If any of you suffered a third or fourth degree tear when delivering one of your babies, what did you plan for your subsequent births - vaginal delivery again or c-section? And did you tear again if you had a subsequent vaginal delivery? I'm just now halfway through my second pregnancy and my OB talked to me yesterday about the pros/cons of having a c-section to avoid another 4th degree tear. I'm not sure what I will do.
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Following! I am not pregnant but had an awful third degree with my first and I never want to relieve that experience.
Anecdotally a good friend had a 4th degree tear with her first and no issues with her second vaginal delivery.
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@mrsjd: Do you think you would want to try vaginal delivery again, even if the risk of another tear? Or would you want to do a c section? Also, do you know if your friend's second baby was smaller than her first? My first baby I delivered pretty much on time and she was just a normal 7 pounds. So its not like she was huge and tore me. I just tore!
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No personal experience here, but I just want to say good luck and I hope your birth experience is easier this time around.
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@agold: I don't think her second baby was any different in size, but her second's head was smaller. I think my issues were head size and a fast, induced labor. My daughter was 8lb 1 oz (at 39 weeks!) but her head was 95th percentile. I had two round of cytotec, but from water breaking on its own (at 0cm dilated) to fully dilated was 2.5 hours.
I go back and forth on what I'll do. I love that high of pushing and delivery. I loved my delivery and handled the pain of contractions very well, but the recovery was brutal. I couldn't sit easily for a month, at least. But, I'm vain and I don't want a C-section scar.
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@mrsjd: I ditto everything you said, including being vain and not watching a c-section scar!
Thanks for sharing your thoughts on this. @LemonJack: Thank you so much, lady. I am truly praying for that also.
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@agold: hi there!
I had a really bad 3rd degree plus a couple other smaller ones. My OB (and myself) were concerned about incontinence issues and I had no desire for a long healing process again.... or to start crapping my pants regularly
I went with a c section and it was great. Recovery was good. Sore at first obviously but when DD was three weeks old I took both kids to the library by myself and felt fine!
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Basically copying my response from a similar thread:
I didn't have 3rd/4th degree tears, but I did break my tailbone delivering my first vaginally (induced at 41+1, DS was 8lbs5oz/21in but with an off-the-charts head). Recovery was terrible - I was on vicodin for three straight weeks, used those hospital ice packs for a longgg time, and couldn't sit down comfortably for 4-5 months. I had a second vaginal delivery with DD (went into labor naturally at 40+5, she was 8lbs7oz/21.5 in but "only" 83rd percentile head) and it went really, really well. Recovery was super easy comparatively -- I never even filled the painkiller prescription. In my case it really did seem to be the size of the head vs. the overall size! I also had mild second degree tears with both deliveries.
If we were going for a third and I had broken my tailbone a second time, I would probably be speaking to my doctor about the possibility of a c-section.
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I had a third degree tear from DD1. For me, it was just merely how quickly she came out. I also had some really rotten "scrapes" inside from her exit. My Dr turns epi's off around 9cm if all is progressing well. So this meant when I was sticthed up post delivery I felt EVERYTHING...it was horrendous. In terms of healing...I would say it was a solid 3 weeks before I stopped taking pain meds, and longer before I was not longer very sensitive in the area...
DD2...flash forward...while I was induced with her...she dropped and was delivered very quickly. I had mentioned to my Dr the pain I had experienced the previous time...so she was very careful to properly numb me locally before stitching. It mad the experience much better, with another third degree tear. I also was completely off meds by 7 days following her birth. All in all a much faster recovery.
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@Mrs. Champagne: Those are the same concerns discussed with my doctor. Tearing of the sphincter!
Thank you for letting me know you went ahead with the c-section. Do you feel the recovery after c-section was better/worse/longer/shorter/whatever than the third degree tear? @jape14: Thank you so much for chiming in! Ouch! Broken tail bone. That sounds terrible and a much longer recovery than the 4th degree tear I had. I 'm so glad to hear your second delivery was so much smoother!
@Mrs D: So you had a similar tear the second time around. And omg. I cannot imagine enduring all those stitches without being numbed. I had the epidural and I'm pretty sure they gave me another numbing shot in the specific region. Was there any problem with stitching up the previously-stitched skin? Have you noticed any problems with scar tissue down there or any other problems?
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I had a third degree tear and episiotomy. With my second, I planned for another vaginal delivery and hoped for the best. I ended up with just a second degree tear. It was really not bad at all. I was up and walking an hour later and recovery was a lot easier. I also had a much smaller baby the second time at 7 lbs 10 oz albeit with a 100th percentile head still so I wonder if that was a factor.
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Stitches for days with #1 and no tearing at all with #2
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Third degree with #1. Combo of large head and really fast final exit.
First degree with #2. Same large head. 1oz heavier than his older brother. Probably a slower final exit?
Honestly, though, I think my body was just probably stretchier the second time around.
Good luck!!!
Oh, and my OB never even mentioned the option of c-section given the history of 3rd degree tear. I think I brought it up to her once, but she quickly dismissed the idea and reassured me I would be fine.
Good luck!
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@agold: I had a 3rd (almost 4th) degree tear with my first. He was a normal size and there was no "reason" I tore so badly... I just did. Recovery was awful. My OB did give me the option of a C section with my 2nd but she left the choice up to me. I was very nervous but went with a vaginal delivery and had a 2nd degree tear. SO much different from a 3rd/4th!! I was up very soon after delivery and could sit normally just days after the birth. I just had my 3rd and this time only a 1st degree tear-- this recovery was a breeze!! I am so glad I didn't choose the c section!
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I had an episiotomy with #1 (long labour, pushed on my back for 2.5 hours and baby was delivered via ventouse) and I had a âpartial 3rd degreeâ tear with number two who was delivered standing up and with minimal pushing (he was almost ten pounds!). Iâm still intending on a having a ânaturalâ delivery with #3 even though the OB would like to induce me at 40 weeks (Iâll refuse unless it becomes medically necessary) but I am legit trying to grow a smaller baby as I had GD with #2 and he was just fat all over!
@agold: can you discuss optimal foetal positioning with your medical team and options for delivering (squatting, standing etc, water birth, perineal massage) that might help you avoid another damaging tear?
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I had a bad 3rd degree âstarfishâ tear with my first. With my second, he was bigger and came FAST like a freight train, and I had a very minor 2nd degree tear which I didnât even take Advil for.
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I had a very bad 4th degree tear with my first, and it took my OB an hour to sew me up, so painful! My OB actually never offered a c-section for my second (or the one in my belly now), and I did not tear at all with my second. The recovery was BEAUTIFUL with my second, I was walking around immediately after birth! So it can definitely be better the second time around
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I had a third degree tear with my first and was definitely concerned about it happening again but when I asked about it, my doctor wasn't worried and said I wasn't at a higher risk for it to happen again. My first had a giant head and was born with his hand in his cheek and the cord wrapped around his neck, so maybe it was circumstances. I don't know. I didn't ask a ton of questions, honestly.
My experience the second time was a lot better though I did tear again. My midwife diagnosed it as officially a second degree tear but basically a third and called in the OB to do the stitches. My midwife was right there the whole time I was pushing though and worked to stretch things and had me push in different positions so she could turn my baby (I think he was sideways) so even though I tore again, the experience was sooo much better.
Recovery was hard both times but I was fortunate not to have terrible pain. I just couldn't get back on my feet for a couple weeks.
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I canât remember what level of tearing I had with my 1st, but recovery was painful and I had a couple of internal abrasions that never healed correctly and caused long term aggravation. With my second I wouldnât have torn at all, but they had to do a minor episiotomy because of the scar tissue from my first wouldnât stretch enough to let out babyâs giant head. Recovery was significantly easier with #2.
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I made a similar post before I had my second - 4 th degree tear with my first and was offered a C-section with my second. I ended up delivering vaginally with my second and had a minor first degree tear with a few stitches, much easier recovery with this one.
Mainly I tried to speak to a few providers in my practice to see what they thought, including the one who delivered my first. Ultimately I didn't want the section so was willing to see what would happen this time. I delivered this one on my back with the midwife supporting/guiding him out. He was more than a pound bigger than my first and his shoulder got stuck, but it went well.
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My neighbour had a fourth degree tear with her first, and actually needed two follow-up surgeries to...I donât even know, I felt like the less I knew the better. She had a third degree tear with her second.
For what itâs worth, re: scars, the only person who would ever see mine is my husband - itâs very very low. If I were wearing clothes that would expose it I would also need to wax.
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@agold: definitely a better and shorter recovery. I'd say the first couple days were as painful, but it was stomach pain as opposed to my vagina so I preferred that, lol.
Also when you have a c section people are helpful. When you have a bad vaginal delivery, no one seems to understand.. at least in My experience anyway. I'm pregnant again and will for sure have a c section.
A couple friends ended up with c sections for their second after uneventful/minimal tearing for their first and they said they preferred the c section. I know it's not for everyone but it was good for me.
My scar is low, cannot see it in a low rise bikini.
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@Mrs. Champagne: Thanks for sharing these thoughts. You are so right that no one seems to know about or care about vaginal tearing!
It was so terrible and I couldn't believe how much it hurt to literally move any part of my body. So crazy. I do remember thinking that c-section probably would have been better. It's just interesting to be offered a decision in the matter.
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@agold: I had a bad 3rd degree tear with my first. Recovery took forever and it ached for months. In the beginning it was so swollen down there it was like the size of a grapefruit. Just awful. I couldn't even walk for a couple days. And yes, no one seemed to care or understand. And none of my friends had as bad tearing.
When i got pregnant with my 2nd i seriously wanted to ask for a csection. I never got far enough to ask cause he was born premature and I ended up with an emergency c-section. Recovery was painful but WAY better than my vaginal delivery. Laughing or coughing the first week or so was super sore, but other than that it was alot easier. And my scar is super low, like below my low rise underwear.
Good luck with whatever choice you make! A lot of my friends had much easier vaginal deliveries with their 2nd, so it's hard to say what's the best choice. Glad your Dr is discussing with you and giving you options.
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I only had a second degree tear with my first, 8lbs 3oz (pushed for 4 hours though, took me forever to get him out, and probably since it was so slow it saved me from tearing worse).... My second was 9lbs 6oz and the doctor said I tore in the exact same spot, but the recovery felt easier and he was so much bigger and I only pushed for an hour.
i don't know if this is true, but the doc that delivered my second said it's pretty typical to tear in the same spot...
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@hellobeeboston: same for me. I pushed for 3 hours with my first and just a few minutes (like too fast!) with my second and I felt amazing after! I tore a little bit along the scar of my first.
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@hellobeeboston: this is really interesting. I pushed for only 3 pushes and my girl came out, but it was after a 36 hour labor. I thought the 3 push delivery may have had something to do with the severe tear. Thanks for letting me know you tore less, or not as bad, your second time around even with a bigger baby.
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@agold: wow I canât even imagine only 3 pushes!! Yeah, it makes sense all that pushing and the head right there for such a long time allowed for a lot of âstretchingâ before he actually came out.
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@hellobeeboston: Yes, it was just three pushes! Maybe the pushes were like a two-part process, so maybe 6 pushes. But it was super quick, with a little oxygen break between the first two pushes. The pushing took a matter of minutes. It was the stiching up and manual placenta removal, followed by the hunt for a missing needle that all took forever! Not to mention the multi-personal cleaning crew that came in at some point during all of that. I honestly don't even remember pushing!
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I had third and fourth degree tears with my first. Minimal scraping with the second and literally nothing but a bit of an internal bruise with my third. I was up, showered and dressed visiting with people within 1hr of delivery.
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@Crisark: That's amazing! Was there anything drastically different with your second and third pregnancies? Like a small baby??
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So I've had 2nd degree not 3rd/4th but I have torn the same all 3 times. First baby 7 lbs, 2+ days labor, 30 mins pushing with an epidural. Second baby 8 lbs, 15 hr labor, I think again close to 30 min pushing? Third baby <7 lbs, labor 8.5 hours, pushed out in one (two? For the suction..) push with a failed (too late) epidural. I feel like I'm just destined to have that same tear no matter what. (But I'm done having babies now!)
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@Crisark: so jealous! I'm getting close ton2 weeks pp and still so sore if I walk around or pick up my toddler.
I thought maybe #3 would be an easy recovery but so far no luck!
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@agold: Nope the next two were bigger lol but the birthday themselves weren't as dramatic. So maybe that had something to do with it? @2littlepumpkins: awww I'm sorry. Hopefully you feel better soon.
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Nothing to add (except that I will likely need a FULL tummy tuck for my horrible C-section scar), but I have been off HB for awhile and Iâm so happy to see that you are pregnant! Yay! Congrats.
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@2littlepumpkins: Do you wish you would have a c-sections? Any lasting effects that you are aware of since having those tears each time? And congratulations on your latest baby!! And I feel your pain on the tears! I hope all heals quickly!
@Amorini: Thank you so much, lady! And I'm so sorry to hear about your bad c-section scar. I have a feeling that any scar I'd get would be horrible, too!
Thanks for sharing your thoughts on this. 
Thank you for letting me know you went ahead with the c-section. Do you feel the recovery after c-section was better/worse/longer/shorter/whatever than the third degree tear? 
It was so terrible and I couldn't believe how much it hurt to literally move any part of my body. So crazy. I do remember thinking that c-section probably would have been better. It's just interesting to be offered a decision in the matter.
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