C-section or natural after 3rd degree tear?

[Anonymous]

Anonymous wrote:

Anonymous wrote:I'm not the pp you refer to. Your friend's story sounds terrible.

I note that in the posts above there are many examples of trauma. There is a link to a book on traumatic birth. There are many support groups on line with thousands of women who have experienced traumatic births. Please understand that we who have experienced them are trying to warn women that they are more common than we would all like to think so that they can make informed birth choices, and do thigns to prepare, like see a pelvic floor PT and have frank talks with doctors, get a late-term u/s, etc.

Misplaced anger on the part of the PP? I would not say so. Again, people with injuries in this string have made it very clear how this has affected them. It's hard. You need to respect that. It sounds as if you did for your friend.

We are tired of being marginalized. And would like to see a little more sisterhood, frankly. Because this is something that affects many more people than any of us would like to think.

All of the deep sexism in our society that the #metoo movement rises up against plays into these problems. Why is it that in 2017, we can't figure out how the nerves and muscles of the pelvic floor work, and how to protect them? Why is it shrouded in mystery? Why can I get a hamstring avulsion fixed, but not a levator avulsion? A muscle is a muscle, a tendon is a tendon. Why is it that when I went for my follow up visit and told my provider that I had no labia on my right side anymore (the least of my worries, but one more example of being mutilated), I just got a shrug back. Like this part of my body did not matter at all. Why is it that when I suspected I had levator avulsion, three urogynecologists told me they would not do diagnostics unless I was ready to sign up for surgery? Why did I not desrve to know and see the damage in an MRI, like if I had torn my roataor cuff or something? Why was this part of my body less important? Why is it that when I contacted three lawyers I never heard back? Why is it that when I reached out to my seven sister alumnae network about this, every women told me they had also been unsuccessful at retaining a lawyer? I never found anyone - including a woman I met who had fistula - who manged to sue. If something happens to your baby, yes, you can sue. But if something happens to a woman, a mother - forget it.

I apologize to OP for going so far off topic. I fervently hope I live to see the day when a woman's pelvic floor, which supports her sexuality, continence and core strength is treated every bit as seriously, thoroughly and carefully as any other part of our bodies. If it were the case now, this string would not exist.

Coming back to this years later as someone who is livid (4 years after delivery) that I was never warned about the high risk of levator avulsion (1 in 5 vaginal deliveries!) or the near certainty of levator ani tearing with vaginal delivery.

With that said, I recently ruptured my hamstring (direct tie to the left sided damage I sustained during my vaginal delivery 4 years ago — my pelvis no longer moves correctly and trying to run again is basically a hilarious chain of fantastic injuries I never had in my prior 15 years of running) — I discovered during my frantic searching for a surgeon that hamstrings haven’t been repaired for that long. The surgery protocol used today was written in 2007, and there are hardly any reports in the literature before that. I’m less than excited about getting my tendons nailed to my butt (thank you, vaginal delivery, for yet another stellar experience), but it makes me hopeful that levator avulsions will be repaired in our lifetime. We need top sports orthos working on the problem, not urogyns. They simply don’t have the skill set and they are too biased — if you had to admit that 1 in 5 vaginal deliveries is going to need a very complex repair that requires total immobilization of the pelvis in a 0 degree angle for 6 weeks, suddenly elective C sections are looking pretty good in comparison.

Such a depressing thread. No wonder the birth rate is so low. A woman would have to really want to be a mom to go through all this voluntarily. No thanks.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I'm not the pp you refer to. Your friend's story sounds terrible.

I note that in the posts above there are many examples of trauma. There is a link to a book on traumatic birth. There are many support groups on line with thousands of women who have experienced traumatic births. Please understand that we who have experienced them are trying to warn women that they are more common than we would all like to think so that they can make informed birth choices, and do thigns to prepare, like see a pelvic floor PT and have frank talks with doctors, get a late-term u/s, etc.

Misplaced anger on the part of the PP? I would not say so. Again, people with injuries in this string have made it very clear how this has affected them. It's hard. You need to respect that. It sounds as if you did for your friend.

We are tired of being marginalized. And would like to see a little more sisterhood, frankly. Because this is something that affects many more people than any of us would like to think.

All of the deep sexism in our society that the #metoo movement rises up against plays into these problems. Why is it that in 2017, we can't figure out how the nerves and muscles of the pelvic floor work, and how to protect them? Why is it shrouded in mystery? Why can I get a hamstring avulsion fixed, but not a levator avulsion? A muscle is a muscle, a tendon is a tendon. Why is it that when I went for my follow up visit and told my provider that I had no labia on my right side anymore (the least of my worries, but one more example of being mutilated), I just got a shrug back. Like this part of my body did not matter at all. Why is it that when I suspected I had levator avulsion, three urogynecologists told me they would not do diagnostics unless I was ready to sign up for surgery? Why did I not desrve to know and see the damage in an MRI, like if I had torn my roataor cuff or something? Why was this part of my body less important? Why is it that when I contacted three lawyers I never heard back? Why is it that when I reached out to my seven sister alumnae network about this, every women told me they had also been unsuccessful at retaining a lawyer? I never found anyone - including a woman I met who had fistula - who manged to sue. If something happens to your baby, yes, you can sue. But if something happens to a woman, a mother - forget it.

I apologize to OP for going so far off topic. I fervently hope I live to see the day when a woman's pelvic floor, which supports her sexuality, continence and core strength is treated every bit as seriously, thoroughly and carefully as any other part of our bodies. If it were the case now, this string would not exist.

Coming back to this years later as someone who is livid (4 years after delivery) that I was never warned about the high risk of levator avulsion (1 in 5 vaginal deliveries!) or the near certainty of levator ani tearing with vaginal delivery.

With that said, I recently ruptured my hamstring (direct tie to the left sided damage I sustained during my vaginal delivery 4 years ago — my pelvis no longer moves correctly and trying to run again is basically a hilarious chain of fantastic injuries I never had in my prior 15 years of running) — I discovered during my frantic searching for a surgeon that hamstrings haven’t been repaired for that long. The surgery protocol used today was written in 2007, and there are hardly any reports in the literature before that. I’m less than excited about getting my tendons nailed to my butt (thank you, vaginal delivery, for yet another stellar experience), but it makes me hopeful that levator avulsions will be repaired in our lifetime. We need top sports orthos working on the problem, not urogyns. They simply don’t have the skill set and they are too biased — if you had to admit that 1 in 5 vaginal deliveries is going to need a very complex repair that requires total immobilization of the pelvis in a 0 degree angle for 6 weeks, suddenly elective C sections are looking pretty good in comparison.

Such a depressing thread. No wonder the birth rate is so low. A woman would have to really want to be a mom to go through all this voluntarily. No thanks.

Some of us were too dumb to understand that this was our fate. I would have been a great dad — parenting with an able body sounds like a blast. But I’m a shitty mom who has hated the last 5 years of my life and will probably hate it forever more because my body was so horribly and irreparably broken by vaginal delivery. I didn’t care about aesthetic changes, but I definitely care about the functional movement damage. (A lot of this can be prevented with planned c section, though, if our society would just come around to a planned surgical route for delivery.)

[Anonymous]

I empathize with the feeling of being broken by becoming a Mom and just having no clue ahead of time. I was healthy, running, 14% body fat, eating well….and all hell broke loose. I had an emergency C-section with my one and only kid 5 weeks early. It took me 6 weeks after delivery before I could walk up the stairs. Kid & I were so sick I hired a high school girl who was next door to come help 5 hours a day. But, given I lived through a very rare & deadly condition starting at 11 weeks pregnancy, I was lucky to be alive. If doctors had known the genetic condition I had, they would have recommended I never have a child. As it was, when I was in the hospital at 20 weeks, my doctor had to literally throw “helpful” nurses out of my room as they kept trying to tell me that it’s ok to save myself if I needed to terminate and try again later. I’m pro-choice and looking back I know they meant well, but at the time, I was a mess after crying & shaking.

Husband got fixed weeks after I delivered, and I was resentful he did that for a long time…..even if I knew in my head I wouldn’t make it through a second time.
My kid is away at university now. We are really close. ❤️ They grow up. It does get easier.

People should go look at the tombstones of old cemeteries. Women & children died all the time. Thank God for modern science.

I wish the OP peace and healing after your delivery, whatever which way you decide.

[Anonymous]

Anonymous wrote:Scheduled c sections are awesome, easy recovery, relaxed procedure etc. They're great.

Except neither you nor the baby get the benefits that a vaginal birth confers.

[Anonymous]

Anonymous wrote:I've only had c-sections so I have no idea how painful the recovery after a tear is, so please take that into account in my response.

Just remember that a c-section is major abdominal surgery where your muscles, uterus, and nerves are cut through. Here are a few things that you should seriously consider about having a c-section vs. risking a second tear:

- You won't be able to carry/lift your older child for at least two weeks, possibly even longer after you give birth.
- You will have a really hard time going up and down stairs for at least a few days, possibly even longer after you give birth. I live in a three story townhouse and just assumed my recovery would be as easy as last time. I forgot that the first time, we lived in a ranch, so of course it was easy.
- You may have nerves cut that don't repair themselves. Read up on abdominal numbness after c-section. I didn't have this the first time, but it's 15 months after my second, and there is a chunk of my lower abdomen that I can't feel because the nerves didn't grow back. My OB says that at this point, it's probably permanent.
- The C-section shelf is real.

There is so much more...

I had an acupuncturist fix the numb nerves. It was amazing. She used some kind of burning technique. I don't know what it was, but feeling came back in two sessions.

[Anonymous]

Anonymous wrote:I empathize with the feeling of being broken by becoming a Mom and just having no clue ahead of time. I was healthy, running, 14% body fat, eating well….and all hell broke loose. I had an emergency C-section with my one and only kid 5 weeks early. It took me 6 weeks after delivery before I could walk up the stairs. Kid & I were so sick I hired a high school girl who was next door to come help 5 hours a day. But, given I lived through a very rare & deadly condition starting at 11 weeks pregnancy, I was lucky to be alive. If doctors had known the genetic condition I had, they would have recommended I never have a child. As it was, when I was in the hospital at 20 weeks, my doctor had to literally throw “helpful” nurses out of my room as they kept trying to tell me that it’s ok to save myself if I needed to terminate and try again later. I’m pro-choice and looking back I know they meant well, but at the time, I was a mess after crying & shaking.

Husband got fixed weeks after I delivered, and I was resentful he did that for a long time…..even if I knew in my head I wouldn’t make it through a second time.
My kid is away at university now. We are really close. ❤️ They grow up. It does get easier.

People should go look at the tombstones of old cemeteries. Women & children died all the time. Thank God for modern science.

I wish the OP peace and healing after your delivery, whatever which way you decide.

Sounds brutal, so sorry you had to go through that. What condition did you have? I have a friend going through something similar

[Anonymous]

I came down with high inter-cranial pressure during my pregnancy. It required several spinal taps while pregnant (many after). The opening pressure was almost 50. It was so ungodly painful. It took 10+ years before it stabilized.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Scheduled c sections are awesome, easy recovery, relaxed procedure etc. They're great.

Except neither you nor the baby get the benefits that a vaginal birth confers.

There is no research that shows any benefit to a vaginal delivery. Also — my body, my choice. But we should be giving women accurate information about the very severe and lifelong disability that can be caused by vaginal delivery so they can make an informed decision and choose a c section if they’d prefer to save their pelvic floor.

[Anonymous]

I had a c section because my son was breech and wouldn't turn. He's seven now. I didn't think the recovery was that bad. My kid is happy and very healthy.

I remember the weird comments I got. Someone was like "oh did you not exercise during pregnancy?" (I am very physically active, I did regular ten mile hikes while pregnant, and swam pretty much every day when I was trying to get him to turn).

People are jerks, listen to your doctors and do what's best for your body.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Scheduled c sections are awesome, easy recovery, relaxed procedure etc. They're great.

Except neither you nor the baby get the benefits that a vaginal birth confers.

Lol

[Anonymous]

Anonymous wrote:

Anonymous wrote:Scheduled c sections are awesome, easy recovery, relaxed procedure etc. They're great.

Except neither you nor the baby get the benefits that a vaginal birth confers.

literally shut up. I hope you never say this in real life.

I ended up having a second vaginal delivery despite a 3rd degree tear after my first at the insistence of the ob who was on call at the time (second baby came 3 weeks early). I had a c section planned. I’m grateful it worked out and the ob ended up being able to fix some damage from my first delivery, but I couldn’t in good conscience advise a woman to definitely do a vaginal after first horrible experience, or even a vaginal delivery to begin with.

It’s such a personal choice and you just don’t know what the damage will be with a vaginal birth until it’s too late.

[Anonymous]

Anonymous wrote:

Anonymous wrote:This has been such an interesting discussion and I really feel like I learned a lot from reading the pps stories. I googled levator avulsion and that brought up a lot more information on the topic as well as pelvic exercises and other research.

I had an incredibly simple vaginal birth with epidural. But I was looking for info like that while pregnant so I knew what to ask for and what to try to avoid. I'm pregnant again. I don't know how you avoid long pushing? When I dialated 10cm they told me to push. What should you do if you've been pushing for an hour and you don't know how much longer it will take?

I've worked with older women and my grandmas and great aunts were very candid. They all have pelvic floor issues. Some gave birth with forceps and most had twilight sleep. They all had multiple births. I'm an only child and my mom had me via c section- she has pelvic issues now in her 60s.

This is interesting because my mother also had two children, both via c-section but now in her sixties has uterine prolapse and pretty significant incontinence issues. This is a big discussion amongst her friends of the same age, and their experiences run the gamut, with most having given birth vaginally, and about half with some mild incontinence issues and/or the need for pelvic OT. Interestingly, my mom's closest friend gave birth to six children naturally, and now has zero issues in her seventies. Most experiences are more middle of the road, but she does have a friend who never even experienced pregnancy but has significant incontinence issues in her sixties. I wish there were a better way to predict and protect women's health in this area, regardless of childbearing status or birthing history, and more attention and better treatments available as a whole.

Most of the incontinence issues can be controlled with pelvic floor PT and other core strengthening exercises. Don’t forget that specific vaginal PT, including frequent “O”s, can ward off incontinence.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Scheduled c sections are awesome, easy recovery, relaxed procedure etc. They're great.

Except neither you nor the baby get the benefits that a vaginal birth confers.

literally shut up. I hope you never say this in real life.

I ended up having a second vaginal delivery despite a 3rd degree tear after my first at the insistence of the ob who was on call at the time (second baby came 3 weeks early). I had a c section planned. I’m grateful it worked out and the ob ended up being able to fix some damage from my first delivery, but I couldn’t in good conscience advise a woman to definitely do a vaginal after first horrible experience, or even a vaginal delivery to begin with.

It’s such a personal choice and you just don’t know what the damage will be with a vaginal birth until it’s too late.

This is the bottom line — vaginal birth is unpredictable and carries a high likelihood that you will be affected by a “quality of life” issue — prolapse, UI, OASI, pelvic floor tearing (whether it’s a complete tear off of your pubic bone or tears throughout the muscle). Active women seem to notice symptoms and limitations from these horrible injuries more than inactive women, so honestly, I’d think very hard about whether you want to jeopardize your exercise habits with a vaginal delivery if you consider yourself an athlete or very active. Maternal request c sections are permitted in the US, and studies have shown they are just as safe as planned vaginal even just looking at short term complications. There’s a lot of unnecessary fear mongering and shade thrown at c sections, when they really can be the best option for women. Those of us who were told otherwise got burned by our friends and the healthcare system. We are just out here trying to educate other women and let them know they have a choice and the OBs and midwives paint a really rosy picture of vaginal delivery that’s entirely unwarranted in terms of physical injury to the mother.

[Anonymous]

I had a 4th degree tear with my first and my second came out easily with a tiny tear. My recovery for the first was terrible, second I was back on my horse a week after giving birth! No way I would elect surgery instead.

Both 9 lb big babies.

[Anonymous]

Anonymous wrote:I had a 4th degree tear with my first and my second came out easily with a tiny tear. My recovery for the first was terrible, second I was back on my horse a week after giving birth! No way I would elect surgery instead.

Both 9 lb big babies.

I’m so glad you had a choice. Please respect the choices of others that may be different than yours. For me, a scheduled C section after a forceps birth that caused me to have severe birth injuries, prolapse, anal incontinence, PTSD, and nerve damage was the right choice. I was happy to protect my nerves and whatever was left of my anal sphincter and not risk worsening my injuries and causing retraumatizarion with a second labor. Recovery was straightforward and much easier than I expected. And so much easier than the multi-year recovery that I had with a bad vaginal birth. Everyone is different. most women after 4th degree tear are recommended to have a C section.