Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote: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.

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.

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.

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?

I had a doula and delayed my epidural a long time with my first birth. Also, it seems here that over 7% of women who have a third or fourth degree tear have one again their second vaginal birth, so not 1%. Where are you finding the 1% number?
https://www.rcog.org.uk/en/news/bjog-release-new-study-examines-mode-of-delivery-following-a-perineal-tear-and-recurrence-rate-in-subsequent-pregnancies/

Anonymous wrote:

Anonymous wrote:

Anonymous wrote: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.

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.

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.

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?

Anonymous wrote:Scheduled C recovery > vaginal recovery

Yup. And I didn’t even tear terribly with my first!

I had a lot of pelvic floor issues after my forceps delivery, including multiple forms of prolapse and fecal incontinence for 6 months, and every single doctor and specialist I have seen had recommended that I have scheduled Caesarean section next time. A c section is serious surgery however the issue with having a vaginal birth and then developing these issues is that the surgical outcomes for treating them are terrible. In my instance I am looking at hysterectomy, mesh, etc. I

Anonymous wrote:I had a bad 2nd degree with #1 and not 1 stitch for #2! Both 9+lb big headed babies.

Same here! BAD 2nd degree with DS1 and then I think I cried when the doc said no stitches after my 2nd 9+ lb baby.

I'm with the women who said the second was easier.

1st: 2nd degree tear, a section didn't quite heal right and needed corrective in-office visit
2nd: also a 2nd degree tear, but barely. Got a stitch just to be sure everything healed right, but could have gone without.

Anonymous wrote:

Anonymous wrote: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.

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.

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.

Anonymous wrote: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.

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.

my friend was in this situation, and chose vaginal birth. Not a single stitch the second time - the first baby really "cleared the way" or something. She'd had prolapse, incontinence (urine for months and feces for weeks), and the babies were born 23 months apart. It worked out well for her, but it's impossible to know how it will turn out for you, OP.

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.

I chose a scheduled c section after my first birth with a 3rd degree tear. My tear was so painful! I lived in the bathtub. i could barely walk or sit. I ended up needing a surgery at 6 weeks postpartum to correct the tear. Then i had to heal from that. So it was a no brainer for me!

The scheduled c section = no big deal.

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 a fourth degree tear with my first and was also given the option of a scheduled c section. Surgery really freaks me out though so I tried again for vaginsl the second time. I ended up with a second degree tear the second time. Recovery was so much easier!

The second one was so much easier for me! Baby #2 was bigger and yet I didn't have any tearing. Had a 4th degree with my first. I was given the option for a scheduled C but really didn't want to do it unless necessary.

I had an awful, awful tear with my first. He was sunny side up and turned funny and finally came out with forceps. I decided to try again, and my second was super easy even though he was over 8 lbs. I would try again instead of a c section. Don't underestimate how hard it is to take care of a toddler and a baby.