Two Severe Lacerations

[redsoxdoula]

Would you recommend future vaginal births for a mother who had fourth degree lacerations from both previous births?

[onelilguysmommy]

not a mw, but if i knew that mama, id tell her she was brave for thinking about it even! i know most people wouldnt even go there in their thinking after the first!

[MsBlack]

Well...it is definitely something to think about carefully.

I would not automatically rule out vag birth, but would definitely have to know more about this woman, circumstances of her births/tears, and current condition to really say anything useful.

[wombjuice]

Where did her previous births take place? What position did she birth in? Was she induced? Did she have an epidural?

These are all factors that would come into play in regards to whether or not she would tear so severely were she to birth vaginally again.

The poor mama.

[redsoxdoula]

Great responses!!!!

Well...I'm the mom.

1st Birth-
no epidural
pushed for 3+hours
episotomy
purple pushing.....so yeah..I get it

2nd Birth
way more satisifiying, and positive
dad caught baby
shoulder dys.
no episotomy
epidural
40min of self-directed pushing
even though I endured another 4th, oh my it was a beautiful birth...so much love/respect in the room. I really couldn't have ask for anything for beautiful and empowering.

SO...b/c of my positive experience...if we do have more children, I'd love to go with the vaginal birth again. I just love it. However..the skin is pretty thin now and who know how well it will heal up in the future. And yes, it's all aobut "the future"....like continence and other side effects as you're all probably well aware of. As a doula, I am all for what the mother wants. But I wonder if circumstance, like this one, plays a role in deciding future birth options.

What do you guys think???

[jenmidwife2b]

I really believe that if you were allowed to chose your birth position you would have less likelihood of tearing. A waterbirth and no one telling you when to push, how to push, etc. will also be of benefit to you. I had an episiotomy and then tearing with my first, had another episiotomy and fourth degree tearing with my second, had third degree tearing with my third (so far all hospital births and all epidurals), and then with my fourth, a home waterbirth and only a slight tear that didn't need sutures, with my fifth, another home waterbirth unassisted with dh catching, and no tears.

[MsBlack]

I would get proactive now....work toward optimum healing of your scar/s. This means really good nutrition, plenty of protein along with vitamins and minerals and minimizing junk food; it means doing pelvic floor exercises where you focus not just on the 'tightening' but just as much upon the second phase of 'relaxing' those muscles; it means also using a high quality Vit e cream/salve on your perineum and on up inside. Each of these 3 points could be expanded quite a bit--I've just tried to give the basic point.

And I don't know for sure since I haven't been there--but I think in your shoes I'd be looking to do everything possible toward a vag birth. I would want so much to give it one more try. And if it happens (3rd or 4th degr tear) again, well, I suppose THEN I might decide any more kids would have to be birthed via csec.

[mamasunflwr]

http://www.mothering.com/discussions...d.php?t=266955

http://www.mothering.com/discussions...d.php?t=793920

Thought these old threads might offer some insight.

[ktbug]

Perineal support and massage, as well as the freedom to give birth in the position that feels most comfortable for you, can make a lot of difference.
Perhaps a very well-trained doula or a sympathetic CPM?

[redsoxdoula]

Interesting...'
Oh and great link discussions!

I often wonder, which isn't a wonder-game, if I had the say and primitive rights to do as I do, would I tear again (and as bad?)?

Also, I forgot to mention that little DS was 10llbs. 12oz....a little a larger side!

I did have a compassion MW. She, herself, had a fourth with one of her children and the DOC that repaired had 3rd with hers.

We romanized homebirth for awhile but DH was totally against it. So, I know for a fact, I am just destined for hospital births. I would guess that having a very experience doula would help in assisting on staying on track with a birth plan that mimiced homebirth. And as a doula that had done several hospital births, I know that is hard to achieve.

You guys are too sweet. Fourths totally suck. But if I could just a little personal, it might encourage those who has suffered in some way:

Being pregant with my second made me confront the fact that I could very well tear again, especially opting for a vaginal birth. BTW, cesearean births and vaginal births are something each woman has to carefully chose for themselves-very personal. However, I would encourage anyone to opt for another vagainal birth.. Though I tore a 4th AGAIN, the birth was beautiful and amazing that I would encourage those to take a hard look on what birth truely means to them. Anyways, totally off track-sorry. But that's exactly what I did. I really asked myself the hard questions. And I came to the very conclusion that I do risk the chance of enduring another fourth. SO, am I gonna cry about it and fall into a depression of "failure", "brokeness" and feeling "victimize"??? OR do I surrender to the UNKNOWN. Acceptance and finding the positives (which lurkes everywhere) made my birthing experience totally spiritual, exilerating, like a heroin-like shot of EMOTIONAL. To me, it was ephoric. My husband caught our little moose and laid him on my breasts/stomach while we cried happy tears. Utterly amazing!!! And here's something kinda funny...I actually tore a bit deeper into the rectum this time and I healed much faster and the recovery process was a lot easier. My mental state was clear, healthy and I found nursing rewarding and just lovely. SOOOO, I guess I could do the same if I get pregant in the future. But lets get a little medical, if I fourth again...will I be wearing diapers just as my babies did? And sex is so amazing...will the great sex I have now getpainful if I have a fourth for the third time? Sure, now we pee a little with a good laugh...but will I be losing it when I am still? DOES ANYONE KNOW OF ANYONE WHO FOURTHED 3 TIMES??? 'cUZ, if so, I wanna talk to her. Anyhow, yeah, I just love Homebirth and would love to do it. But like I said before, that will won't happened.

Thanks for all of you replys, ladies! I love reading them and I can truely sense your compassion and your desire to see women birth with confidence and find trust in the process!

hAVE a relaxing weekend...!!!

[teachermom]

are there any free standing birth centers in your area where you could find a middle ground between homebirth and hospital? I tore to a fourth with my first. with my second, who was almost twice his size it was only a tiny first. the next two there was no tearing at all. I think that for me, the biggest factor in this was that I never got onto a bed. I walked, danced, rolled on birth ball, and floated in water. I think that getting that baby in a really good position helped so much. that and being in control of how and when I pushed.