Faulty Perineal Repair

[zhiruo]

Hello everyone, I have been lurking on this forum for the past couple of days. I wish I found out about this forum months ago so I can better protect myself. I gave birth to my first baby on July 26th. He was 7 lb 7 oz and 19.5 inches. I had a really long labor and finally had pitocin and an epidural. Overall, the birth was pretty smooth compare to some of the other nightmare stories I read here, but I am still unhappy about the whole process and it depresses me the more I think about it. Here are some of the things that just didn't feel right to me.

-I felt rushed. I only felt the urge to push when the baby already started to crown, and even then it wasn't a strong urge at all. The nurse was yelling at me "I don't want you to scream, I want you to push", "hold your breath and don't let go", and "that push was no good, I want good pushes". Babies vital looked good, so what's the rush? How do you even push when you don't feel the urge to push? It boggled me, but I was in so much pain I was just doing whatever they told me.

-My female OB was not on call during that weekend, so it was a male doctor who delivered the baby. I was very confused toward the end from the epidural and not getting any sleep in over 24 hours, and the doctor never said a word to me and offered explainations when he poked and prodded me.

-After the birth of my son, they put him my belly and all of sudden I felt really sharp pain in my abdomen, and it turns out they were pulling on the umbilical cord to get the placenta out. I always thought placenta delivers spontaneousely after birth, and it just didn't seem right they have to rip it out of me especially without warning or a word of explaination.

-The doctor did an incredibly bad job of repair my perineal tear. He told me I had a very small tear, between 1st and 2nd degree. Initially I was pretty happy about it, those perineal message must have worked. However, I noticed I had an extra flap of skin down there when I was still in the hospital, but everything hurts so bad that I didn't want to jump to conclusion, maybe once I am healed, this extra flap of skin will shrink. I am now 4.5 weeks post partum and I still have this extra flap of skin. It looks like I have a second clitoris at my perineum. My vaginal opening is also much smaller than before I had the baby. I only found out about something called the "husband stitch" today. I don't know if I was subjected to that, but this seems unethical and illegal to me. How in the world can anyone legally mutilate a woman's body without her consent.:

These trauma combine with the fact that I had to undergo emergency appendectomy when I was 3.5 weeks post partum have made me depressed and unsure about my body. Do you think the doctor was negligent for performing such a shotty suturing job or does this problem occur so common that it gets scrap under the rug?

[battymama]

I am sorry you had such a horrible experience, lots of hugs for you. I actually had a bit of a flap of skin when i tore, it was a first degree tear that went a bit funky. My midwife and i opted to give it a go with stitches to see if it would heal up, but it ended up soming free at about 2 weeks post partum, i just cut it off in the shower as it was dead, sorry if thats tmi. It sounds as if you may of had a similar thing? but yours actually healed, i think if mine had of healed it might of formed a bump, it can sometimes take a while for everything to go back to normal. I really hope you havent had the "husband stitch" i think it is horrible to perform what is basically cosmetic surgery without a patients consent, although by the sound of the way you were treated, not being told what was happening ect it wouldnt suprise me.

Please give your body time to heal, it can take a long time to return to normal. I had a very good birth, and didnt have my apendics out and i was no where near fully healed at 4.5 weeks. Is there any way you can ask your ob what happened?

[nashvillemidwife]

Originally Posted by zhiruo

Do you think the doctor was negligent for performing such a shotty suturing job or does this problem occur so common that it gets scrap under the rug?

I sympathize with your situation. You had a horrible experience and it definitely sounds like many things were handled inappropriately. However, I don't think it's fair to conclude that the suture job was one of them. Things can heal funny, even with the best repair, and that does not mean they were shoddy jobs. I wouldn't be so insensitive as to advice you "scrap it under the rug", but it is common and not necessarily the result of negligence.

[Daniel's Kitty]

Sounds pretty normal to feel different after the birth. It is still really soon after the birth. I will admit I am not a huge fan of stitches there though. My dr stitched about an inch to repair my 1/4 inch tear with number 1 and it looked okay but it was so tight and sex was painful until after #2 was born when the old tear opened up and was just glued shut.

Personally I would be more bothered about the trying to pull the placenta out if it were me.

[paquerette]

It sounds like they did a lot of wrong things.

As far as the repair goes, it's likely that you didn't need any repair at all for something between 1st and 2nd degree. I had a lousy repair job too and fortunately mine seems to have evened itself out over the years. You could try some perineal massage if it's not still too tender and see if that helps it release. Or just wait a while. Or try to find a GOOD midwife to take a look at it and see if it seems candidate for surgical repair. Or, if you're having more babies, there's a chance you'll get another small tear and can let it heal on it's own, if you can plan on a week or two in bed with your legs together after birth, better still.

[BeachBearMama]

I had a very good repair of 4 minor first degree tears. The only one that didn't get stitched was the internal tear b/c my MW didn't want to risk causing scar tissue. Well, it didn't heal right and now there's this lovely little "finger" of tissue that should be inside but is outside. It's not attractive and it is uncomfortable, especially when I try to use my DivaCup once a month. I went back to my MW and she referred me to another doctor and I'm planning on having a revision done in a few months (especially since I've met my deductible and it will be at no cost to me.)

It is possible that things like this just happen, even with a good repair. I second the advice to get a good doctor or MW to look at it and tell you if you're a candidate for a revision surgery if you want one. I was also given the advice that it would probably correct itself with Baby #2, but since I don't plan on having Baby #2 for several years and the deductible is met now, I'm going to take care of it surgically this year. Good luck.

[honeybunch2k8]

Originally Posted by zhiruo

Hello everyone, I have been lurking on this forum for the past couple of days. I wish I found out about this forum months ago so I can better protect myself. I gave birth to my first baby on July 26th. He was 7 lb 7 oz and 19.5 inches. I had a really long labor and finally had pitocin and an epidural. Overall, the birth was pretty smooth compare to some of the other nightmare stories I read here, but I am still unhappy about the whole process and it depresses me the more I think about it. Here are some of the things that just didn't feel right to me.

-I felt rushed. I only felt the urge to push when the baby already started to crown, and even then it wasn't a strong urge at all. The nurse was yelling at me "I don't want you to scream, I want you to push", "hold your breath and don't let go", and "that push was no good, I want good pushes". Babies vital looked good, so what's the rush? How do you even push when you don't feel the urge to push? It boggled me, but I was in so much pain I was just doing whatever they told me.

-My female OB was not on call during that weekend, so it was a male doctor who delivered the baby. I was very confused toward the end from the epidural and not getting any sleep in over 24 hours, and the doctor never said a word to me and offered explainations when he poked and prodded me.

-After the birth of my son, they put him my belly and all of sudden I felt really sharp pain in my abdomen, and it turns out they were pulling on the umbilical cord to get the placenta out. I always thought placenta delivers spontaneousely after birth, and it just didn't seem right they have to rip it out of me especially without warning or a word of explaination.

-The doctor did an incredibly bad job of repair my perineal tear. He told me I had a very small tear, between 1st and 2nd degree. Initially I was pretty happy about it, those perineal message must have worked. However, I noticed I had an extra flap of skin down there when I was still in the hospital, but everything hurts so bad that I didn't want to jump to conclusion, maybe once I am healed, this extra flap of skin will shrink. I am now 4.5 weeks post partum and I still have this extra flap of skin. It looks like I have a second clitoris at my perineum. My vaginal opening is also much smaller than before I had the baby. I only found out about something called the "husband stitch" today. I don't know if I was subjected to that, but this seems unethical and illegal to me. How in the world can anyone legally mutilate a woman's body without her consent.:

These trauma combine with the fact that I had to undergo emergency appendectomy when I was 3.5 weeks post partum have made me depressed and unsure about my body. Do you think the doctor was negligent for performing such a shotty suturing job or does this problem occur so common that it gets scrap under the rug?

Ahhhh!!!!
That's just aweful, and so abusive. Have you considered making a formal complaint??? I don't mean to be alarmist, but those things they did really put your health in jeopardy.

Everything sounded negligent, not just the suture. They are NOT supposed to yank on the placenta.

It's not your body that was the problem, it was the doctor, so please don't feel unsure.

I'm so sorry!!!

[zhiruo]

Thanks everyone.

I am sorry you had such a horrible experience, lots of hugs for you. I actually had a bit of a flap of skin when i tore, it was a first degree tear that went a bit funky. My midwife and i opted to give it a go with stitches to see if it would heal up, but it ended up soming free at about 2 weeks post partum, i just cut it off in the shower as it was dead, sorry if thats tmi. It sounds as if you may of had a similar thing?

The flap of skin is actually pretty sensitive. It feels more like what Beachbearmama described, it should be inside, but now it hangs outside.

Things can heal funny, even with the best repair, and that does not mean they were shoddy jobs.

I had what the doctor himself called "small clean tear right down the middle". Can you explain what complication can occur here? In addition, I had the flap from the very beginning, so its not the result of scar tissue or skin stretch funny once it healed. I can't picture any responsible individual can leave me looking like the lady with two clitoris.

I second the advice to get a good doctor or MW to look at it and tell you if you're a candidate for a revision surgery if you want one. I was also given the advice that it would probably correct itself with Baby #2, but since I don't plan on having Baby #2 for several years and the deductible is met now, I'm going to take care of it surgically this year. Good luck.

One question about revision surgery. Wouldn't that be consider as cosmetic and not cover by insurance? Do you get that done by an OB or a plastic surgeon? Will the procedure give you more scar tissue? Getting cut again and going through the whole healing process is the last things on my mind right now. I am so tight down there that I can't imagine having sex, let alone squeeze another human being out.

They are NOT supposed to yank on the placenta.

That was shocking to me. I wish I had known before hand and opt out of gettig my placenta pulled out. There are plenty of materials about pregnancy and labor, but nobody ever told me about the nasty bits right after the birth. There wasn't even a warning like "hold on, this is gonna hurt alot". Same thing happened when the nurse started to knead on my abdomen 30 min later to get the residual blood and fluid out, shockingly painful and without warning.

[Jane]

It's too early to say, at only 4.5 weeks. Give it at least to 6 weeks, but 8-12 is more likely. It's normal for your opening to feel different/smaller (even women with no tears feel that way sometimes) as the hormones of post-partum are different.
I have seen many times a little flap on the outside that returns to normal - the tissues are often swollen after birth and return to normal at different rates.
I recommend my clients look at their bottom the day of the birth or wait until 6 weeks. It often looks funny and not reflective of the final healing during the middle time. But it's your bottom - you should do as you wish. It's just not uncommon to have women freaked out over something that's not reflective of the true healing.

If it doesn't heal right, you've got options and I encourage you to have whatever you need to get better. The best reconstructive docs in my area are gyn surgeons, but might be obs or plastic surgeons in your area.
Also, sometimes steroid or hormone creams can helps TONS. You have options.