badly healed perineal tear - help?

[cactuspear]

I had a 2nd degree perineal tear with a nuchal hand birth 5 months ago.  My CNM stitched me up, but I was still having pain and tenderness at my 6 wk checkup.  She said that was normal, but it never felt "right" again, and the discomfort continued.  I went back for my yearly exam yesterday, learned the tear never healed right, and now I might have to get reconstructive surgery.  I have a consult with a surgeon next week.

Has anyone ever dealt with a similar problem?  Did you finally recover and what was it like?

I'm horrified.  Will my vagina ever be the same?  Does this mean things will get even worse if I have another vaginal birth?  I was in tears on the way home and have been depressed and scared ever since.

[cactuspear]

Wow, lotsa views and not one reply.  Kinda disappointing.  Well, if you were interested in this thread, I've got an update:

Surgery was possible, but not necessary, so I opted out.  The internal healing went well, so it was mainly external tissue that was misplaced and irritated after my tear was sewn up.  That was a big relief.  They also said I could have a reconstructive procedure immediately after giving birth again if I choose to get an epidural.  I'm not sure if I'll want that, but it's nice to know it's an option.

I didn't have pain-free sex or exercise until more than 6 months after my daughter was born, and things may never feel the same, but they are much better.  This is the new "normal" and it's not so bad.  As long as I'm talking about something as intimate as my perineum, I should note that getting an expensive lube formulated just for women (at a sex shop) did make a huge difference for my lady parts.  Hope this helps anyone in a similar situation :)

[APToddlerMama]

I never saw your original post, but had a third degree tear that healed terribly as well and was offered surgery and declined.  I think it was six or maybe even seven months before we could have sex and I guess I have never felt totally 100 percent normal but 99 percent of the way there.  I'm pregnant with number two and concerned about the tearing as well.  Just remember though you probably won't have the same circumstances that lead to your bad tear again.  I had a posterior baby and needed a vacuum delivery.  I am hoping without those factors, I'll tear less. 

[lifeguard]

Interesting thread. I just had my 2nd & was horrified to find out I hadn't healed well. I'd had no pain or problems & yeah, things didn't look & feel quite the same but I figured that was normal (I had a 3rd degree tear the first time). My ob this time was visibly upset about how I had healed from last time. I will be looking into whether we need to do anything about this when I go in for my 6 week pp visit. We want more children & this delivery became slightly complicated by the scar tissue. The ob had to stretch & stretch it & I still re-tore (though not as severely as last time). Things most definitely look awful down there now.

[AndtheStars]

I had a 3rd degree tear with DS two years ago and ended up getting surgery to fix the repair job about 7 months after birth.  The OB who stitched up my tear basically sewed my inner labia together along with some of my vagina.  It was awful.  I still don't have pain-free sex 2 years later.  It's bearable (I'm pregnant again so it works at least) but it will never be the same.  I'm absolutely terrified of labor with #2.  My midwife has already said that I'm probably going to tear again because even with the repair, I still have a 'lip' on the side.  I'm just hoping that it's not as bad or there's a good repair done if necessary.  I'm really hoping that different birth circumstances will also help.  I would really like to 'breathe' this baby out, instead of bearing down pushing.   

[lifeguard]

andthestars - fwiw - I had to slow down on my pushing because of the tear with dd. They even tipped the bed back so I was pushing uphill 'cause we needed to give the scar tissue extra time to try to stretch. I definitely did not push as hard as I did with ds.

[AndtheStars]

lifeguard, I really think that that might be the key with this birth.  I was a homebirth transfer for DS and I'm surprised that the hospital even let me try to push.  I was in such a state at the pushing stage that you could have told me to push standing on my head and I would have done it.  It also didn't help that I had no pushing urge whatsoever at any stage of the game so I couldn't follow my body's lead.  I didn't really know how to push and my body wasn't giving me any help so I just PUSHED and no one told me otherwise. 

[lifeguard]

I also did not have the desire to push with ds - it was awful. Have you talked to your midwife about waiting until you have the urge to push this time around? Just having that discussion with my ob this time made me feel better & he was fine with waiting as long as we needed to (which wasn't necessary!).