C-section or Vaginal Birth After Severe Tear

I've only had c-sections (one an emergency, the second planned), so I might not be able to give you the kind of feedback you need, but I do want to speak out and say that, in my experience, recovery from c-sections wasn't bad at all. I couldn't drive or pick up my 2 year old for a week, but those were the biggest issues I had (and my mother and husband were there to take care of those things). I didn't even take any pain meds after leaving the hospital.

I can't imagine going through what you went through - what a nightmare! Personally, I would definitely choose a c-section over that. But then, I'm not someone who's hung up on a vaginal birth being the only "right" way to do things, as some people are.

I don't know which to tell you but good luck. I would think that the tear could happen again since it is just scar tissue there now.

While I am definitely not an advocate for elective C-sections (but to each her own), I would definitely opt for one in this case. You suffered terribly after a vaginal birth...why risk the same outcome or worse?

It is possible that the circumstances of your first delivery contributed to the tear- epidurals, pushing on your back, episiotomies, and vaccum or forceps deliveries increase your risk of a serious tear. So if any of those happened you could reduce your risk of a serious tear by avoiding those things.

There is controversy on what is the best management for someone in this situation. I would consider that vaginal delivery does have some health benefits for baby when you think about this- less likely to have body heat, blood sugar, or breathing issues. Of course- a healthy, happy mom is also a contributor to a healthy baby.

I would clarify whether is was a 3rd or 4th degree tear- at least that would make a difference in knowing what the worst possible outcome could be. Then consider another opinion from another OB or midwife outside of your current doctor's practice.

Unfortunately there are no guarantees, you may have a hard c-section recovery and an easy vaginal delivery recovery or vice versa. I hope it is easy whatever you choose!

First off, C/s are NOT 'safer for everyone'. It's a major surgery that shouldn't be taken so lightly. I've had 2 that did go very smoothly, but I think they could've been avoided. I always have wanted a big family and most dr's would prefer you not have more than 3 c/s. Most around here won't even consider a vbac so just keep that in mind. If I were you, I'd really educate yourself and start looking now for a dr that wants the same thing you want. I don't know why your first delivery would affect your second. There are so many things you can do to avoid tearing...your dr should've done a better job with that as well. It really just shouldn't happen. Good luck to you with whatever you decide. I did have a very easy recovery, but there are plenty of drawbacks to a c/s...just start researching now so you are well informed before you make this decision. congrats and enjoy your new little one!

I had a 3+ degree tear with my son (firstborn). I tore back and up into the vagina. Sucked. I didn't have an epidural with him, only a local, but within 5 minutes of having him they rushed me into surgery because I was starting to hemorrage (?) and that's when I had an epidural. I cannot imagine willingly having an epidural to give birth.

That being said, I had my baby girl when my son was 26 month and didn't tear! Not one bit! So yes, it is possible to have another vaginal delivery without tearing. I met and talked to several women that were in the same situation as me, and who didn't tear. All of them had a doctor. I chose a midwife with my second and I think she was determental (sp?) in me not tearing. If you choose to have a vaginal delivery, I suggest you get a VERY good doctor or a midwife. My midwife let me delivery on my side, which I think helped me not tear. Question: why did you tear? Could it have been prevented by your ob? I tore because I pushed too hard (because my ob told me to...) and didn't listen to my body.

That also being said, remember that a C-section is considered major surgery (even the tear repair I had was considered major surgery) and there can be complications, just like with any surgery. No matter what people tell you about it being easy, every person's body is different and if narcotics didn't help with your tear repair, they will most likely not help you with the pain after a c-section. So, either way you go, make sure you are okay with the consequences from said method. The fear is hard, I had it too, but as long as you trust (completely!) whoever you choose (doctor or midwife) then your chances of tearing are diminished. Good luck and congrats!

That is such a tough decision! I too am totally pro natural birth and even I would be hesitant so I can understand your fear. With my first I had nothing and I had a severe 2nd degree tear and I thought that was bad enough! I was sore for 3-4 months down there. With my second, he was over a lb bigger at 8.10 and I still tore but only a 1st degree this time. I was only sore for a few weeks and even with that it was WAY better than my first. I had midwives with my second and think if you do want to try for a vaginal I would HIGHLY recommend getting a midwife instead of an OB. They are trained in natural births (but you can totally get pain meds including epi if you desire!) and I told them my biggest fear was tearing and they were really good about when I was pushing telling me to stop, etc. so you don't tear as bad. I also used Hypnobabies with my second and HIGHLY recommend it because the more relaxed you are (even if you do want the epidural this CD system is amazing imo) the less likely you will be to tear. They even (I believe) have a CD that you can buy separately about not tearing. Anyways, unfortunately there's simply NO way to know how a birth will go. My SIL had a 4th degree with her first and then only a 1st with her second and said it was WAY better. I suggest you really research how tearing happens, how you can prevent it and reduce it from happening (see if any of those methods were used in your first delivery) and look into switching to a midwife if you want to try vaginal OR really interegate your OB about what she is willing to do to prevent you from tearing (the problem with OBs is that even though they may know how to prevent/reduce it, they usually only come in at the last minute anyways, this is why I recommend midwives). Good luck on making this super tough decision! Just remember EVERY birth is TOTALLY different, this birth WILL be different than your first, I think everyone will tell you that so try not to focus on "it will be the same" if you can, I know that's hard to do! Good luck with whatever you decide!

I am so sorry for your dreadful experience, but take heart; there is HOPE! I had a 4th degree episiotomy with my first child. There were not immediate complications but the good news is that I went on to have 2 totally natural births without ANY TEARS!!

Did your first birth include an epidural where you were unable to move about? That was me at my first birth. The other births were medication free with midwives attending instead of an OB. These experiences were much more enjoyable and recovery afterwards was MINIMAL! Please give me a call. I would love to share my experience with you more fully. My first child is now 29 years old. Since then I became a Childbirth Educator with the Bradley Method® (I also used this method with my second and third births) and I am a birth doula. I know I can help you!!

K. Voigtsberger
____@____.com

I too experience horrid tearing with my second he had shouldier dystocia and I had no pain meds, needless to say I didn't go by there advice and take it easy on the pushing because I knew once the baby was out I would feel better. They spent over an hour stitching me up and well it is not the same down there. It took me over a year to fully heal from the ordeal, And a little longer to get over the itching feeling. Now close to delivery with my third there is no way I would opt for a c-section my midwife assures me that we can prepare the area better this time around.

I have a friend who had a 4th degree tear during her first delivery and opted for a c-section with her second child 16 months later. She said there is no comparison in the recovery ... hands down, c-section was soooo much easier. She would do it over it again without a second thought. Good luck with whatever you decide!

I have had both a 3rd almost 4th degree tear and a c-section. I would choose the tear any time over the c-section. I have delivered 3 children. The first was a c-section. The 2nd was a VBAC with a horrible OB that tore me horrible with handling of the pushing stage and a shoulder dystocia. I tore so badly. My 3rd was also a VBAC but the doctor was so much better. He handled the pushing stage so much better and even though it was my hardest physical delivery so far it was by far the easiest to recover from. I had a 2nd degree tear that was just barely a 2nd degree and it has healed up very nicely. My 3rd child also had a should dystocia and was larger than my 2nd child. He was 8lbs 11oz at birth. Every birth is different. I would suggest not allowing them to do an episiotimy as they are known to actually cause larger tears than would have happened naturally.

Hi D. I TOTALLY know where you are coming from...with my first I had a 4th degree tear and it was the worst experience ever!!! I had a second child 21 months later and was terrified that I would have that same problem. However that delivery went MUCH smoother and I only got a 2nd degree tear. I was not at all sore after my second...my doctor told me that he had never seen a back to back 4th degree tear, but he was very sympathetic as well and let me have her 2 weeks early. I am now pregnant with my third and am not near as scared. I have had several friends that have had c-sections and they didn't like the fact that they couldn't pick up their first child and were afraid that the child would take it the wrong way. Good luck and sounds like it is good you switched OB's! I would like to add also that I believe I tore so bad because of the nurse they had with me at the hospital...she made me push hard...2 hours of HARD pushing and my OB was not a happy camper when he got there and realized what was happening...he stitched me for 45 minutes...with my second he was there earlier on and made me stop pushing at one point so that I wouldn't tear anymore...so honestly I think and blame the nurse for pushing me so hard to push!

D., I too had a serious 4th degree tear on my first delivery and had the same pain, incontenence etc.. as you did. I prefer NO medication so I was practicing lamaze long after my delivery because I wanted to nurse and was nuerotic about drugs. I waited 3 years before I got pregnant again and had that baby natural without madication. Let me say that I was a whopping 263 lbs at the delivery of my second with NO MEDS! SO painful but NO tear! Because I did my Kegle exercises throughout the pregnancy I made sure THAT muscle was as ready as I was. I had a third pregnancy and because they were twins I delivered a 6.5 lb baby and the other child did not survive. Still no ceasarian. I was very frightened because all three births were high risk pregnancies and all big babies. 8.7lb 7.15 lb 6.5lb as you see they became smaller. I guessed it was because I was more careful what I ate. I don't know if this is helpful at all but felt you needed as much support from both perspectives as you can get. Don't be pushed into anything one way or the other. It is Your pregnancy and Your comfort. Good LUck! Just an added note, I too used a midwife my 1st time but an OB the 2nd and 3rd but was glad I had more experience because my ob's insisted that I wasn't in labor the 2nd and wouldn't acknowledge the twin in the third until they delivered it! I also listened to Sade cds while giving birth the 2nd and 3rd.

With my first child, the epidural didn't work, I had tearing, and then her cord was doubled around her neck, so it took some work to get her breathing. After THAT experience, I was afraid to have another if I couldn't get a c-section! For me, the recovery from the c-section was WAY easier than from vaginal. The first 48 hours were rough but for me, the rest was much easier. After the first delivery, it was literally months before I could sit comfortably on the floor or stand for any length of time without pain. That did not happen w the c-section. BUT, of course, you have to figure in the scare and risk factors of abdominal surgery, too. :(. Good luck.

Hello,

I had a 4 degree tear with my 1st baby. He was 10 lbs. I was in SOOOO much pain for weeks.. just urinating was excruiciating. I decided have a C-Section with my 2nd child because of the scar tissue from the tearing, and the fact i have such big babies. I was SOOO glad I did. A few friends scared me talking about their recovery time with a C-Section, but my recovery time was much quicker than with the tear. Of course when you have major stomach surgery, there is a lot of pain, but for me, the pain only lasted several days, and it was so nice to be able to go to the bathroom without crying.

I also had 14 hrs of labor with my 1st.. so going in for a scheduled C-Section was much easier on me mentally and physically too.

Best of Luck!

My first baby was a C Sec, he was 8'9" and I was so glad he was C sec. I never dilated past a 1/2. Then when #2 came along, my doctor gave me the choice and I said if I could have a 5 lb baby girl I'd try and he laughed and said he couldnt guarantee that I said, get out your calendar. She was born by C Sec 15 yrs ago tomorrow. Do not be afraid of a C Sec. I claim to be the C Sec Queen. I feared going thru what you did. Im short. Yes, it hurts but I"m sure nothing compared to what you went thru when you tore. The nice thing is since you have one child already, you will know when #2 will come and you can plan. No suprises. I liked that. Had family to help w/ #1, prepared before handhand for so many things, got up showered, put on makeup and went and had a baby. My things were packed, no surprises. But that is just my personality. If you want to email me at ____@____.com we can chat and xchange phone #'s.....I"m in Dallas and happy to visit with you.

With my first baby I had 3rd degree tears but my doctor did a really great job that I really had no pain but with my daughter who is now 3 I had a tougher time I had another episiotomy and ended up with a huge hematoma that the nurses kept saying was hemorrhoids and then the nurses at my doctors office kept saying was a bladder infection till I demanded that my doctor check me and look at what he found so really I don't know who to blame but any ways It it still sore every once in a while and having sex is still uncomfortable at times. Therefore right after I had her I made my husband get fixed for fear that I would have another baby and have to go through this again. So I would look more into getting a c-section and since you are early enough you can research it more. Good luck and God Bless!!

Hi,

Sorry to hear about your experience. I had a 4th degree tear with my first son. I did not have all the complications you did though. I went on to have 2 more boys and had them both vaginally. Each one of the next two boys got progressively bigger also. I did not have any trouble with their deliveries. No unusual amount of tearing. I understand your fears, and I think you just need to do what you feel most comfortable with. Best wishes!

With my first I tore horribly I don't know the degree. Recovery was horrible. With my son, he was even bigger than my daughter, we had to have an emergency C- section cause he got stuck. But anyway, the recovery from the C section was so much faster and easier than the vaginal delivery recovery.

D.,

First, I just want to say I can't imagine what you must have gone through! That must have been the most terrifying experience, and especially trying to adjust to life with a newborn...

That said, I had an emergency C-section with my first pregnancy (Emma is 3 years old), and was so devastated because it was not in my birth "plan." :) I struggled a lot with feeling like I'd been robbed of the birth experience, and thought that any trouble with nursing etc. was because of the surgery. The only complication I suffered was an allergy to the pain medication that we couldn't figure out, so I had an itchy rash all over my entire body for almost 2 weeks after Emma was born; while recovering from surgery...

HOWEVER...

None of that even comes CLOSE to what you experienced. I will say that I am attempting a Vaginal Birth this time (I'm 27 weeks pregnant with our 2nd little girl); but not because I was so horrified by the C-section experience. All said and done, it really wasn't that bad. I think the worst part for me was just the disappointment of things not going the way I expected them to - I put a lot of weight on that as a first time mom, and know now that you can't do that. :)

The recovery was a little painful, but I had medicine (after we figured out what was causing my rash), and a supportive husband/family/friends, and I got through it. Also, I was under the impression that I would be completely out-of-commission for at least 2 weeks... I was up and around after only a couple days. Yes, I did have to take it easy, and there were times my body would hate me for doing too much, but after a few weeks I was completely fine.

I would say that the C-section recovery is WORLDS easier than what you went through with your delivery. I have not done it the other way, yet, so I can't give you the other point of view, but I think if I were in your shoes, I would go for the C-section.

It just seems like since you already have scar tissue that has torn, it would be a risk for that to happen again.

I understand your fears, and I pray that you would have peace about whatever decision you make with your doctor and family. You can do this!

S.

Hey D.,

I had a similar experience with my vaginal birth and went with a scheduled c-section with my next one. It was SO MUCH EASIER. I could concentrate on my baby instead of on my pain. You will still have a baby, either way and c-sections (given your previous experience especially) are safer and easier on everyone.

Good luck and congratulations on your new addition!!! :)
M.

I did not tear with my first but I delivered a 10 lb baby and my OB had to cut me to get him out. It hurt for 8-9 months after that. When I had my second I opted for a csection and was SO glad I did! I would rather have pain in my tummy area than down there. My biggest advice after a csection is to get up and walk and get moving. My recovery was much better the second time around.

Did they do an episiotomy? Will they offer that? Just because you tore once doesn't mean you will again. Actually the healed area will be stronger now that it was to begin with.

A C section is no walk in the park. I've done it both ways. It's Major, abdominal surgery and there is a much greater risks to you and your baby. It's saddens me that Dr's just offer them at the drop of a hat. They should be reserved for only the most special of cases and true emergencies. Yours may be one of those special cases.

Your situation sounds awful and I can't even imagine. I would a little leery of having a normal delivery again.

My C section was a more difficult recovery than my normal delivery. It was painful and I was sore for a while. I still have not regained feeling near the scar site and it itches all the time, and it's been nearly 4 years. It wasn't the end of the world though. I was still able to nurse immediately, and my husband was very helpful.

You will have to decide what you think is best for you and your body/baby. I wish you all the best.

i had 2 3rd degree tears with my first. I needed a lot of stiches and i lost a lot of blood. My doctor also gave me an episiotomy which doesn't prevent you from tearing as much as it helps you tear in the right direction instead of through your rectum. I didn't have all of the complications you listed but my 2nd child was born vaginally and was a breeze. (this child was bigger too) i was concerned also about having a 2nd child and the tearing. ( i am not a very big person) but it was so easy. i am currently pregnant with number 3 and i am expecting another easy delivery. i would take into consideration how many years it has been since your first baby. I have heard that if it has been within 3 years deliveries go much easier. Good luck.

Your doctor should not have let you tear! When my doctor saw that I might tear, he cut me instead. Not only does a clean cut heal better but he is able to control where the cut is. Please ask your OB about this.
God bless you!

Right! It is called an episiotmy. Not exactly a new technique. Mine was done 55 yrs. ago. 2 friends had babies about the same time and they were sitting on pillows and rings for weeks and were amazed that I could sit anywhere I wanted

Well, I had a 4th degree episiodomy with my first child. My experience was not as bad as yours but was painful. My son's head was HUGE...and still is... My second child was born vaginally and I had NO problems. I had a little tear and no problems. I think my body was adjusted to birthing baby and recovered a lot faster the second time. Congrats and good luck.