Came back to update - another VBAC, only a small 2nd degree tear!!! Baby was even larger. Took lots of care and my time pushing, slowly and breathing deeply. Paused through many contractions with no pushing and just let baby move down slowly (that fetal ejection reflex really kicked in if I relaxed) until it was time to do the hard work. Then was careful and slow, but still powerful pushes; especially when getting her head past my pelvis. I still had a partial bulging bag in front, so we went ahead and ruptured and then she came down nicely and turned. When head crowned (I made sure to use a large mirror so I could see exactly what to do), I stopped and let the stretching happen several times. Nurse held hot compresses to my bottom for counter pressure, and other than that there were no hands/fingers on my perineum at all. Listened to Hypnobabies Pushing Baby Out track on repeat with one earbud in and never took it out. It was my best birth ever! I would have cried with joy if I had gotten a 3rd degree this time too ;) I highly recommend Hypnobabies to prepare your mind ahead of time, and seeing a PT for pelvic floor strengthening/relaxation/alignment. She had seen lots of tears/scars and told me how excellent mine had healed, how to do extremely gentle perineal massage and that she expected no more than a 2nd degree tear this time, if any.
(btw mercii, I was unmedicated when I had my big tear, and didn't even know it happened; I also had no ring of fire, I really didn't feel anything other than the pressure of pushing (I needed to push so hard, in positions that the baby would move down in - and they were not ideal positions; we tried everything for a few hours. The recovery is very hard, and my MW told me right away it would be similar to a c/s recovery or harder, and she was right. It's certainly not the worst thing that could happen, but of course no one wants any lingering effects from an anal sphincter tear)
Good luck to anyone making a decision - I think it's a difficult process and as long as you are comfortable with your decision then it means it was the right one for you. You know your body and yourself better than any Dr., statistics or anyone giving advice.
@ Ninabear: How did it go? I just joined this forum, very late, but I am very curious. I, too, had a 4th degree tear, the result of a sunny-side up baby and forceps and I am heavily thinking it all through when we go to have our next one. The more I think about it, the more I want to try, but I fear my husband would rather play it "safe" with a c-section, though we all know the amount of risk and complications involved with that! I think that had he been born in a typical way, I wouldn't have torn, or no where near as bad at least...but he echos the words of our midwife/doctor who said that I needed a c-section the next go around. So...how did you do?
Hello again! I posted in this thread years ago, I had a 4th degree tear (hospital birth) with my daughter, and a 3rd degree tear (home birth) with my son. I'm pregnant again, and hoping for a better outcome!!!
This time I'm going to try birthing on my side and breathing the baby down. With my son he came out in one huge push, this time I want to slow things down. I'm going to start the hypnobabies home study program to train myself to calm the heck down cause I get so anxious at the end of labor.
It was encouraging to come back here and read the stories of women who were fine in subsequent births! Maybe this will be the healing experience I'm looking for. It sucked because with my son, I had to go to the hospital for stitches, and walking into the hospital I felt like a million bucks (despite having the big tear!). I could BARELY walk out after over an hour of being stitched up. It's the stitches and healing afterwards that are so hard - I had a small taste of what it would feel like to be free down there without so many stitches on that short walk inside, and now I want a recovery like that!!!
Yes, I had thoughts like this too, but honestly, another vaginal birth might heal, rather then hinder. If anything, the c-sec might just be more pressure down there,without your body getting the chance to heal.
I was in the same boat, and after my second baby (almost 10 lbs!) I was so fricken ecstatic I chose to birth the way I did. (At home, and no one touched me) I literally felt great after her birth. I pray this for you as well.
All of that took place almost 5 years ago and I am pregnant with baby #2 ! I'm older now and much more knowledgable about overall healthy living. I plan on doing a home birth this time around and was worried I would run into trouble and would have to be wisked away to a hospital.. But ladies, you have inspired me! Thank you for sharing your war stories (lol) it has given me a newfound strength and I am determined to have a healthy, fulfilling, peaceful birth
I had a beautiful home birth last year, Sept 22, 2013. I had a lot of therapy (EMDR) to help with the birth trauma, and I believe it took the fear out of giving birth. I also took childbirth classes with my husband (the Bradley method) because I knew my best chances for a vaginal birth were it to be done naturally. So, we committed to it and we did it! We learned everything we could, we learned about all the things done in hospitals that are routine based, not evidence (like episiotomy) and we learned how to cope through labor and transition. I have to say, it was amazing. I wasn't afraid of birth, like I was in my first. Every time I had a contraction and saw blood, I focused, told my body to "open" and I knew it was doing it's job. I had no fear. I knew that each contraction was about a minute in a half and that half way through the wave would be the highest but I would come back down...and I did. Each time. I wasn't afraid and I wasn't in pain. I was focused on staying loose and limp and just allowing my body to birth this baby.
My labor was just 2 hours!! And it was awesome! And hour and 15 minutes into labor, my water broke, but up until that time, I was texting my girlfriends and letting them know what was up in between contractions. I was at ease and it was beautiful.
We had tried to do perineal massage, but it just felt silly to have my husband do it, so we didn't. I was worried that not doing it, would have caused me to have problems but it didn't.
Sheryl, my midwife, who has been attending births with the Amish for over 30 years with no running water or electricity, had seen enough that she knew that 4th degree tears just don't happen....someone always causes them....and she knew that my body could do what it was designed to do. She did give me some tips though. I made sure we had warm compresses available for whenever the time was ready for her to support my perineum. She also wanted olive oil to help him slide a bit more. She also didn't allow me to birth in any position that would cause stress on the perineum or have it not be supported, so I gave birth on hands and knees. Being on your back causes your pelvis to close and is too painful. And a squat does cause too much pressure. Hands and knees was best for us and it was perfect.
As he crowned, I breathed. I knew from my childbirth classes that if I pushed too fast, I could cause a tear because my body needed to stretch to give birth. So, I breathed. I breathed my baby out. At one point, he had a nuchal hand, which meant him arm was up by his face, and this caused him to get stuck. For about a minute and a half, Sheryl worked to get him out, using every trick in the book. She was aggressive, but not in a mean way, in how she was trying to get him out because his cord was compressed. Because of this, I did get a 2nd degree tear, but it was minor and the recovery was nothing like not being able to control your bowels and crapping on yourself (which is just too awful to describe or go into detail, which is also why I had ptsd and needed to get help for.)
It was absolutely perfect in every way and I encourage every mama to do what she feels is best for her. If you need a second opinion, go get one. If you feel that you want to give birth, find someone who will support you. Ladies, the choice is yours.
Also, I have my birth video on hands and knees, showing Sheryl supporting my perineum, for anyone to view if they want. Find me on facebook https://www.facebook.com/trisha.stock and I'd be more than happy to share it. Peace, love and happy birthing to you ladies!!
I had a 4th degree tear also. I had no epis., I just tore. I didn't feel it b/c I had an epidural but the pain afterwards was certainly incredible. I was lucky in that my OB is an excellent surgeon and after a very long healing process, I have no long-term problems. I do have a tiny fistula but it's expected that this birth will cure it.<br><br>
I spoke with the OB who delivered my son and repaired the tear the other day. He laid out my options: 1) C-section, which he didn't recommend; 2) medial-lateral espisiotomy to hopefully spare the rectum this time, just in case i would tear in the same spot and end up with long-term problems (that would be AWFUL!)<br>
3) No medical interventions and just hope that nature takes care of things.<br><br>
I know I won't do the c-section unless abslutely necessary at the last min. I am not sure what is worse to heal from, a c-section or a 4th degree tear. I will say that my friends who had c-sections were healed and running around a lot quicker than I was. However, I know that c-secs have plenty of their own risks and problems, so I would rather avoid one.<br><br>
As for an elected epis., I don't know. It might invite trouble, as my OB admitted.<br><br>
I am just terrified that I'll tear again and end up with long-term problems. I also fear I'm going to have another epidural, b/c I can't imagine going through the pain of a tear without it.<br><br>
Does an epidural increase the risk of a tear? The doc said no, b/c it slows the urge to push.<br><br>
Any other thoughts?
Mothering dot com won't let me paste the link here so if you search "4th degree perineal tears support group" you should find it. Peace and love!
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