb and see how I went but as i said it wasn't as bad as yours.

Sent from my HTC Incredible S using Tapatalk 2

How are you doing, hun?