Tears During Second/Third/Etc. Births?

[second.time]

When I had my son in 2012, I had an episiotomy that led to a third degree tear. Apparently it was pretty bad because I remember a nurse wincing sympathetically when someone told her the extent of the tears. In retrospect, though, I got off really easily -- I healed thoroughly and smoothly, was able to go off pain meds after just a few days, everything went 100% back to normal within a few months, and I haven't had any lingering complications.

I don't think I realized then how serious third-degree tears are, but now I've read more about them and it scares me for my second birth! I don't know if I'll "get lucky" a second time -- if I tear that badly or worse this time, I'm very concerned it will leave me with permanent issues, or result in a really long, painful recovery time.

My mom had a fourth-degree episiotomy/tear with my big brother and then had five more children (no C-sections) without any further issues or major tearing. She said the other births were totally fine, and we were very large babies too.

If you tore with your first birth, how did your second/third/etc. births go? I have nothing against C-sections, so I'd consider one if it will help avoid major injuries, but I'd also like to try a natural birth if I can.

 

[Twag]

I had an episiotomy with my son (baby #1) and sadly was stitched up funny which left me with quite a large skin tag down there but as was having #2 decided not to get it sorted - anyway baby #2 my daughter I suffered with a 2nd degree internal tear (she came out very quickly) once I was all healed from this I went and spoke to my Dr about getting my large skin tag sorted and I have been fine since

 

[second.time]

I had an episiotomy with my son (baby #1) and sadly was stitched up funny which left me with quite a large skin tag down there but as was having #2 decided not to get it sorted - anyway baby #2 my daughter I suffered with a 2nd degree internal tear (she came out very quickly) once I was all healed from this I went and spoke to my Dr about getting my large skin tag sorted and I have been fine since

Thanks! It's good to know that you were able to get things taken care of, even after some time had passed. I'm glad you're doing well now!

 

[sippy1989]

I had two tears with my son's birth, one was internal but not bad and the other was minor but more up towards the labia. It healed fine in a few weeks with the only real complication being a bit of discomfort when peeing. Now with my daughter's birth I didn't end up tearing at all. She was a full pound heavier than my son and came out much more quickly (7 hours first labour vs 3 hours second - 1 hour of pushing vs 5 mins of pushing). Midwife said first babies really clear the way for future babies so hopefully you will be fine

 

[second.time]

I had two tears with my son's birth, one was internal but not bad and the other was minor but more up towards the labia. It healed fine in a few weeks with the only real complication being a bit of discomfort when peeing. Now with my daughter's birth I didn't end up tearing at all. She was a full pound heavier than my son and came out much more quickly (7 hours first labour vs 3 hours second - 1 hour of pushing vs 5 mins of pushing). Midwife said first babies really clear the way for future babies so hopefully you will be fine

That's SO reassuring to hear! I keep reading that you might be more likely to have a third-degree tear if you've had one already, but then anecdotally a lot of women seem to tear far less in second births. I'm really hoping that's the case for me. I'm definitely going to have a birth plan that says no episiotomies (I worry it was the episiotomy that contributed to my first tear), so fingers crossed. Thanks!

 

[NDH]

What they dont tell you about episiotomies is they are prone to tearing further and are often harder to heal fully. Cutting an episiotomy the skin isn't fully stretched yet, and sometimes muscle can be cut too. If a tear happens it is often to a lesser degree than an episiotomy would be cut and it happens when the skin is stretched super thin. Imagine cutting a piece of cardstock and then tearing a thin piece of paper. Now try matching them back up and taping them together. the cardstock is hard to match back up without a gap, and if you overlap its really noticeably thick. The paper on the other hand has jagged edges that may even be thinner in places and you can overlap them back together without gaps and as thick of a seam.
These are some of the reasons why episiotomies are not best practice and shouldn't be done routinely (they have a place for sure, as in an instrumentally assisted birth) Its frustrating when Drs still do them anyway. You can absolutely insist you not have one again. There are things that can be done to minimise tearing, but even still I would rather tear than be cut.




My own experience is I had a 2nd degree tear with my first requiring about a dozen stitches. I pushed for 2 1/2 hours, following directed pushing instead of following my body's cues. My second I had a minor graze that was not stitched. She was born in 10 minutes of pushing, following my body's cues, kneeling on the bed. My third was born in one mighty, uncontrollable/involuntary push while standing and I didn't even have a graze.

You may tear only a little bit or not at all or you may tear just as bad as previously, but please don't stress about it. Our bodies are amazing at healing.

 

[Eleanor ace]

I suffered a bad tear with my 1st but like you I healed well and suffered no lingering complications. When I was 6 months post partum I had tests done to check everything was functioning as it should (I tore up to my bowel and they checked that was OK, internal sphincter function and ability to hold liquid they pumped into me- proper fun ) and then when I was 20 weeks pregnant with my 2nd LO I met with my consultant to discuss whether I wanted a c-section or to try for a vaginal delivery. I opted for a vaginal delivery and I only sustained small 2nd and 1st degree tears. I was given the option of getting stitches (it would have been only 2 stitches) or going without and I chose not to get stitched and I recovered fine. My 3rd LO I only got a small 1st degree tear with no need for stitches

 

[EverythingXd]

I had an episiotomy with my first, which healed no problems.

With my second, he came out with his arm up on one big push and I got a 3rd degree tear (3b). I have had some minor issues since - day to day I am fine, but I cannot hold liquid rectally so if I get the runs I need to be at a toilet! Luckily it happens rarely and the warning tummy cramps have been enough to save me from any embarrassment so far. Tests showed everything is functioning correctly except my squeeze pressure so I'm hoping it can be improved/fixed with physio.

Now I'm pregnant with third. The rectal consultant recommended I have a caesarean, which is standard for anyone with any ongoing continence issue. I really didn't want to, as I had this idealistic image of having a natural birth and 'getting it right' this time. I was favouring natural birth with 'hands on' approach by midwife (they will push skin together at perineum to try to avoid tearing) and elective episiotomy if necessary (they will direct it away from original scar tissue). I booked caesarean to give myself more time to think about it - my midwife thought I'd made my mind up so then told me there's research both ways on 'hands on' approach and elective episiotomy so some say it doesn't help.

I also read that just giving birth naturally without tearing puts pressure down there that can make any incontinence issues worse. They can also be worsened with menopause. My consultant said there was 20% risk that my issues would be worse from having vaginal birth, a risk I've decided is too much for me.

I have read so many accounts of women having no tears or just a graze from births after a 3/4th degree tear though, and I'm sad that I won't be one of those women.

Now I'm just trying to be positive about the caesarean. Sorry for essay!

 

[second.time]

NDH, thank you! Yes, I was really frustrated at being given an episiotomy. I didn't even know it was happening until after the fact. It wasn't my usual doctor at the delivery, it was someone I'd never met (my doctor was actually in labor herself!), and I worry it was just impatience on the part of the doctor. I want to be much more proactive this time about a birth plan and maybe working with a doula who can speak up for me. I'm grateful that mine healed but I resent that the decision was made for me. And thanks for the comforting words about healing. It's just hard to let go and trust, but I know it will all be OK in the end.

Eleanor, that's great to hear! Very encouraging.

Everything, it sounds like a c-section is a great option for you. I understand your disappointment, but I would probably go the same route. I know a lot of women who have had c-sections and had great experiences and quick recoveries. It sounds like you're in good hands!

 

[PaiytonsMummy]

I had a 3rd degree tear (3c almost 4th degree) with my first daughter.
Was told it was unlikely I'd tear badly again. They were wrong, I had another 3rd degree (3c again) with my second!
I tore in different places each time so I'm like a patchwork quilt down there!
I opted for a section with number 3 and will be having a section again this time.

The worst thing was that with my first I had to go to a hospital out of town as ours was full.
So when I tore they couldn't give me any pain medication because they didn't have my medical records because they never got send over or were lost in transit.
No suppository, no paracetamol. Nothing.
I was sent home 6 hours after surgery and didn't get any strong pain meds until my community midwife came round 36 hours later!
I was young and though it was normal to be in that much pain after labour so I never thought to rung the doctor!

 

[second.time]

I had a 3rd degree tear (3c almost 4th degree) with my first daughter.
Was told it was unlikely I'd tear badly again. They were wrong, I had another 3rd degree (3c again) with my second!
I tore in different places each time so I'm like a patchwork quilt down there!
I opted for a section with number 3 and will be having a section again this time.

The worst thing was that with my first I had to go to a hospital out of town as ours was full.
So when I tore they couldn't give me any pain medication because they didn't have my medical records because they never got send over or were lost in transit.
No suppository, no paracetamol. Nothing.
I was sent home 6 hours after surgery and didn't get any strong pain meds until my community midwife came round 36 hours later!
I was young and though it was normal to be in that much pain after labour so I never thought to rung the doctor!

Oh no, that must have been incredibly painful! I'm so sorry. It sounds like a c-section was a wise choice for you. I talked to a doctor about it yesterday and he seemed to think a c-section wouldn't be necessary after a third degree, only a fourth. But he wasn't my usual doctor and I really want to talk to another doctor about it and get a second opinion.

 

[LoraLoo]

My first I had a couple of internal tears with stitches. 2,3,4,5 and 6 just grazes. Number 7 i tore again but just got away with no stitches.

Im not sure why I tore last time- bAbys head was a smidge bigger and born in her waters (but so were 3 of my others) but I think the midwives werent v encouraging and didn't help me control the pushing either.

 

[second.time]

That's awesome that you had so many births without tearing, LoraLoo! Also gives me hope that maybe this birth won't have as much tearing for me.

 

[Zephram]

I have been thinking about this too lately! I had an emcs with my first and I was determined to have a VBAC with my second, which I achieved, only he turned out to be a forceps delivery which came along with a third degree (3b) tear and an episiotomy. We are going to TTC our third at some point this year and I'm wondering whether to have another VBAC or go for an elective section... I have to say that despite having the tear and the episiotomy my recovery was definitely easier than with the caesarean, so I'm sure another VBAC is probably the way for me. I'm just scared because I have a pretty obvious scar down there and I am worried about having a worse tear next time! I am lucky in that I have healed perfectly from the tear and episiotomy and haven't had any probs with wee or poo, so I don't want to end up having probs if I have another similar tear!

 

[LoveCakes]

With my first I had a second (almost third) degree tear and a few firsts. Recovery was quite sore and she was 8lb10

My son was 9lb11 and I had barely a second degree tear and felt better within a few days.

It was definitely better the second time, plus my labour was faster and easier

 

[Mummafrog]

With my first I had a home water birth and a 2nd degree tear, it was quite a simple one and stitched on my sofa she was 8lb12oz and I pushed her out in under twenty minutes which is quite fast for a first.
This time the only thing I want to change is pushing out more gently/slowly, the midwives who were with me were clearly very 'nature take its course' kind of midwives which I understand but I actually think more direction to slow me down would have been better so this time I'd like to be in the pool again but I'm going to instruct the midwife/birth partners to really slow me down and help me breathe, I think it's far more about doing it slowly than how big baby is that matters.
Of course sometimes bodies don't let you do it slowly so we'll see what happens
Best of luck x

 

[ClairAye]

.

 

[marmoset]

With my first I had a second (almost third) degree tear and a few firsts. Recovery was quite sore and she was 8lb10

My son was 9lb11 and I had barely a second degree tear and felt better within a few days.

It was definitely better the second time, plus my labour was faster and easier

This is so encouraging! I had a partial 3rd degree tear with my first (8 lbs 12) and have been worrying about what might happen in the future with an even bigger baby (DH was about 10 lbs and I'm a small lady!). So I'll keep this in mind for reassurance!!

 

[sil]

With my first baby I had an episiotomy. They did not tell me they were giving me one and just went up and snipped me. I tore as well. I was really upset afterwards when they told me they did one without consulting.

With my second baby, I did not have an episiotomy. I ended up with one minor labial tear and that's it.

 

[second.time]

Thanks for all the stories, everyone! I'm still a little worried about it but not quite as petrified as I was. I'm having more faith lately that I'll be able to avoid a major tear this time.