Tearing and future babes...

[pumpkinhead]

So, I'm a little scared...Dh and I are discussing TTC #2, and while I'm THRILLED, I'm a bit aprehensive. I tore fairly bad with ds. I think it was because he came too quick and the OB really didn't apply any counterpressure when he was crowning. To add insult to injury, I don't think he stitched me up as well as he could have...things kinda looked uneven there for a while. I have a significant band of scar tissue that I can still feel and I can feel the line where I was stitched. It's tight and unyielding. I also had to have granulation tissue burned off with silver nitrate at 8 wks pp.

So the point, I'm worried about tearing the second time around. Won't it be ten times worse now with all of tha scar tissue? Is there anything i can do about it? Does anyone have experience with this? Give it to me straight! Horror stories if you have 'em I can handle it! I'm still gonna TTC #2 any way .

[momto l&a]

I tore pretty good with my first and had to go be stiched up. The dr put in a "husband stitch" so it made 'relations' with dh very painful for awhile.

With my second I tore but not nearly as bad and no stitched where required. It healed very much off kilter but no pain. Just dont look at it :LOL

I put pressure down there during the birth because it felt so good, dont know it it helped with less tearing or not.

[Kim2002]

I had an episiotomy that turned into a 3rd degree tear of the sphincter muscle and am also a little nervous about tearing again. My son's head was very large and his hand was on his face when he came out, which is why the OB cut me. It was most unfortunate that the cut turned into such a horrible injury. The recovery time was very long and I, too, have a thick scar that is unyielding.

What has been recommended to me by both my doula and my midwife is to do perineal massage with evening primrose oil starting at 35 weeks. The way she explained it to me was to break open an EPO capsule, have hubby apply the oil to his fingers, then insert 2 fingers inside (up to the 2nd knuckle). Press downward toward the rectum and hold for a count of ten. Then slide to the left and press for a count of ten. Then slide to the right and press for a count of ten. She said to do this a few times each night for the remainder of the pregnancy.

We've also discussed birthing positions that will minimize tearing. The typical on your back with legs in stirrups is the WORST position and will only maximize the possibility of tearing. So she has suggested I either stand, semi-squat, sit on a birthing stool, lie on my left side, or even kneel on all fours. The key is to keep a narrow gate. KWIM?

[fireflies~for~me]

I had a third degree tear-just pushed right through even though DH was desperately trying to slow me down. My doc ( a family doc)was the one on call-her first birth out of residency.

DH was a little freaked by the blood but I was in a blissful state of baby ecstasy and didn't feel a thing...

So...for us next time around, we are planning a homebirth with a very experienced CN Midwife, so I am not expecting (nor is she) for me to tear at all.

[Aura_Kitten]

fwiw, my sister tore horribly with her first baby... and has not torn at all with her other three. her kids all ranged in size from 8 to 10 lbs.

s

[SaraC]

With my first birth,I had 3 episiotomies(HB non-emergency transfer w/ vacuum delivery) and tore to the 3rd degree with all. With my second birth I delivered a slightly larger baby with no tears at all. I think if you educate yourself and choose a knowlegable care provider then you will have less of a chance of tearing.

[USAmma]

Everyone's different of course, but I was terrified of bad tearing with my second baby. With baby#1 I had a 2nd degree episiotomy with lots of pain for months afterwards. I was terrified that the scar tissue would make me tear more, but after talking with my doula, decided to allow a tear vs. a preventative cut. Glad I did, because I only tore a tiny bit with baby#2 despite the fact that she came out in 3 pushes. The tear was to the side, caused by uneven head presentation, and was so small that I didn't need any stitches.

Since you know what kind of care you want "down there" during the birth, just make sure it happens next time. I massaged EPO into my scar tissue starting the last month before the birth. Not sure if it helped or not but it certainly didn't hurt.

Darshani

[AnaNicole]

I was just talking about this very topic to a friend of mine today. I had a minor tear with my firstborn that my midwife didn't stitch (she should have). It was incredibly sensitive after healing, i.e. sex was extremely painful, until it retore after my second birth and my midwife (not the same one as before) stitched it. What a difference! I healed up just fine and had no more pain.

The one thing my second MW did that was different from my first birth was apply warm compresses to my perineum while my daughter was crowning. It felt amazing, and gave me something to push against. So, with my third child, I started demanding compresses before I even started pushing! I don't recall how long we used them, but it was awhile. When one would cool down I'd demand another! Then, my most fabulous MW really supported me when my daughter was crowning. Though it felt like a train rocketing through me her head actually came out quite slowly.

I didn't tear at all.

The best part--my first two babies were both under 8 pounds (7 12 and 7 14 respectively). My third, on the other hand, was nearly 10! And she had a HUGE head.

We didn't do much perineal massage (really, that always creeped me out). We did some, maybe, but not nightly by any means. I attribute my success to the compresses and a wonderful amazing midwife. Who I imagine will chime in on this thread at some point!

[pumpkinhead]

Wow, ladies!!! I'm feeling quite a bit better about this! Thank you all soooooooooooooo much for sharing your experiences with me!

Before the doctor arrived, my incredible nurse was applying compresses and doing perineal massage , but once the doctor arrived, there was none of that : I wish she'd caught ds!!! He was only 6lb 14.5oz! big head tho

Again, thank you ALL so much!

[Mindful Mom]

I had a horrible 4th degree tear with Ean (he was 9 lbs 7 oz and stupid OB cut an epi ). Zoe was 8 lbs 10 oz, caught by a midwife (hospital birth) and despite a ton of scar tissue I wound up with a tiny skid mark and didn't need any stiches!!

It can be done!!

[Slabobbin]

What is this "husband stitch" that you speak of? I have always thought that my doctor sewed me up too tightly but I didn't realize it happened to others.

I had a fouth degree epi with my first and have been wondering about this issue myself. Good to hear that it may can be avoided with the next one.

[AnaNicole]

Originally Posted by Slabobbin

What is this "husband stitch" that you speak of? I have always thought that my doctor sewed me up too tightly but I didn't realize it happened to others.

I had a fouth degree epi with my first and have been wondering about this issue myself. Good to hear that it may can be avoided with the next one.

Far as I know it's an extra stitch designed solely to make you tighter, down there. And not, obviously, for YOUR benefit, thus the name. :

[3_opihi]

I had a level 4 episiotomy with my first and tore upwards too. I was really nervous with my second...We ended up having a water birth and had absolutely no tearing. I think the warm water warmed up the tissue and helped it to stretch. That's actually pretty common with waterbirths.

[pumpkinhead]

Wow. I'm so happy to hear all of this! You ladies are the BOMB!

[momto l&a]

Originally Posted by AnaNicole

Far as I know it's an extra stitch designed solely to make you tighter, down there. And not, obviously, for YOUR benefit, thus the name. :

Yup thats what it is. :

I have a friend who long ago used to be a L&D nurse. The dr she worked for always did a husband stitch, the dr was a man of course.


I can tell you my dh did NOT like that 'extra' stitch.

[pamamidwife]

Originally Posted by AnaNicole

Then, my most fabulous MW really supported me when my daughter was crowning. Though it felt like a train rocketing through me her head actually came out quite slowly.

I didn't tear at all.

The best part--my first two babies were both under 8 pounds (7 12 and 7 14 respectively). My third, on the other hand, was nearly 10! And she had a HUGE head.

We didn't do much perineal massage (really, that always creeped me out). We did some, maybe, but not nightly by any means. I attribute my success to the compresses and a wonderful amazing midwife. Who I imagine will chime in on this thread at some point!

It was YOU, Ana, not me! You pushed her out so gently and slowly - in fact, her head was out, if you remember, for a whole four minutes before her body emerged!

I don't think that there is much I can do as a mw to prevent tears. Positioning, health of the mother and baby's position really affects it all.

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[nikirj]

The first time around, my daughter came out slowly and I had a 3rd degree tear.

The second time around, my son came super-fast and I had a tiny tear. He was a pound heavier than my daughter, too (and we didn't do anything to try to prevent tearing in either case).

[curlygrrl]

Originally Posted by pamamidwife

I don't think that there is much I can do as a mw to prevent tears. Positioning, health of the mother and baby's position really affects it all.

I'd like to hear more about positioning of the mother to avoid tearing. I had a pretty good tear with DS and am really hoping not to tear this time. I mentioned that to my midwife and she said she prefers the side-lying position.

[pamamidwife]

I think that it has to be mother-led. We can all have these ideas on which is best, but I think that whatever the mother chooses is going to be the best. If you're sidelying and someone has their hands all over you, pulling and tugging on your vaginal tissues, you may feel more inhibited and tighten up more than you would if you were standing or kneeling.

I have a page on my site about vertical delivery - I find that when left alone to their own devices, most women will be upright. I suggest a birth stool, too, if their legs get too tired.

To me, water birth is the perfect solution. Water provides nice counterpressure and moms are often buoyant enough to assume different positions easily and can provide their own perineal support, rather than having someone else's hands on them.

Here's my page on vertical birth: http://www.midwifemama.com/vertical_delivery.html