WWYD after a third degree tear?

[Anonymous]

Anonymous wrote:OP here-- thanks for all the advice! I'm so thankful to hear other people's experiences. Frankly, it's just nice knowing I'm not the only who tore herself silly down there. For me, it was a little humiliating (or should I say humbling) that it happened despite my and my Dr.'s best efforts to avoid it. The first delivery was a induction that ended up being vacuum-assisted after a very long time pushing w/ little progress. Yes, I took Lamaze so I understood everything there is to know about interventions. Yes, I even saw a midwife who was affiliated with the practice. Yes, the baby still came blazing through w/ the little suction cup on top her head. She's healthy, I'm healthy.

I'm not sure what you meant by seeing the midwife. Did she actually assist at the delivery? Or do you mean you've consulted with her about a future delivery? I still strongly recommend that you interview an independent midwife or midwifery practice. If you do not do that, you honestly will not be making a fully informed decision.

So with a vacuum-assisted delivery tearing is indeed much more likely. As well as with induction, epidural, long pushing, supine position. I would be absolutely shocked if you had similar tearing with a second baby. And, the evidence clearly shows that there is less tearing with second babies than with first. Has your doctor explained this to you?

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here-- thanks for all the advice! I'm so thankful to hear other people's experiences. Frankly, it's just nice knowing I'm not the only who tore herself silly down there. For me, it was a little humiliating (or should I say humbling) that it happened despite my and my Dr.'s best efforts to avoid it. The first delivery was a induction that ended up being vacuum-assisted after a very long time pushing w/ little progress. Yes, I took Lamaze so I understood everything there is to know about interventions. Yes, I even saw a midwife who was affiliated with the practice. Yes, the baby still came blazing through w/ the little suction cup on top her head. She's healthy, I'm healthy.

I'm not sure what you meant by seeing the midwife. Did she actually assist at the delivery? Or do you mean you've consulted with her about a future delivery? I still strongly recommend that you interview an independent midwife or midwifery practice. If you do not do that, you honestly will not be making a fully informed decision.

So with a vacuum-assisted delivery tearing is indeed much more likely. As well as with induction, epidural, long pushing, supine position. I would be absolutely shocked if you had similar tearing with a second baby. And, the evidence clearly shows that there is less tearing with second babies than with first. Has your doctor explained this to you?

OP here-- I appreciate your advice about seeing a midwife. Given that I had some other complications during my first pregnancy that may complicate my second, having a midwife handle my delivery is likely not an option. The point of my post was not to see whether I should question my Dr.-- he happens to have a great reputation by word of mouth and has been rated one of the top docs by the Washingtonian. As far as "evidence" goes, in my experience with pregnancy, there is LOTS of conflicting "evidence" out there. In fact, there are camps in support of both sides of nearly every issue that may arise. As such, I'm more interested in hearing anecdotal evidence to help me decide. Thanks again for your response!

[Anonymous]

Well, you did start your post by asking for advice. What would I do? Well, I would try a vaginal delivery with a care provider who had vast amounts of experience with helping women not tear during delivery. Being a doula myself and working extensively with many of Washington's most well-known doctors, as well as with many of the areas midwives, I can say without a second's hesitation that some midwives are lightyears ahead of doctors when it comes to preventing damage or trauma to the pelvic floor. For what it's worth. There are also a number of techniques that both you and your doctor can learn and implement to lessen the chance of further damage or tearing.

As for anecdotal evidence, here is mine:
First baby - Pushed for one hour. 2nd/3rd degree tear "2.5" as my doctor said.
Second baby - Hardly pushed. Maybe 5 minutes. No tearing whatsoever.

[Anonymous]

Get a midwife! I had an OB for my 1st child and my nurse happened to be a retired midwife. The midwife did all the work--stretching and massaging me, I barely tore at all and I had a very hard labor (pushed 2 1/2 hrs). Because of my experience w/ the midwife, I've switched to a practice that has both OBs and midwives.