Subsequent birth after 3rd degree tear

[NovemberAli]

I'm 12+2 with my 2nd baby, at the booking appointment the midwife referred me to consultant led care due to a 3rd degree tear when I had DD. I was a bit surprised at this as hadn't realised this might impact future births, now reading round it seems that C-section might be advised?

Consultant appt is on Fri, but I was just curious as to other people's experience of birth following 3rd/4th degree tear and if vaginal birth was recommended or not, and, if so, did it go okay 2nd time round?

[LittleMissLucy]

I would see what your consultant says, it doesn't necessarily automatically mean a C-section. Many consultants assist in vaginal births.
Its good that they're talking through the options -
My consultant did a very tidy sewing job on my tear with 2nd Dc. Better than the first one.

[madamecake]

fTry not to worry. I had a third degree teat last time, and this time had a consultant appointment at 20 weeks. In my area it is hospital policy to see a consultant during pregnancy after previous third/fourth degree tears.
I was told that unless I had any issues such as with pain or incontinence I could have a vaginal birth and so was signed back over to midwife led care.
The midwives are aware of the tearing so will try to manage the second stage to minimise any tearing this time (in other words, stop me from pushing so hard and quickly!).

[madamecake]

Tear not teat!

[NovemberAli]

Thanks for the responses, I did heal well afterwards so hopefully all will be okay for VB. i do have a minor bladder prolapse (result of 2.5hrs pushing I suspect) so hoping for a shorter 2nd stage this time . Will see what the consultant says on Fri.

[AmIGoingMad]

Hi!
I had 3rd degree tear on DS and am now 33 wks with dc2. I had consultant appt and expected her to suggest a elcs but she said that as I have no incontinence issues and also had a post partum bleed last time, vaginal birth would be best for me.
I have to admit that I'm pretty terrified this time around but they've said that I'll have senior doc present to lead birth this time to try to avoid recurrence. I'm a little dubious as to whether it'll happen tho!

[learnermummy]

I had a third degree tear with my first (he was back to back and delivered without turning). I had no problems at all with incontinence post birth and it all healed very well.
When pregnant with my second I was automatically referred to a consultant and was told there was no reason I needed a CS as I had no issues from the tear. I went on to have a very fast home birth with just a slight tear along the old scar but didn't require stitching. I was very scared to push baby out though and in the end midwives made me give up the gas and air so I had to just go with the urge!
Am now 35 weeks with number 3 and again was automatically referred to a consultant who basically said 'why are you here?' and referred me back to midwife led care. Hoping for another home birth this time, perhaps just not quite so quick!
Good luck with the birth.

[youaintallthat]

just barging in a bit on this thread but after some advice too- I got a third/forth degree tear with my lo that was really badly repaired, i need further surgery to correct how badly the repair was done but have been told I cannot have this surgery until 'my family is complete' due to the risks. I still have lots of pain more than 12 months on as well other issues....i'm so scared of having another vaginal birth as last time i lost more than half my total blood volume and ended up on a hdu needing blood transfusions and emergency surgery etc. I didn't get to meet my baby until nearly 8 hours after he was born...but it was a completely mismanaged labour and birth with a midwife who didn't even notice my baby was breach until he delivered she also failed to notice his hr was 40 on the monitor hence he became quite distressed and needed a paediatrician at his birth!! it was so mismanaged and traumatic that I half want an elective caesarian next time but as i have a ds at home would kinda like a vaginal birth too so i get to go home afterwards i'm just worried about whether this scar tissue will open up again during delivery and cause me massive bleeding again. I was so ill for so long after my lo ds was born i missed out on the first three weeks completely and i really don't want to risk going through that again. but on the flip side my bm is high so i'm worried about caesarian due to this too....i'm concerned a consultant will try and push me into vaginal birth to meet targets (as this is what happened last time hence all the problems i had) but don't know if its best......

[learnermummy]

Sounds like you had a really hard time youaintallthat. Might be worth seeing if you can get a debrief from the hospital. Consultant wouldn't push you into a CS if you've had so many problems I'm sure.

[NovemberAli]

Thanks all, the consultant said as i didn't have continence issues (well related to my bowels anyway) I should be fine and there is a very low risk of tearing like that again. There will be a senior midwife to assist at delivery and will be a low threshold for episiotomy in order to direct any tear from the scar.