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I had a 3rd degree tear and episiotomy with my first. No one mentioned a c-section/long term complications and I would not have gone for a c-section anyway unless the indication was that my second would be much bigger than my first (9 lbs 5 oz). Growth scans looked good and they estimated an 8.5 lb baby. In the end, I had an incredibly quick, unmedicated birth with natural 2nd degree tearing (baby was 7 lbs 10 oz). It was a walk in park compared to the 3rd degree. I was up and walking unassisted within a couple hours whereas with my first I had problems walking for weeks. I was very happy with my second birth experience. I also don't think I've had any complications (although I'm only 4 months pp so I guess time will tell).

My delivery with #2 was so much easier, even though he was almost 1.5 pounds bigger than #1. With #1 she was sunny-side up so labour was extremely long and eventually i had an episiotomy (3rd degree tearing). Recovery was long and painful, and i saw a post-partum PT for a few months. With #2 i laboured at home for quite a bit and by the time i got to the hospital i was already 6cm dilated. I got to the hospital a little after 8:30am and my DS was delivered at 10:18am. Since he was positioned better, it took about 15 minutes of pushing and i had 2nd degree tearing.

I would consider a c-section in your case, but it would really depend on how the pregnancy was progressing.

@agold: When I was induced with my second I asked my Dr to please make sure I had a local before any stitches this time (the stitches were the hardest part of my first delivery since my Epi had been turned off for some time) - she agreed and noted it on the white board! After I delivered my second she said "you tore again - looks like a 3rd degree - will require a few stitches" I replied with "damnit - how can I prevent this going forwrd" and she said "probably not push them out so fast - your body isnt given the time to ease into it"

DD1 - I def didnt progress SUPER fast (about 1cm an hour...then like I said pushing for 2-3 contractions).

DD2 - I was induced. They broke my water at like 3pm (I was 5cm and she wasnt not completely lowered), she was out at 3:40pm....so I think it just all happened so fast - my skin stood no chance.

I had an episiotomy with my first (long, medicated labour and ventouse delivery) and tore badly during my second labour (much shorter, "natural" labour but 9lb 12 baby!) and have healed nicely both times so will be aiming for another natural delivery with my third. Having said that, I do gave a friend that tore badly and suffered an awful haematoma with her first child and she's opted to go with an elective c-section for her second baby because her first recovery was awful!

@Revel: I don't know how well you will be able to control the pushing part, if you are going unmedicated. I had an unmedicated birth the second time and don't think I could have stopped the pushing any more than I could stop a freight train. Also, I didn't get to the maternity ward until 10 minutes before I had my 2nd, so that might have something to do with it.

I didn't really tear at all with my second, but she had to make a small incision because the area that tore with my first developed scar tissue and wasn't stretching enough to allow baby's head. She had to recut the area with scar tissue and restitch. In the end that was better because it hadn't healed correctly the first time.

Similar story here-- I had an unmedicated, pitocin-augmented labor with my first and had a 3rd/borderline 4th degree tear. Recovery was very hard and I was so scared of tearing badly again with my second. My second labor went pretty quickly and i delivered in much fewer pushes than my first, but thankfully I only had a 2nd degree tear and recovery was a breeze! I'm glad I decided to go ahead with another unmedicated vaginal birth with my second.