10lb8 baby, 4th degree tear...BIG delivery decision!!!!

[ONE.OF.MY.OWN]

I had my son in 2011 and he was a big baby weighing 10lb8.5oz. He was delivered naturally but via forceps and I suffered a fourth degree tear and needed blood transfusion etc. There was no given reason for him being so large, no diabetes etc. I was stitched and healed quickly and have not suffered since.
The midwives at the time, urged me that should I have another baby, I should definately have a section due to the trauma I suffered. This view was echoed by the consultant when I went for my 6mth check. He said that I had healed so well, and the stitches had been so neat, there could be no guarantee that if I was to tear again, that this could be done. He too suggested a section for future babies.

I am now pregnant again and the choice of how to deliver is mine. I'm provisionally booked in for a section but the consultant (a different one) said that the background advice, would be natural delivery! I have of course been terrified by the prospect of tearing again, but would really like to avoid a section if possible. I will have a growth scan at 34 weeks and can decide after then. If it's predicted big again I'm more than likely gonna go with section, but if it's average....I'm so tempted to try for a natural delivery.

Anyone any experience of a natural delivery after 3rd / 4th degree tear? Is it virtually a given that I'll tear again in the same spot. I'm so undecided, a section could be the sensible option but it's obviously major surgery.


Thanks for reading.

 

[MrsM254]

Hi,

I don't have any advice to offer I'm afraid but I'm struggling with the decision myself! My son was born Oct 2012, only 7lb 14 but I had a 3rd degree tear. I also healed well but was told at the time that if the same happened with future babies there would be a high risk of some level of incontinence as a result, this is what terrifies me most as I already have to be careful with coughing or sneezing! I'm only 13 weeks and haven't seen the consultant yet but spoken to the midwife who said the chance of tearing again is much lower but obviously can't be guaranteed that I won't! I'm similar to you in that I don't really want a section as major surgery and I'm worried about the recovery time but I'm also terrified of being incontinent at 28!!

Will be really interested to read responses from people who have been through it, how far along are you?

 

[Becki_k1]

My daughter was born nov last year same as you big baby 9lb8 tear, haemorrhage and blood transfusions etc absolutely awful experience no reason why was just one of those things. Found myself pregnant after 8 weeks at 34 weeks was measuring 7 weeks ahead growth scan determined another big baby so induction was booked. Consultant against c section as higher risk if haemorrhage than natural. My little girl arrived on Monday at 38 weeks she came out in 2 pushes after 1 hour of labour and weighed 11lb 2oz I didn't even graze she flew out on gas and air alone!!!

I like you was petrified of history repeating itself but honestly I can't believe how easy it was and how amazing I feel after I'm up and about 4 days later at the shops etc. I hope my experience can help you in some way x

 

[ONE.OF.MY.OWN]

My daughter was born nov last year same as you big baby 9lb8 tear, haemorrhage and blood transfusions etc absolutely awful experience no reason why was just one of those things. Found myself pregnant after 8 weeks at 34 weeks was measuring 7 weeks ahead growth scan determined another big baby so induction was booked. Consultant against c section as higher risk if haemorrhage than natural. My little girl arrived on Monday at 38 weeks she came out in 2 pushes after 1 hour of labour and weighed 11lb 2oz I didn't even graze she flew out on gas and air alone!!!

I like you was petrified of history repeating itself but honestly I can't believe how easy it was and how amazing I feel after I'm up and about 4 days later at the shops etc. I hope my experience can help you in some way x

Aw well done that's amazing! I would love a story like this! Congrats on your beautiful big baby!

Did you know she was going to be so large...icant imagine attempting a natural birth after bad tear in the knowledge baby was so big!

I'm unsure if I would even be given the option of being induced any earlier but I suppose it's something I can ask after my 34 week scan. Sounds more appealing than a section...I'm just so wanting to avoid the surgery and prolonged recovery associated.

I'm 21 weeks at the moment.

 

[ONE.OF.MY.OWN]

Hi,

I don't have any advice to offer I'm afraid but I'm struggling with the decision myself! My son was born Oct 2012, only 7lb 14 but I had a 3rd degree tear. I also healed well but was told at the time that if the same happened with future babies there would be a high risk of some level of incontinence as a result, this is what terrifies me most as I already have to be careful with coughing or sneezing! I'm only 13 weeks and haven't seen the consultant yet but spoken to the midwife who said the chance of tearing again is much lower but obviously can't be guaranteed that I won't! I'm similar to you in that I don't really want a section as major surgery and I'm worried about the recovery time but I'm also terrified of being incontinent at 28!!


Will be really interested to read responses from people who have been through it, how far along are you?

I'm 21 weeks. Why does the midwife think the risk of tearing is lower....I'd kind of think it would just re-tear in the same spot!!!! Really hope not. Xx

 

[roomaloo]

I think it's because your body has been 'stretched' before so is more prepared. Also scar tissue stretches quite nicely. I had a natural home birth a few weeks ago after a 3rd degree in previous birth. I only tore about 1cm along my scar (though after the mw did say she was worried it was going to go again!)

 

[MrsM254]

I was thinking the same as you, the tear is already a weak spot so surely more likely to tear again. A friend of mine had a bad tear first time and second time they cut her so it was a straight cut which they could repair, apparently if it had torn again it would be a jagged cut and much harder to repair a second time.

But the midwife did say you generally have a much lower risk of tearing with second and subsequent births as you're already stretched which does make sense too. Apparently cases where a woman has suffered a 3rd/4th degree tear twice are very rare but I've not looked into it myself so don't know if that's true or not.

Congratulations Becki_k1 that's an awesome birth story, comforting to hear things can be completely different 2nd time!

 

[ONE.OF.MY.OWN]

Thanks everyone, It's reassuring to be told scar tissue can stretch quite well. I'll update this thread when I've been for my growth scan at 34 weeks and would be grateful of more similar words of advice or stories regarding my situation, good or bad x

 

[Eleanor ace]

Hiya, I had a 3rd/4th degree tear with my DS (the surgeon who stitched me said it was a 3rd degree but when I had my 6 month check they classified it as a 4th degree ). He wasn't that big, 9lb 15, but I'm pretty small and have a narrow pelvis. I was encouraged to have a section by my consultant but when I opted to try another vaginal delivery I was OK'ed and given advice on how to avoid another bad tear. Basically don't labour/push on my back (unavoidable with my 1st as I had to be on my back for monitoring), labour in water if possible, keep mobile and push slowly to give my scar tissue a chance to stretch. I had a great labour and got a little 1st degree tear over my scar tissue tiny 2nd degree tear which I didn't have stitched. I probably wouldn't even have torn if but DD got her shoulder stuck so I just pushed hard to get her out.
Oh also my DD was 8lbs, almost 2lbs lighter than my 1st .

 

[eulmh82]

My friend is struggling with this decision. I just remember how much pain she was in after the birth. She lost the use of get bladder etc. personally id go for a c section. You've three children to care for. You were lucky to have such a neat tear last time

 

[Whitesoxfan41]

I had a 4th degree tear with my first, she was 9lbs 8oz with a 16 1/2" head, hemorrhage and a million stitches. It was pretty traumatic all around.

My 2nd I was induced at 9:00am and she was born at 10:37am! She was 8lbs 3oz and I pushed twice, I didn't have medications. I did have a small nick, 2 stitches.

My 3rd was early, 34+ weeks, 6lbs 8oz. . .induced because my water had broken, 1 push. No tears.

I would definitely give it a try, you never know!

 

[CountryMomma]

I had a 3rd degree tear with my first, he wasn't overly big at 8lbs 1oz but I was in labor for 36 hours and it was my first so I think my body just gave up and tried to push him out as fast as possible. Had my second 2 years later and no tearing at all, not even a nick. He was a bit smaller at 7lbs 7oz but he came fast and furious.

 

[josephine3]

I had a 3rd degree tear with my first too. I had internal tear but not external but they had to cut me to get to the inside to repair i had to have spinal for repair work too. Also had heamorrage and blood transfusion. I kno i will be offered a c-section but i really dont want one, its such a hard decision tho. I passed out a few times after the birth which was really scary for me. I thought i was dying.

im hoping that because my second wil be close to my first baby that i will already be 'stretched' so to speak so wont tear as bad... Sigh.. I just dont kno.

 

[liz1985]

I had a 3rd degree tear with ds. Not exactly sure why, he waa only 7.7 so not big, but he was back to back so may have been why. I healed really well, although my pelvic floor is a lot weaker now. I was offered a section. I have to give my final decision at 37 weeks but im 99% sure im going for a natural delivery. It took a very long time to make the decision and tbh I still worry I should go for the section. Im going to do everything I can to avoid tearing, rlt, perineul massage, hopfully having a water birth and not giving birth lying down.

My friend had a 4th degree tear and they told her if she got pregnant within 2 years they recomend a section, but after that a natural delivery as she had healed well.

All doctors/consultants seem to give different advice, it would be so much easier if there were a black or white answer. Do your research and go with your gut.

 

[shinona]

My son was 10lbs 14oz and born in theatre by foreceps. I tore and had an episiotomy. I was worried like you in second pregnancy but my mw said in her experience girls who had foreceps or ventouse first time tended to birth their second without any help at all. She was spot on. Gas and air and about 3 pushes saw my beautiful daughter arrive weighing 9lbs 3.5oz. I did tear as it was so fast but I was stitched with only a local anaethstetic and it's healed brilliantly. Much much easier recovery. Xx

 

[snowfia]

I'd definitely give it a go if I were you!

I had a 3rd degree tear with DD and she was 7lb 8oz. I wasn't expecting a big baby second time around and ended up with a 10lb 14oz boy but escaped with just a graze and no stitches! I put a lot of it down to being in the water.

 

[bassdesire]

I only had a second tear, but I did tear exact
The same second time around. Babies were 7.4 and 8.

 

[goddess25]

I had 3rd borderline 4th tear with my DS.also forceps delivery. C section was never discussed with me. I have had 2 babies since then, I did tear again both times in the same spot but only 1st degree this time and both babies were out so fast. it was wonderful to only have 1st degree I expected the worst and it was fab.

 

[Sweedot]

I researched this myself before my second delivery. I had a third degree tear with my first baby, she was a tiddly thing, just 6lb but I pushed for well over an hour and she was dragged out to avoid a crash c section and the tearing was bad. I had 34 stitches and it took months to heal because internal tissue was still protruding through the healed scar for months and it was very painful. I was not offered the option of a c section the second time and honestly, I never really considered it, but I had read some horror stories of women suffering terrible incontinence due to third and FTP degree tears, some for years...and it did scare me.

I tried to prepare my perineum better this time around, utilising massage techniques, and using evening primrose oil as a lubricant. I believe it did hell, I tore again this time, but it was a second degree and required much less stitches. It's sore, but bearable...and I got my natural delivery.

 

[kaths101]

Difficult decision but I would say try for the natural birth, my first was 7lb 8 and my second 10lb 11oz, I had him in water and only had a few stitches, I think if you can keep calm, maybe have a water birth and as it's your second it may go differently.

Good luck x