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Tearing.....

post #1 of 21
Thread Starter 

As I get closer to my EDD I find myself thinking on this more and more.  Tearing.  Not a super fun topic but one I'd love to discuss!

 

What are your experiences with tearing with previous deliveries?  Do you feel something in particular contributed to it?  Planning on doing anything specific to avoid it?

post #2 of 21
I tore a bit with DD - nothing major, a few stitches, easy recovery (though I LOVED my peri bottle to help with the stinging when I peed) and no long term discomfort at all. I was induced at 41 weeks and did get an epidural do I was on my back to push. This time I really hope to go into labour naturally, hopefully skip the epidural and maybe try pushing on all fours or kneeling. Having BTDT with an 8lb baby I'm not really worried about it this time
post #3 of 21
I had a second degree tear with my dd. I would like to avoid it this time as I had some healing issues with it. It still feels pretty tender. I delivered on my back and I am pretty sure that caused it. Also rushing to push the baby out (pitocin induced distress). I had no epidural so not feeling wasn't an issue. This time around I am planning a homebirth and hope to be able to push in a more comfortable position. I also hope to be able to take my time with pushing so my skin has time to stretch before I birth the head.
post #4 of 21

I had an episiotomy after the head was out with my first - epidural, pitocin, back pushing. She gave the excuse that the shoulders were big, but it was practically immediate and I have some serious doubts about that. I'm thinking she just wanted to make a few extra dollars? It took me a year to feel pretty normal and not have pain there. 

 

With my other 2 I did mostly hands and knees pushing and had no tears at all even though I wasn't doing anything special to avoid it. I think the position probably helped and I guess, I didn't really tear with my first either - the doc cut me, so yeah. But, I really believe position matters and doing things according to instinct some may help, but I am theorizing. I hope I don't tear this time either, but unless the baby is in a weird position, I don't think I will. It's much easier not tearing or getting cut because it doesn't hurt every time you pee. So, get in a good position, use that oil stuff if you think it'll help and gentle pressure/support, breathing baby out if you can, any of that good stuff. Haha


Edited by dayiscoming2006 - 4/29/13 at 5:47am
post #5 of 21

I had an episiotomy with my first because the OB on call (I had a midwife but was in the hospital for an induction) used the vacuum and did an episiotomy as a routine thing beforehand.  I didnt tear beyond that.

 

I'm a little worried that the scar site will not be as stretchy and be more prone to tearing but I think it'll be just fine

post #6 of 21

i tore on top very slightly- no stitches and on the bottom--a couple of stitches required. we had a homebirth and i delivered into my own hands. what's interesting is i felt the one on top and held myself because of the slight sting i was feeling...and the one on the bottom i didn't feel at all while it was happening. however recovery for the stitches was not fun...i could feel it tight during sex for a long time--maybe 6 months it was very uncomfortable.

 

i plan on delivering again into my own hands...and would like to use warm compress or oil as the head comes out to help. i don't want to tear again, but mostly i want to know i've helped support both the top and bottom--even if i don't feel any pain again on the bottom. :) i don't want anyone else touching me, like last time. last time i was expecting to have a water birth--but got out to push the baby out on land--the tub/water felt too big or like i couldn't feel enough. anyways i got out to push so hadn't really planned anything for perineum. won't repeat that. :)

post #7 of 21

A resident at a military hospital delivered my first.  I was only 20 years old and when he said BEFORE I started pushing "do you want me to cut you or do you want to risk tearing" I responded with "UM I HAVE NO IDEA" he took it upon himself to make the stupid cute.  She was only 6lb4oz and I'm SURE I could have birthed her without it.  I never had a tear or cut after that and the range for my vaginal deliveries afterwards was 5lb11oz, 7lb3oz, 7lb12oz and everything was fine.  I will say that recovery after the episiotomy SUCKED and well, I don't even know what else to say. 
 

post #8 of 21

I've heard the episiotomies are...horrible. My doctor says that she does them in only 2 situations (both rare): (1) If the baby is in serious distress and they need to get it out ASAP, and (2) if i looks like the alternative is a super-serious tear. I'm hoping that (plus the doula we might be hiring??) will be enough to avoid one.

post #9 of 21

Yeah, after having an episiotomy, I pretty much decided I'd much rather take a chance on tearing at least that leaves a chance that there won't be much damage if any while an episiotomy guarantees damage. And I read tears usually heal better than episiotomies despite some docs claims because their more natural I guess, but I suppose they aren't as much fun to stitch up. I think I would only do an epsisiotomy if the situation was seriously emergent - baby really stuck and in distress. 

post #10 of 21

The hospital that we will deliver at doesn't allow episiotomys. I was wondering though, is there anything I can do to prepare my perineum? I have been doing Kegel exercises, but is there anything else to do now, or even during labor, to help stretching? 

post #11 of 21

I don't know anything much about it, but some people do perinial(spell?) massage to stretch the tissues. I don't do anything myself. During the birth though you can also have someone use like olive oil and support the tissues while the head is coming out from what I understand. I've never done that either, but it's an idea. 

post #12 of 21

I had a third degree tear with my first birth. Thankfully I was expertly stitched up by a plastic surgeon (took well over an hour to stitch up) Extremely, extremely painful recovery but it healed up very well. I had no complications from this other then lots of scar tissue :( My first was a 9+lb baby, normal presentation, I pushed for almost 2 hours. (doctor applied warm oil and pressure to perineum during pushing stage) I tore badly as the shoulders came out too fast according to the OB though I personally suspect I tore so badly because I was being coached when to push and didn't really feel "pushy"

 

I was terrified about another significant tear during labour with my second but thankfully it was only a second degree tear which is a huge difference from third degree OMG!!! Took maybe 10mins to stitch up (OB stitched herself) and recovery was so much faster even though I did blow a few stitches a few days after birth which sucked.... (I am going to REALLY limit exercise after birth this time if I tear again!)  2nd baby was also a 9lber but was delivered posterior. This time I only pushed for 6minutes. The OB just watched me and encouraged me so I pushed only when I felt like I needed to or when my body involuntarily pushed-which was a little scary for me at first but really was an awesome experience and my pushing felt way more effective. This OB applied pressure as baby crowned but no oil or anything else.

 

This time, it will be a different OB delivering again (and at a new hospital) I am hoping to push when I feel the urge and to push in whatever position I feel comfortable in. (which has been OKed by my OB as long as baby is not in distress) If I do tear badly again, I will take good care not to overdo it so those stitches stay closed.

post #13 of 21

This is interesting because the recovery from my episiotomy (mediolateral) was no big deal.  I was more bothered by a slight laceration I had near the front that stung when I peed.

My entire crotch area in general hurt the first week but it never bothered me for months on end or anything, and sex was fine

post #14 of 21

Books I've read recommend perineal massage, slow and steady pushing rather than forcing it, and applying gentle counter-pressure on the stretching tissue as the baby emerges using a warm, possibly moisturized towel. 

 

I am going to try perineal massage since my husband knows what it is and didn't seem fazed by the thought of stretching out my vagina as a favor, LOL... but it might prove to awkward to continue after the first session, so IDK yet. I'll have to ask my OB if he usually does counter-pressure or not, and if it's something he would do or something my husband would do. I hope it's the OB, because I want my husband next to me as I push! 

post #15 of 21

With my 2 babies that I didn't tear or get an episiotomy with I pushed involuntarily for 99% of it with DS2 and I pushed only when I felt like it with DD since it was a UC, though I never really got the involuntary thing with her that I'd hoped for. It certainly may have helped.  I think my midwife would do the gentle pressure with a towel thing, but I don't know if I'll tolerate it. I HATE being touched when I'm in a lot of pain. 

post #16 of 21
Dayiscoming, I'm the exact same way!!! I don't want to talk or be touched.
post #17 of 21
Thread Starter 

Thank you all for sharing your experiences!

 

 

I had bilateral sulcus tearing - 2nd degree.  I had no outer tears past the vaginal opening, mine was all internal tearing.  I had 2nd degree tears down both sides of the vaginal wall, extending from the cervix all the way to the vaginal opening.   It took about 2.5 hours for the OB to suture me up (I delivered with a CNM but it was beyond her scope to repair...) and he estimated around 85 stitches (hard to tell because they were continuous VS individual).  The repair itself was really, really, really bad.  The OB that did the repair was horrible, mad that he even had to come in to do it, made because I was a VBAC without an epidural, started suturing without a local because he *assumed* I had an epidural, said "well you can just do this with nothing if you'd prefer" when I asked if the demerol they offered to take the edge off the pain would be ok while I was nursing my newborn son, ect..  He was just BAD.     Recovery was pretty rough too....  I didn't heal properly and he crossed from side to side with the sutures so he literally sewed parts of my vaginal walls *together*.  It was horribly painful to the point where I could hardly walk from my bed to the bathroom without crying and I ended up going back in at 2 weeks postpartum  to get things checked out.  The CNM I saw commented on the sutures extending across the vaginal walls and clipped those which provided some immediate relief to the constant tugging and pulling feeling.  There had also been several places where the sutures had ripped from the pulling so she had to chemically cauterize those with silver nitrate....  I went back in at 4 weeks PP for more cauterization on areas that didn't heal still.  It took about 8 months for the pain to totally go away and I'm left with lots of scar tissue and odd scaring...

 

That is what I just can not go through again....

 

The main reasons I believe I tore so badly is because I had an oddly positioned baby (posterior the entire labor - turned at the VERY end - delivered with an asynclitic head), plus after 40 minutes of pushing my CNM paged for the on call OB to possibly assist with a vacuum and I heard her (she didn't intend for me to hear) and I was NOT letting that happen....  I was a VBAC and I had come too far to not push him out on my own when both he and I were NOT in distress and a vac wasn't needed... SO I pushed with all my might and he FLEW out in two more pushes - she literally hardly caught him he came so fast....  Not to mention I was flat on my back and despite the fact that I'm a doula myself, I just wasn't in the frame of mine after a pitocin induced (BP issues) un-medicated VBAC to remind myself to get upright!  Between those issues I'm sure that's what contributed to the tearing...

post #18 of 21
Gosh, that is awful and scary. I do hope things go so much smoother this time mama!!
post #19 of 21
Holy crap that's an awful story! Do you file a complaint about that OB? It makes my heart hurt to read about those words towards a just birthed mom.

I had only tiny tears, one required three stitches, one I didn't bother stitching cause it was superficial and in the same place as the last tear and in figured I'd just let it be. I've seen some doozies though, the two worst were from a funny head position/shoulder distocia with a lets say 'stressed' quick delivery and one with an elbow accompanying the head.
post #20 of 21

Never torn 3 kids and the worst was a "sandpaper" tear which is basically the feeling someone rubbed sandpaper across you

 

Honestly I think the worst things that contribute to a tear is

 

induction

epidural

bad OB/midwives

 

I was induced with baby #3 and still didn't tear and I believe it's from the lack of epidural and an amazing midwife who helped stretch and use hot cloths on me
 

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