4th degree tearing

Hi everyone,
5 Weeks ago I gave birth to a beautiful baby girl. After pushing for nearly 2 hours, I had to be prepped for a forceps delivery. During this delivery I had an episiotomy and I also tore. I was later told that I suffered from 4th degree tearing. As far as I can tell my stitches have dissolved but I still can't sit down. I'm using one of those blow up cushions with a hole in the middle but it's still not great. Some days I think it's getting better but others - like today - I think it's getting worse. Today I've experiences sharp pains in the perineum. I have an appt next week at the hospital to have a check up of the perineum.

My questions to all those who also suffered from 4th degree tears:
1. How long did it take for you to recover fully - ie sit down normally and not have to think about which position is best/sit on cushions etc
2. What will the hospital do at my check up?
3. Any tips/hints on a speedier recover?

thanks heaps,

The best thing for tears is a salt bath. I only had a 2nd degree tear but i can remember i couldn't sit properly for about 3 weeks and the pain didn't go away for at least 7 weeks.

Hi, I had a 2nd degree tear and still had alot of pain after my stitches had supposedly healed. At my 6 week check up the GP found that 1 of my stitches was still there and had become infected which was making sitting difficult. I had a course of antibiotics which cleared up the infection. I also had to have a thrush treatment because the bleeding was keeping the area moist and living in Nth Qld that was a problem, lol. I hope you start to feel better soon.

I had a 2nd degree tear with a forcep delivery and I also had alot of trouble sitting for the first 6 weeks, I was actually struggling to walk for about 3 weeks duie to the ache and alot of aching etc for a good few months. My Ob didn't actually check me out at my 6 week checkup, but I had to had proud flesh removed at 3 months.

hi i had a episiotomy and it took about 6-8 weeks to heal, sometimes it still gives me a little discomfort. All i can say is Salt baths and lots of them.

Pelaja - I`m a 4th degree tearer, there doesn`t seem to be too many of us!!!! Anyway like you I had an epi for a forceps delivery but then also tore. I`ve had many problems with infection`s down in that area, it`s now 11 weeks post birth and is only just starting to feel like it might be coming right but I still get moments where I get sharp pains, more so if I`m doing more or carrying heavy items around. Many, many times I`ve felt like I`ll never be the same again but I`m very slowly getting there, it`s just taking it`s time as it`s a HUGE tear.

I`ve been having 3 salt baths a day for about 6 weeks, they are very soothing plus I was told by my SIL to blowdry the area after each bath.

At your check up they`ll take a look to see how well your healing and ask the same old question are you incontinent with your bowel movements :rolleyes:

Have you been told any further births will have to be via c/s? I was told because of having a 4th degree tear all my babies will need to be born via c/s as women with 4th degree tearing will tear straight down there again.

Take Care

Dee

I had an episiotomy and am still healing. It seems the ache comes on alot more for me at night. I cant stand or walk around for too long either before i start to ache. Ive been having salt baths of an afternoon when DH gets home from work, and although it helps alot at the time, the ache still comes back. I havent been able to have my 6 week check up yet as ive had AF for the past week. I guess in a way im glad im no longer breastfeeding as for me Nurofen Plus does wonders but you can take paracetamol if you are. Other than that i dont think theres much else you can do apart from rest as much as you can and stay off your feet. But its probably a good idea to let you GP or the hospital know.. from what ive read its pretty common to still feel aches.

Hi pelaja,

Mine was a strange experience with still no answers. I had a 2nd degree tear which didn't properly heal for 3mths. I had discharge and EXTREME pain particularly when going to the toilet. I had 2 swabs taken with the all clear. I had salt baths to try to help the tear heal. What made the pain disappear was I was in hospital about 3mths after labour with severe abdo pain (I think that turned out to be too much licorice!) and as a precaution the Dr gave me a strong dose of antibiotcs. Days later there was no more discharge and no more pain. All very weird. SO, if it happens again and swabs show nothing, I will be demanding the same antibiotics. Maybe something similar in your case?

Hi Pelaja,

Your poor thing, my heart goes out to you. I had a nasty 3rd degree tear with my little boy (he had really broad shoulders). Glad to say that it does get better, but it is a long road...

My best advice is to rest whenever you can. Get your feet up and don't do too much housework. The aching goes on for many months.

I could sit without too much pain after a couple of months. My midwives advised me against the donut cushions as they only make the blood run to the wound site and make the pain worse. They put me on to the little egg shell cushions. But a nice soft couch worked for me.

I had a couple of courses of antibiotics and I also relied on some strong painkillers (which were safe while breastfeeding), lots of metamucil and panadol for many months afterwards.

Make fibre your friend! I thought having a bowel movement would never be the same, but as long as I stayed soft it was ok. I used to hold a wad of toilet paper against my perineum to help with the pain.

Sex was out of the question for me until about month 7 (yes that was month 7!). It does get better though, I remember crying at night to DH saying I would never be the same again, but I am completely healed now, and expecting number 2 in April.

I don't think you can hope for it too heal any quicker than it wants to. But it will be bearable soon, and you just have to perservere I think. The best thing is time and rest, don't try to do too much!

I wish you all the best in your recovery and hope motherhood is still bringing you joy.

Regards,

Hi,
I recently sustained a 4th degree tear and am trying to find any women who have had a 4th degree and had more babies since. C section seems the most likely option but I want to know what other women have done.
If you could help that would be fantastic.
Thanks

Pelaja: i had a 3rd degree rectal tear which got infected and i also ended up with cystitis and thrush which didnt help, but salt baths were pretty much it. My stitches were removed and it was left to heal by itself, which ended up with skin tags which were then burnt off, but it was a good 12 monthes before i felt "normal" I too was told no donut cushions although cant rememeber why!?
Frankie: i am 33 weeks and scheduled for a CS due to the bad tearing, i have done alot of research as i really didnt want a CS but i did have a few ungoing issues, but the main reason the ob said CS is because my pernium is extremely short and there is a very high chance of tearing throught the rectum again, so i guess all circumstances are abit different.

hun a 4th degree tear is VERY severe, messy and will take a while to heal. I had a 3rd degree tear with my first and from memory it took about a month to heal. Your is worse so give it longer. If you think it's not right go to the doctor. You are supposed to have a 6 week check anyways so mention it then.
GL :)

Hi Pelaja & Frankie :) I'm a 4th degree tearer too! As Deejoy17 said, there aren't that many of us around thankfully.

It took some time to heal fully. After I stopped breastfeeding my first at 22 months I found it healed more. I saw a friend go through a similar experience and I then remembered how awkward and uncomfortable it was initially. I thankfully was stitched up well and suffered no major long term effects so at the follow up check my pelvic floor strength was checked and I was given good pointers on how to improve it as much as possible. I was also given an anal scan to check the muscle strength.

I did DTD at 6 weeks post baby and felt pain at the scar at the entrance to my vagina and that continued for some time. Wasn't painful enough to want to avoid sex but uncomfortable enough to stop me enjoying it properly even with extra lube iykwim?

When I was pregnant with my second my pelvic floor weakened a lot but the area was still tense so I used very soft internal massage to stretch the scar tissue. I didn't go down the CS route and with another anal scan to again check my sphincter muscle I was given the go ahead to birth vaginally again. I did a lot of work emotionally and with visualiation and breathing as well as the massage and confidentally birthed my second sustainng a small 2nd degree tear away from the scar and a slight graze, no episiotomy. I did my research and in the end opted for a homebirth rather than a hospital delivery.

I was very happy with that result. I've been very fortunate. I was advised that I would most likely suffer some form of incontinence after the birth of my second and I did trump for a while without being able to stop myself fully............But thankfully that's settled down now and I have full control over those things!

Best of luck with it all.

Feel free to PM me if you want to chat!

ETA: Scooby I was told that was the reason why the episiotomy tore the first time. The second time around my independent midwife remarked that I had a very short perineum after the birth. So I figure I really do have a short perineum and it wasn't some bull***** excuse used by the Ob to cover his back :).

Sorry i hope im not hijacking the thread, i just found your story so compelling Claire and that is just awesome you went on to have a home birth. Its funny cause when i was researching i could not find anyone with first hand experience and of course there are lots of women who have torn and lots of studies on women who have torn, but none relating to short perineums, so i wasnt sure it was a viable excuse. I have to say though even with all my history, the ob was very happy for me to have a VB, until she examined me, which gave me a little more faith. Unfortuantely my final decision was based on family history, my mum and nana both suffer fecal incontinece which has been put down to the way in which they gave birth, and it is such a debilitating thing.
Your story is definatley one of hope though and i really appreciate you sharing that info with me. Thanks!