Labial tear & hemmys with 1st baby...subsequent babies?

[ihugtrees]

I've done a few searches and have read about extensive tearing, far more extensive than mine, and seen that in subsequent births, you are less likely to tear. However, none mentioned specifically labial tearing. I'm also worried about hemorrhoids and what kind of issues they can cause in future births.

First, I'll tell you a bit about my birth...On the way to the birth center, at about 10:30 pm, I was feeling pushy. When I got to the birth center, I was feeling pushy. The student midwife checked me and told me I was 'almost complete' and that I could push if I wanted...and I really wanted labor to be over. I'd had sporadic, but very intense and long contractions for 12 hours. I also really wanted S to have the 7th for a birthday, as that's my lucky number ;-) I was pushing, sort of, at 10:45-11 but I didn't think I "should" be pushing. My mom, a friend, my doula, the midwife, the student, and the assistant were all just staring at me, and every time I opened my eyes they were all standing there. My husband was behind me, his arms around me in the tub, which was very supportive. The student midwife checked me again, then asked the midwife to check me because she wasn't sure. Midwife told me to push her hand out. Then said, in an almost dismissive manner, "You're not ready to push. If you can't push my hand out, you're not ready."

When it was finally 'time to push' at 12:45, I mostly just wanted labor over. There was no overwhelming urge to push. I didn't know how to push. Nobody suggested a different position to me, and I was flat on my back, semi reclined against my husband--he really wanted to catch, and I knew that, too, but clearly he couldn't reach the baby from behind me. I thought about it but couldn't vocalize that I wanted to move, and I couldn't move myself at that point either. The student midwife had her hands inside of me, stretching me, the entire time I was pushing. Once the head was out, the student midwife told the other midwife, 'double cord!' which alarmed me. Student then told me I needed to to get the rest of the baby out, and it sounded urgent. So I pushed really hard and she was out, at 1:04 am, after 19 minutes of pushing (clock over the jacuzzi tub=worst idea ever.) We have the last 5 minutes of pushing on video, and I see right when I tore--trying so hard to get the rest of her out ASAP. The cord was twice around her neck and had her arms pinned to her sides, as well...not sure if that was serious--it sure looked scary, and it was difficult to untangle her!

This part may be TMI...
I didn't need any stitches, according to my care providers. I had some inner abrasions, but the serious pain was my outer labia...basically there was a hole in it, like somebody hole punched it, coming just a hair's length away from my clitoris. It oozed blood all of the time, for weeks, and for weeks, I cried when I peed. I feared peeing, held it in, resisted the urge. Now, at 14 months pp it is all healed up, though it still looks funny, of course--you can't even see where the tear was. It didn't help that I had awful, untreated hemorrhoids before birth. I used the prep h wipes before birth, but nobody told me about the suppositories and I didn't know they would help more. I may even have an anal fissure or something else, I'm not sure. But I resisted pooping for DAYS after the birth and then when I did, I moaned and cried and I almost felt like I was in labor again. This went on for 6 or 7 weeks. I drank prune juice and grape juice to make it easier, and used preparation H wipes, but it didn't helped. Finally around 6 or 7 weeks pp, I discovered the prep H suppositories, and I still use those frequently. I feel like the hemmy's never get better. If I skip a few weeks of prep H (those are EXPENSIVE!) then I start bleeding when I poop, and having lots of pain again. Even though I am rarely constipated like I was throughout pregnancy, I still bleed every time I go, and have pain. Even when I do kegels, I have pain (sometimes in the area where the tear was and sometimes in my rectum.)

These two things make me terrified to have another child. What if I tear in the same place again, or even into my clitoris? And I can't imagine pushing a baby out with the hemorrhoid issues I have right now...I'm sore all the time already, and I don't even have a baby sitting in there, putting weight on the area.

Does anyone have any words of advice for me?

[AnneCordelia]

I have been interested in info about tearing and anecdotal evidence too.

Here's my own experience, as it relates to your question. My first was born after 4 hours of pushing in a hospital bed, big baby, two episiotomies and then tearing into the rectum. More than 40 stitches. Ick.

My second was born after 5 minutes of pushing. I tore along the same lines as my first, although much more shallowly. Recovery was much, much easier and although the tear was along my previous cuts/tears, it was a much smaller and easier wound. I also tore up towards my clitoris. Enough that my midwives gave me a few stitches in that direction too. Another big baby, squatting position, and I am also an impatient pusher...I was baby OUT and it's very hard for me to be slow.

My third was born after less than 5 minutes of pushing, in a side-lying position, and again impatient. Midwife told me to slow down and I said "No &%$#ing way!" as he shot out. But, the change in position, I believe, was easier on my perineum. I had a very, very small tear in comparision to my previous two. My midwives argued over a stitch. LOL. I did NOT tear up in this delivery, and I believe it's because the position put less pressure on my pelvic floor than the upright position of my 2nd birth. It also took pressure off my tailbone to allow the area to open up more easily.

This pregnancy, I play to deliver side-lying again because I attribute that to tearing less, in combination with being a multip too.

[BlackSheepPDX]

First birth - about 7 hours of labor, 3 hours in pushing phase, lots of hemis, 3rd degree tear. 8lb6oz, 20"

Second birth (two days ago) - about 3 hours of labor, less than an hour pushing, no hemis, no tear (only a very minor skid mark), and a weird labia minor varicosity that seems to be resolving well. 9lbs, 22"

Hands and knees/kneeling both deliveries. I do know that I let my body do the work and dictate the pace much better the second time, though everything was crazy fast. No idea if it made the difference in the end.

[MsBlack]

So sorry to hear of your pain with all of that! Easy to see why you would dread another pregnancy/birth.

First thing to do, IMO, is to further your healing of labia and hemorroids. You might want to get an exam to rule out a fissure--this is important info to have, for sure. There is a lot you can do to heal hemi's and prevent further troubles--exercise (not just kegels, but walking and other 'all around' exercise), diet and water intake, and possibly using varicose vein supporting herbs (hemi's can be related to varicose veins physiologically--are var. veins in your family?). You really don't have to suffer hemorroids forever! There is so much that is in your power to correct--and if you do take steps, I think you'll see an overall boost in your general health, along with healing/prevention of hemi's.

I have seen some women with similar issues with the hemi's...with very much pain and a long time resolving it after birth. But who also were able to greatly reduce the whole problem, between pregnancies and during, by their attention to diet, water intake, exercise and for some, the use of herbs/supplements to strengthen varicose veins. It is not normal to have chronic hemi's...not just your 'fate' or just the way you were made, not at all.

You could benefit greatly by seeing a natural health practitioner (of various sorts) who can help you figure out your personal constitution and so, what lifestyle measures will help you attain 'general good health' as well as resolving this painful issue.

And you might seek other care for your next baby--or at least be more pro-active in working with the same ones, if you trust them and the overall experience of care suited you well enough. It doesn't sound as if you received the care most suited to your nature and the unique details of that birth....and circumstances of that birth led to both worsened hemi's and the labial tear (in great part via the instructions you received, people staring at you, panicking somewhat over a cord...). Those things do not have to be repeated.

[loveneverfails]

I had labial tearing with my first birth, but not with the subsequent births of larger infants. And my stitches ripped out at 10 days post partum too. Still let me deliver an 11 lb baby without even a skid mark.

Good luck!

[ihugtrees]

Originally Posted by MsBlack

So sorry to hear of your pain with all of that! Easy to see why you would dread another pregnancy/birth.

First thing to do, IMO, is to further your healing of labia and hemorroids. You might want to get an exam to rule out a fissure--this is important info to have, for sure. There is a lot you can do to heal hemi's and prevent further troubles--exercise (not just kegels, but walking and other 'all around' exercise), diet and water intake, and possibly using varicose vein supporting herbs (hemi's can be related to varicose veins physiologically--are var. veins in your family?). You really don't have to suffer hemorroids forever! There is so much that is in your power to correct--and if you do take steps, I think you'll see an overall boost in your general health, along with healing/prevention of hemi's.

I have seen some women with similar issues with the hemi's...with very much pain and a long time resolving it after birth. But who also were able to greatly reduce the whole problem, between pregnancies and during, by their attention to diet, water intake, exercise and for some, the use of herbs/supplements to strengthen varicose veins. It is not normal to have chronic hemi's...not just your 'fate' or just the way you were made, not at all.

You could benefit greatly by seeing a natural health practitioner (of various sorts) who can help you figure out your personal constitution and so, what lifestyle measures will help you attain 'general good health' as well as resolving this painful issue.

And you might seek other care for your next baby--or at least be more pro-active in working with the same ones, if you trust them and the overall experience of care suited you well enough. It doesn't sound as if you received the care most suited to your nature and the unique details of that birth....and circumstances of that birth led to both worsened hemi's and the labial tear (in great part via the instructions you received, people staring at you, panicking somewhat over a cord...). Those things do not have to be repeated.

I would LOVE to see a naturopath. Unfortunately my insurance doesn't cover any part of the bill and we are very short on money. I am going to start working part time soon, and I hope that I can afford more naturally minded care then!

I've already made huge strides in my diet and upped my water intake significantly. Does that effect varicose veins? I'm not sure if they run in my family, but I do know my mother has had hemi's since she had me 22 years ago. I DO need to exercise more and spend less time sitting on my behind!! That's something I really struggle with.

I WILL be seeing a different care provider next time. Unfortunately those were the only midwives in the area, and my only truly great shot at a natural birth. I've moved now, though, and have many options.

Thanks everyone for your input!

[MsBlack]

You know, there are websites related to various natural health/healing practices...I can't think of the sites now, but you could google things like 'chinese medicine', naturopathy, avurvedic medicine...lots of these places have surveys you can take to help you figure out your constitutional type (in their particular terms of course). And also have info on such matters as diet and exercise habits that can be most beneficial for each type. It's worth a shot, if you have some time while saving up the money, to look into it. You could maybe get a jumpstart on improving your health and hemi's in the meantime.

You could also look into the herb/supplement companies, to explore remedies for hemorroids and varicose veins, try some things out...

good searching and good luck!