Reply to C-section or natural after 3rd degree tear?

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]I remembered this thread from a few months ago because I am now in exactly the same situation.  Third degree tear, incredibly long labor, blood transfusion... and so (new) OB says that I am "eligible" for an elective C. She's certainly not pushing it on me, but did talk about how new research is highlighting the risks of tearing and how they can lead to fecal incontinence.  I would like to avoid this.  Like OP from this thread, I would like 2 kids -- maybe 3 if I accidentally got pregnant, but really 2 is my number.  I'm curious what decision OP made -- if any -- and if anyone else has feedback about either a second vaginal birth after bad tearing or an elective c after bad tearing.[/quote]
Were you induced or did you require augmentation? Those are the biggest risk factors for severe tearing.
If so, then what are the chances of you will need induction/augm. this time? Are you AMA? Other pregnancy complications?
Why did you hemorrage? C-section surgery is a risk factor for severe hemmorage and there are other risks with it so there is a lot to consider.[/quote]

I was induced and it took forever -- a week. Forceps (probably related to the hemorrhage, but they attributed that to a long third stage -- 3.5 hours). It's unlikely this would happen again, since it's a second kid.. but, hard to say!  I'm still in my first trimester, and I'm not AMA.  My blood pressure tends to be pretty high. 
[/quote]
You are not very likely to have another severe tear (around 1% do per research). If you can avoid an induction and avoid or delay an epidural, that will be your best bet for minimizing tears. Can you hire a doula? I would strongly consider that, or else do some self-study on measures you can take to avoid tearing. There are evidence-based things you can do that help - certain pushing positions, warm compresses/warm bath, etc.

Your provider's flexibility is big, too - how late are they comfortable with you going before inducing? If a medical indication arises later on, could you still schedule a C at that time? Do they support a low-intervention labor?[/quote]

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