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I would dearly love to birth my next baby as nature intended. And I do not fear my uterus exploding in the process, but what I do fear is sustaining a severe 3rd or 4th degree tear to my perineum. What if this occured and caused a somewhat debilitating recovery? What if I needed surgery to repair it and was seperated from my baby after birth? What are the chances of this happening?
I would love to hear your thoughts. . .
Hi there,
a 3rd or 4th degree tear is about as uncommon as a uterine rupture. There are many things you can do to try to prevent tears. But maybe what would be helpful is for you to explore your fears. What would happen if you had a debilitating recovery? What would it mean if you needed surgery to repair it? What would happen if you were separed from your baby? What does all this mean to you?
And then, look at ways of preventing tears, working with your body, and getting good support for this birth.
Melissa.
Hi Melissa, thankyou for your reply. I wasn't aware that 3rd & 4th degree tears are so uncommon actually. That is good to know. My nan sustained a 4th degree tear when she delivered my father. Mind you, the midwife had left the room just before he was born so my nan delivered him all on her own.
I think my main issue is the fear of being seperated from bub after the birth. Because with my CS having to be under a GA (failed epidural) I found all that hard to deal with and I felt that I missed out on so much. I actually bought an epiNO while I was pregnant with DD (the fear of tears has always been there) but in the end didn't need to use it because I ended up having to have an elective CS due to PE.
Hi Spice. I was terrified of tearing when I was pg with DD.
But during the birth, it was honestly the last thing on my mind. I did sustain a 2nd degree tear (an average sized one) but I believe that's because I was semi-reclining and my pelvis wasn't able to open up fully.
I had lots of lovely cuddles with DD before they even talked about patching me up. And I could've kept holding her while getting the stitches if I wanted, but I chose to let DH have his cuddles then as I thought that'd be more comfy for all of us.
The tear healed well and quickly, the stitching was pain-free and a relatively quick process.
I do understand your fears, and I think it'd be a great idea to talk things over with your care provider once you have fallen pregnant and are planning your birth.
Hi Spice!
I had a VBAC2C on Tuesday (2 days ago) and I actually endured your worst fear (3rd degree tear which went thru to my rectum and had to be surgically repaired.) This is a very rare thing to happen and I will be posting my story shortly so feel free to have a read. I was actually given an episiomotomy (my baby's heartrate actually stoped for a min so it was an emergency) I was so determined to get him out fast I pushed so hard I tore the muscle around my rectum. After a drug free labor I was given a spinal so the damage could be repaired. I know it sounds aweful but I was handed my baby (onto my chest) as soon as he was born cord and eveything still attached he was wet and slimy and looking in my eyes. My hubby cut the cord then I delivered the placenta and sat up. As soon as I was sitting they gave me a spinal and I feed him while my ob stitched me up. He did not leave my side once. They didn't take me to theatre and I was actually quite sick. (I lost lots of blood and went into shock and needed a blood transfusion). I hope this isn't freaking you out. I am actually so happy and proud and would do it all exactly the same again. Although we had problems and it wasn't the gentle slow entrence into the world I wanted I still held him. I fed him. I changed his first nappy. I saw the placenta. My hubby cut the cord. I pushed him out my vagina. It was amazing! And although I will be on antibiotics for three weeks I am only taking panadol and sitting on the computer at home 48hrs later! I would encorage you to find a good OB! Interview a few ask them what they would do. WOuld they take you to surgery or stitch you up in recovery? Find someone you trust and look at hiring a private midwife (we did this and althogh it cost a bit she was worth every cent!!!) I guess what I'm trying to say is that I experienced what you fear and I would rather it 100 times over another c/section! If you have any questions or comments feel free to pm me! :)
Jules
Hi spice... I am another one who was absolutely terrified of tearing, and episiotomy for that matter.... My birth turned out well in that I delivered her without any tearing or even a graze! The midwife wanted to do an episiotomy but I said no, and the OB clearly didn't think it was necessary cause he never even mentioned it. But I was separated from my DD because she wasn't breathing when she was born. She was laid on my chest as soon as she came out, they cut the cord and took her to the resuscitaire. She was there for 20 mins or more, then they just placed her on me in a blanket for a few seconds, the Bear took a photo and they took her to the SCN. I didn't get to hold her again until the following evening. It was weird, but then the whole thing was weird. It wasn't till I took her from special care 2 days later and could bath her, feed her, hold her that she really felt like my baby. I guess it's a bit sad that we didn't get to enjoy that time together but TBH I was just so glad she was OK and I knew she was in the best possible hands. HTH.
Well, firstly i would say that's a VB fear, rather than a VBAC fear, since you had it before your CS anyway :)
It's totally normal to worry about it hun. I know i did. Not so much about repairs etc., but more about the pain and so on, and having to have stitches there. In the end i got a 2nd degree tear, in that it was into the muscle, but i have a very short perineum, so it was actually only about 1cm and i decided not to have it stitched. It wasn't bleeding badly or anything, my midwife had left me a homeopathic gel to put on after birth and with that it never stung. Within 4 days i couldn't really feel it anymore, it'd healed within a week or so, and i never suffer pain during DTD or anything on the scar.
As Melissa says, 3rd and 4th degree tears are VERY rare and there are lots of ways to avoid them. Slowness of delivery and position make the biggest difference, but there are lots of other things that can help. Learning to fully relax the pelvic floor can be so so helpful too.
Ultimately it's useful to remember that a fair proportion of women have some injury to the perineum during birth. It's common in many mammals. It doesn't happen to everyone or everytime and it's rarely very severe, but it happens enough that we can consider it a normal part of birth and no something to worry about. I can honestly say i didn't feel my tear at ALL, at the time or later. I saw it, with a mirror, a few days after birth and it looked very perplexing, but not terribly bad or anything.
On another site which is even more "natural" than this one i know a woman who had a 3rd degree tear from her unassisted birth. The only treatment plan was that she kept her knees together for 10 days after birth and it has healed beautifully without a stitch.
Bx
Hey Spice!! :D
I got a 3rd degree internal tear (unlucky for me :( ) as I believe I pushed real hard at one stage when I wasn't meant to!! That, and she was crowning for a long time. and I was stitched up within 20mins of the birth however still had my baby girl on my chest the whole time.
Only annoying thing was that it distracted me from bonding with her in that first hour as I was distracted from the needles and pain it took to stitch me up!! It hurt but no worse than the pain of the tear :lol:
Good luck you can do it honey ! If you ask me, even if you do tear, it's worth the pain of experiencing a natural birth ;)
You may have seen it but JuJu Sundin's book Birth Skills is great for the crowning phase of labour, it will really help you with visualisations and techniques to help you avoid tearing.
Hi everyone. Thankyou so much for taking the time to reply and to share your own words or wisdom and experiences. It has certainly alleviated my fears somewhat.
Oh and Jules, congrats on your VBA2C. It was very comforting to hear you'd rather another VB with a 3rd degree tear over another CS.
For the most part, I consider myself to have been extremely lucky. 5 VBs and I like to think of it as no stitches at all. With my first I had a teeny tiny little hole which they fussed over for ages, not because it was long (less than a cm) but because it was deep. There are standing there trying to talk me into stitching just in case (needle phobe, haha) when my mum piped up and asked "Does it actually need a stitch?" They both stopped, looked at each other and there was like 30 seconds silence. Mum went on "Thats a no, then. Leave her alone". I can't express how wonderful that support was! Especially being 17 at the time.
But I've never had anything more than common "grazing" since then. The key to it though - don't let them rush you (unless absolutely necessary). Make sure you have an ob that is willing to give your body the time it needs to do what it CAN do.
I have heard that massaging olive oil into your perineum can help prevent tearing. :dunno: Its worth a try.:pray:
I would recommend the pink kit if you're really worried about tearing. It teaches you internal massage so you can stretch the perineum prior to labour (from about 34 wks onwards). I was a bit slack with it though even though I was PARANOID about tearing. So much so that I wasn't really able to push (with all I had) in labour until I could get over that fear. My midwife massaged oil into my perineum while I was pushing and she encouraged me a lot.
I had a graze and some bruising, but no tearing!!