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

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[quote=Anonymous][quote=Anonymous]The PPs who had an anal sphincter tear or fistula/rectocele etc., were you induced or did you go into spontaneous labor? It seems like a fair number of posters who had bad tears are saying their labor was induced, and that is in fact associated with severe tearing in the literature. It's unclear whether induction drugs prolong labor intro obstruction, or increase the need for an epidural which prolongs/obstructs, or maybe makes it worse if the baby is in a tricky position to begin with.[/quote]

Severe rectocele and uterine prolapse and moderate cystocele here. I went into spontaneous labor but was extremely slow to progress after 6 cm. Baby was malpositioned but I did not find this out until after. In hindsight, I should have gotten an epi and pit far earlier when labor was not progressing, pushed for 3 hours and no more, and then had a Cesarean or vacuum. Forceps and a long pushing phase (including hours and hours breath-holding valsalva pushes) and tons of aggressive vaginal stretching seemed to seal my fate.

To answer PP's question, what I would have done differently is:

-Gone with an OB practice and not midwives and asked for conservative management 
-Asked for OB involvement and/or second opinions far earlier when labor was not progressing and when I had been pushing for 3-4 hours and no one seemed concerned about prolonged pushing
-Gotten an epidural as soon as I arrived at the hospital instead of trying for unmedicated 
-Hired a doula who knew spinning babies and was not dogmatic about natural birth
-sought out pelvic floor PT when pregnant for issues I was having during pregnancy that midwives dismisses (leaking urine, back pain)
-gotten chiropractic care in pregnancy to ensure a well stabilized pelvis and well positioned baby
-refused to push longer than 3 hours and refused to do breath holding pushes 
-not done impact exercise in pregnancy
-insisted on a vacuum and not forceps, or had an emergency Cesarean
-discussed my risk factors for pelvic floor disorders with my providers in prenatal visits and demand that they take that into account when formulating my care plan
-insisted on a late ultrasound to estimate fetal siZe when it was evident that my baby was big
-not waited past my due date for spontaneous labor when it was evident that baby was gonna be large and I am petite 
-asked women in family about our history of pelvic floor issues

I would never recommend that anyone have forceps if you have another choice. I still have nightmares about them.

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