Unfortunately I had a fourth degree tear with the delivery of my first child 17 months ago. I believe that this was as a result of an inconsiderate OB who rushed the delivery (it was 10pm on Boxing day when the OB came to see me and I think that he just wanted to go home!). I was a private patient and my appointed OB was not rostered to work that day so I had his colleague instead unfortunately. Without going into too much detail, I had an epidural, after which the OB came to see me for the first time and assessed that I was 8cm dilated, that the baby appeared to be in a posterior position (face up rather than face down). The OB decided then to perform an episiotomy (without telling me!) and then instructed me that I would need to start pushing (I was only 8cm dilated but didnt question the OBs actions feeling that surely he must know what he is doing). Then without even letting me push naturally on my own, the OB decided to use the ventouse vacuum to try to extract the baby which was unsuccessful on first push, then the OB immediately decided to use forceps and pulled the baby out while at the same time rotating the babys body which resulted in me sustaining a fourth degree tear! I had a tough time dealing with this not only was I in excruciating pain for weeks afterwards, I felt very angry that I sustained a fourth degree tear which could have been avoided. There was no reason provided by the OB for the use of forceps/vacuum which I believe caused the tearing and the fact that my body was probably not ready to push (the baby came out after 10mins of pushing/pulling). As a result of the tear I experienced gas incontinence and after 3 months went to see a physiotherapist at the hospital who helped over several weeks with pelvic floor exercises and fortunately that helped overcome the gas incontinence. I also found I needed to wear a pad when doing high impact exercise (bootcamp) due to some urinary leakages. Anyway, I am now 14 weeks pregnant with baby number 2 and have had opposing views on whether I need to have a C-section this time around. My new OB will support whatever decision I make. Whilst I would love to have a better vaginal birth experience I am scared of tearing again and its repercussions. Any advice would be appreciated.