Painful & looong stitch up with #1, already afraid for #2

[TheMommy]

My son is now 2 years old, but I still feel traumatized by one aspect of his birth-- the long and complicated stitch up.  I birthed in the hospital with midwives, but I feel I did more "purple pushing" than I really should have.  Also, my son had a nuchal hand, which made the pushing quite hard. 

After he was born I felt none of the bliss I expected to feel from natural childbirth.  In fact, a few minutes into the stitch up, I was literally asking if I could get an epidural after not wanting one at all during the labor or delivery.  It was so painful.  I could NOT enjoy holding my son or looking at him or nursing him.  The photos of the two of us after the birth are painful for me to look at b/c all I remember is the searing pain of the stitch up. 

It was a 90 minute stitch up and my midwives consulted with 2 different OBs to get the job done properly.  I cringe writing this b/c it ruined the moments I was so looking forward to as a new mother.  I had expected to just "fall in love" with my baby.  Instead I was just crying in pain and trying to hold myself together as they stitched. 

I am grateful it was only a 2nd degree tear, but I am so fearful that my next birth will be like this.  I am due on August, and hoping to give birth in the water (will this help?) in a birth center or at home.  

It took me a full year to have sex without pain.  At 6 months it was still too painful.   

I don't want to dwell on this any longer, and I also do not want it to happen again. 

Any suggestions for the next time around?  Any suggestions to help me stop worrying/thinking about it.  

Thanks for listening, 

Emily

[47chromosomes]

I would be afraid of experiencing something like that again, too.  So sorry.  I wonder why your midwife wasn't able to provide relief.  And, actually, WHY couldn't your get an epidural if you requested one?  humpf.

I would do a couple of things.  One, I think you should realize that your repair should absolutely NOT have been that painful.  If lydocain shots, or whatever anesthetic was not working for you, then in retrospect, you could have asked the midwife to STOP.  Go no further with the repair until she figured out a way to numb the area effectively.  This is good news for you because you, while you cannot control definitively whether or not you will tear in your next birth, you can make a promise to yourself to NOT let anyone do any stitches until you have been effectively numbed.  If this means getting a epidural, or going to the OR for the repair, then so be it.  It is your body, and if you are in pain you, you tell them to do something about it before doing any more stitches.  They cannot keep stitching you if you say "Stop,  Get my pain under control first.  Then go."

I also had pain for months after a previous birth.  Not all the time pain, but a lengthy recovery for sure, and then I could not have sex for months after.  I went to my practitioner at 7 months pp for an assessment, and was prescribed vitamin E oil, as well as antibiotics for a mild bacterial infection.  I don't know if the vitamin E oil did it, or just the action of rubbing it on the scar tissue, but between that, and using TONS of lube, we finally did have sex, and it was uncomfortable, but eventually became normal again.  I would suggest keeping that in your bag of tricks as well.  

Last, I would find a doula who is especially skilled in helping clients who have had trauma or have fears about birth.  Let her know what happened, how you feel, what your are afraid of, and the things you would like her to do for you in birth in order to help you go through this feeling like you have someone on your side to arm you against experiencing that isolating, joy-killing pain, again.  You may ask her to help you avoid a tear, you may ask her to be the bully in the delivery room who helps you to insist on effective pain relief before a repair.  She may ask the practitioner to delay the repair until you have had time to hold your baby and enjoy her.  That kind of thing.

I'm not an expert, I just know that as I work through my own trauma, the things that help me to feel better about the possibility of giving birth are to 1) make a list of what I cannot control, and work through that any way I can, and 2) make a list of what I can control, and how I plan to do that.  Like I said, you cannot ultimately control whether you will tear again, though you can work on prevention measures, but you can control the way in which you are treated during a repair.  You have the power and the right to say, "stop" if it hurts.  So, at least there is that. 

[CBEmomma]

I too had a 2nd degree tear with my first. The tear itself wasn't a problem, but the egg sized blood clot that formed underneath it was. Very painful, it is the #1 painful thing I've ever had. I became pregnant with ds2 2 years later. I was still terrified of having a tear that ended in a complication like ds1. I tore with ds1 because the Dr. used the vacuum and pulled ds1 out too fast that his shoulders came out together. The Dr. had wide eyes when that happened and he quickly put the vacuum down because he almost dropped ds1. So when ds2 was born I stood and squatted while birthing him. That helped, well, I don't know if that is why I didn't tear with ds2, but I didn't. Maybe ask your care provider if you can do a different position while pushing, or have a cloth on your perineum or massage while pushing. I know some Dr.s will do massages, or let your DH or Doula do it. I also agree with getting a Doula and/or care provider that works with women who have had previous traumas or fears. Good luck momma, I hope you can find what you need and things go better the second time around.

[mindosxan]

That sounds very traumatic, and i am sorry you had to go through that.  One thing i highly recommend is perineal massage.  I believe i started doing that at about 32 weeks. either you or your partner can do it, it involves using oil usually mineral or i used vitamin E since i knew that was safe and you insert a  finger into your vagina and apply slight pressure towards the perineum, move your finger around and apply to all parts of your perineum, if you have scar tissue pay a little extra attention to those areas as this can help break up scar tissue.  Also during your labor, if you have a midwife then she can apply warm compresses to your perineum and some will even massage it during labor to help you stretch.  here is a wonderful link on it that details benefits and instructions better than I have.  good luck!!

http://www.pregnancy.org/article/perineal-massage