birth with intact perinium after 4th degree tear/epis??? - Mothering Forums

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#1 of 19 Old 03-13-2006, 01:20 AM - Thread Starter
 
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Is it possible to have a birth with an intact perinium after you've had a 4th degree tear (1st birth, horror story) and an episiotimy (2nd birth/homebirth)??

I'm pregnant with my 3rd. I desperately want some hope. I'm wondering whether there's anyone out there who has given birth with minimal tearing after a really bad tear.

Two midwives have told me it's possible. One even told me she'd seen it. But I need to hear it from someone it's happened to (or do you know someone it's happened to).

I'm willing to buy that my mental state and my beliefs about birth etc. play a large part in how this will go, but I need to know it's actually happened to someone.

I've heard that scar tissue doesn't stretch. Is this true??? Because I've got a lot of it.

Looking for some hope . . .

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#2 of 19 Old 03-13-2006, 01:34 AM
 
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With that said... I had a 4th degree cut with my second.. also a vac birth. My first of 4 VBACs.

I had my last 3 births with NO TEARS that needed repairs.

My third birth I did have a "skid mark" as the MW so affectionatly put it. She gave me the option of having one (1) stitch or letting it heal on its own.

My fourth birth (first HBAC) was the same.. just a small "skid mark", no stitching there either.

My fith birth (second HBAC) was a breeze.. no "skid marks"

You can do it!!!
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#3 of 19 Old 03-13-2006, 01:44 AM - Thread Starter
 
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Wow Tummy!!!! You've made my day!! I am just going to believe this will happen. It'll take a whole lot of work and mental preparation, but I'm going to really, really try to believe this can happen.

Did you do anything that you think helped?
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#4 of 19 Old 03-13-2006, 02:02 AM
 
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I've attended a number of moms after they had a 4th degree tear (generally episiotomy extensions) and have NEVER seen a repeat 4th degree. I just attended an 8th time mom, who had a 4th degree extension with her first babe, and then 6 midline episiotomies with her next 6. This time her scar held up just fine and she had just a first degree labial tear that needed a couple stitches.
Had to add - you had an episiotomy at a home birth? Why on earth?
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#5 of 19 Old 03-13-2006, 06:30 AM
 
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I had a 4th degree epis-turned-tear with vacuum extraction with my first babe. He was persistently posterior and weighed 8 lbs 12 oz.
My second I had a tiny skidmark that needed no repair. He was 9 lbs 1 oz.
My third I had no trauma at all. He was 10 lbs. 2 oz.
You CAN do.
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#6 of 19 Old 03-13-2006, 08:45 AM
 
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A friend of mine had a compound baby in a BC - episiotomy, 4th degree, 12 hours away from the baby, 2 years recovering.

She just birthed a larger baby ALSO COMPOUND at home over an intact peri. She did a lot of massage to her massive scarring but also birthed in water with CPs who don't routinely mutilate.
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#7 of 19 Old 03-13-2006, 11:29 AM - Thread Starter
 
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Wow!! Thank you for all your feedback. It really is encouraging.

drjen: The OB who did the reconstructive surgery after babe #1 said that I would need a bilateral epis (?? does that make sense) with subsequent babies. When I first met with my midwife, I was planning a hospital birth with epidural. We spent hours talking and I eventually came to the understanding that I could do this w/out pain medication and that given the negative experience in the hospital the only place I thought I could relax and concentrate would be at home. I'm so glad I came to that realization. I was still super nervous about tearing and had told my mw that if she needed to do an epis to prevent tearing then she should just do it. I think she was just as nervous about me tearing down the old scar site. When the baby crowned both midwives attending agreed that the scar tissue just wasn't giving at all. Mine was (still is) the only epis they have ever done in a homebirth. I labored for a while in a pool, but then wanted to get out and birthed the babe sidelying. I was completely paranoid that I would tear. I think I asked the mw's a million times to "check if it's stretching" I didn't push a bit (breathed through every single contraction) b/c I was so scared to push the baby out. It took a good hour and a 1/2 after I was dialated to get the babe out and I needed every minute of that time to mentally prepare for that babe coming out.

I'm thinking that with this next birth, ideally, I'd like to birth in a tub, all by myself (not UA, just no help in the pool, except maybe dh). The scary thing for me is, no one will be able to "check if I'm stretching". I'll really just have to trust that it'll all work the way it's supposed to. And worst case scenerio, I'll have a huge tear again, and have to go to the hospital to get it surgically repaired. I don't know if I'm ready to risk that. In many ways it feels safer to just put my trust in my mw, instead of myself. In my head I know that doesn't make sense and that I CAN do this, but it's like my body and my soul haven't caught up to that idea yet. I have a few more months to work through this . . .

Thank you again for all of your input and encouragement. I guess I know it's possible, now I just have believe that in my soul.
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#8 of 19 Old 03-13-2006, 12:08 PM
 
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Something else that can help is to sit in the tub (pre birth sitz baths) every day 3 x a day starting at about 35 weeks. It can be warm water, for about 15 minutes. I used to either bring my toddler in with me or spend the time reading if dh was home. I know lots of moms with bad tears that prepared their skin this way, I think its less stress on the tissues than perineal massage. Good luck to you!

Married Catholic mami : to 5 boys, : 9 6 3 : 5 mo. 5/6/02-6/22/02 (HIE)
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#9 of 19 Old 03-13-2006, 12:35 PM
 
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I had a 4th degree episiotomy with my first and had 2 posterior babies after that with no tearing and just came though my 4th which was an extremely fast birth with no tearing once again so it CAN be done!
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#10 of 19 Old 03-13-2006, 01:38 PM - Thread Starter
 
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Alright, so for you girls who've birthed through the scar tissue successfully, I have another question.

Do you know how much/if you had a lot of scar tissue going into the birth?

I don't feel my scar tissue doing eveyday things. It doesn't bother me during sex. But when I go to feel my yoni, and put some pressure in and around my vagina, it's sore.
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#11 of 19 Old 03-14-2006, 01:14 AM
 
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Quote:
Originally Posted by missm

Did you do anything that you think helped?
Its not what I did, but what the MWs did. I had massages, and hot compresses, counterpressure while pushing.. I was allowed to push how I wanted, when I wanted, and how long I wanted.. none of that bull$h!t 1....2....3....4....5... you get the pic
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#12 of 19 Old 03-14-2006, 02:27 AM
 
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I had a second degree episiotomy with my first baby b/c she went into distress. Was born just fine, but that's another story. For the second birth I said I did NOT want to be cut, no matter what. I stretched myself out a lot in the weeks prior to the birth, I would just pull on my skin until it started to burn, hold it for a few seconds, release. I also massaged my scar with EPO near the end and softend it up. It was hard work. But I didn't tear for the next birth. Okay, just a tiny tear to one side because dd's head was not completely straight coming out, and one arm was pulled out before the rest of her body b/c it was near her head. The tear was so small. It healed on its own within 2 weeks, no stitches needed.

When the baby was crowning, the doctor let her sit like that in the crowning position for a good 2-3 minutes with me not pushing. Then he just eased the skin around her head and her head came out just like that. Then on the next push she was out.

I hope your next birth is more peaceful. ((HUGS))

7yo: "Mom,I know which man is on a quarter and which on is on a nickel. They both have ponytails, but one man has a collar and the other man is naked. The naked man was our first president."
 
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#13 of 19 Old 03-14-2006, 04:17 AM
 
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Yes, a friend of mine had 4th degree (episiotomy of course) w/ #1 (8 pounds), no damage w/ #2 (11 pounds)
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#14 of 19 Old 03-14-2006, 01:29 PM
 
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I tore pretty bad with DD. In fact doc didn't know how best to sew. This time, I didn't tear at all.
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#15 of 19 Old 03-15-2006, 05:39 PM - Thread Starter
 
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Thanks so much for all your replies. It really has given me a new perspective on what's possible.

USAmma, I have no idea what EPO is.
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#16 of 19 Old 03-15-2006, 07:56 PM
 
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Quote:
Originally Posted by JanetF
A friend of mine had a compound baby in a BC - episiotomy, 4th degree, 12 hours away from the baby, 2 years recovering.

She just birthed a larger baby ALSO COMPOUND at home over an intact peri. She did a lot of massage to her massive scarring but also birthed in water with CPs who don't routinely mutilate.
: what does compound mean?

Quote:
Originally Posted by missm
USAmma, I have no idea what EPO is.
maybe evening primrose oil?
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#17 of 19 Old 03-15-2006, 10:37 PM
 
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Quote:
maybe evening primrose oil?
Yep!

7yo: "Mom,I know which man is on a quarter and which on is on a nickel. They both have ponytails, but one man has a collar and the other man is naked. The naked man was our first president."
 
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#18 of 19 Old 03-16-2006, 01:36 PM
 
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I had *2* episiotomies and only tore only a little along the episiotomy line at my third daughters birth.

I just attended a friends birth and she delivered her son with *both* hands up by his face over an intact perineum. She had torn terribly with her second birth, tore slightly at her third birth and this was a waterbirth which may have made the whole difference.

There is hope!!!
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#19 of 19 Old 03-17-2006, 12:34 AM
 
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YES!!!!!!!! I had a 4th degree extension of an epis with baby #1. Very mentally upsetting & physically difficult to recover from. With baby #2, avoiding a 4th degree was my most important goal. My son was 1.5lbs bigger than my daughter (9lbs 7oz), I pushed for only 15min, and I had only a TINY tear. No stitches at all.

I think a lot depends on the provider who is helping catch the baby. I know my midwife helped me so much avoid a big tear.
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