Giving birth again after a 2nd/3rd degree tear.. - Mothering Forums

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#1 of 12 Old 02-23-2008, 04:16 AM - Thread Starter
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I had an episiotomy and a 2nd or 3rd degree tear (doc didn't confirm the degree). The baby weighed 8lb 10oz at birth. I'm assuming I'm prone to having big babies. How likely is it that I would tear that badly again? I'm pretty scared to have any more kids b/c of the tearing I experienced.. as well as the hemorrhoid that's been here for a year and just won't go away no matter what I do. I'm terrified that things would worsen if I were to have any future babies.
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#2 of 12 Old 02-23-2008, 10:20 AM
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I had a 2nd degree episiotomy (needed) with ds#1...with ds#2 I was a bit worried but my epi healed so fast and so well...and I always hear how tearing is better than an episiotomy that I didn't really think of it.

and I tore my scar open. 2nd degree. took almost 3 months to heal to where I could function. I am a bit scared but I have done what I can to minimize the risk of tearing that badly again.

Jami (25) Roland (27) & Caleb (5), Jacob (3.5) , Kaitlyn (2)
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#3 of 12 Old 02-23-2008, 10:56 AM
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With my first I had a 2nd degree episiotomy and my son was 8lbs, 3 oz. OUCH! With my 2nd, I had no episiotomy and a very small tear and he was 9lb 1 oz.. and my 3rd, she was 8lbs 6 oz and I had no episiotomy and no tear! Soo.. I wonder if I could have gotten away without the episiotomy the first time and been alright. The episiotomy afterwards was so painful. Hopefully you will have a better time with your next babies. I was scared after my first one but it turned out okay.
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#4 of 12 Old 02-23-2008, 11:04 AM
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Sorry that you went through that. It is likely that you tore due to your episiotomy. Many episiotomies simply aren't necessary and end up compromising the tissues.

For your next birth there is always something that you can do to prevent tearing. You can perform perineal massage throughout your pregnancy to help prepare your tissues, speak to your care-provider beforehand and state that you don't want an episiotomy, do not use directed pushing (having someone yell 1,2,3...) and push when your body tells you to, and pushing in positions that can decrease tearing (side lying, etc). Best of luck to you!

Three boys.  jumpers.gif
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#5 of 12 Old 02-23-2008, 02:00 PM
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Originally Posted by nummies View Post
Sorry that you went through that. It is likely that you tore due to your episiotomy. Many episiotomies simply aren't necessary and end up compromising the tissues.
Yep. The episiotomy may well have been unnecessary and possibly caused more tearing than you would have had otherwise. Almost 9 pounds isn't excessively huge. Women have had larger babies with no tearing. There are a lot of other factors, as the PP mentioned. That said, I also had a second degree tear, no episiotomy, and an 8 lb 3 oz baby. However, I likely wouldn't have torn so much if I hadn't pushed so hard on the "hold your breath and count to ten" pattern. If I hadn't been so anxious to get the baby out, I would have let it come out more slowly so my perineum could stretch out more slowly. That probably would have helped.

Bear in mind that natural tears usually heal stronger and faster than unnatural cuts. My OB follows the research and does not recommend episiotomies except in rare circumstances.
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#6 of 12 Old 02-23-2008, 02:25 PM
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After the birth of my first child I received a 4th degree natural tear (no episiotomy) and developed horrible hemmorhoids during pushing. My son was 9.5 pounds, and I attribute the tearing to pushing on my back and VERY strong epidural that required others to tell me when to push. It took months to recover.

When I got pregnant again I was terrified that I would tear like that again and have an even bigger baby. I did a couple of things that were supposed to help. For the last six weeks of my pregnancy, I limited my sugar intake, especially in the morning, at the guidance of my midwives. That included fruits and juices and simple carbohydrates. I performed perineal massage every evening after a bath and tried to regularly do kegel exercises. When it came time for pushing I did not push on my back (it is actually very unnatural to do this if you are not numb) and pushed on my side. I should say that I didn't really push at all, but waited for my body to do the pushing for me. It felt very natural to do it that way. It was an amazing experience. My second son was just under 8 pounds, and I tore very minimally, on my old scar, requiring only two stitches. My hemmorhoids did not flare up and I felt fully recovered after three days!

It is very possible to have a different experience with subsequent children. Best of luck!

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#7 of 12 Old 02-23-2008, 02:41 PM
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I had a good (not sure what degree!) tear with dd1 and not even a skid mark with dd2. I also pushed for 3+ hrs with dd1 and less than 10 min for dd2. One of the big parts for me was being much more in control of my second birth, not pushing for a long time and letting the baby descend on her own for a while, etc etc.

Each pregnancy and birth can be so different. I would try not to let the experience of the birth alone determine if you have more kids! I know, easier said than done!

As other posters have mentioned too, your next baby could be a very different size. Good luck mama!
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#8 of 12 Old 02-23-2008, 02:50 PM
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I tried everything I could not to tear and also tore badly in my first birth, with my 8' 10' baby. It was a homebirth, with no episiotomy, and in a "Good" pushing position, with perimeal support, and i had labored in water and used oils vaginally for weeks, etc....But i tore badly anyway. It took about 10 months to really be healed, and 18 for full function without pain to be restored.

I'm sorry to tell you, that despite trying very hard again, i also tore badly this time around...I doi really beolieve that some skin is just prone to tearing. This time, my baby was a measly little 5 pounds 10 ounces...and i tore WORSE this time. another homebirth, completely involuntary pushing, hands and knees pisition, labored in water up until pushing, etc....
I just tear, apparently.
I agree that an episiotomy makes things worse, and this time around, you have a decent chance of not tearing, but you also might tear. I knwo of no way to know for sure. I have read many, many stories on here of women who tear with one baby, and then don't tear with an even bigger baby next might very well be one of them!!

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#9 of 12 Old 02-23-2008, 06:46 PM
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Here are my experiences...#1 - Hospital birth, unmedicated but augmented with pitocin, guided pushing for 45 min. resulting in an episiotomy that tore past to a 3rd-almost-4th degree tear. I had done Kegels a little bit during my pregnancy, and no perineal massage. My son was 8 lbs, 6.5 oz. #2 - Birthing Home waterbirth, unmedicated, no guided pushing resulting in a minor 1st degree with some superficial lacerations that didn't require sutures. I was religious about Kegels, DH did perineal massage every other night from week 38 (I went to 41 weeks). My son was 10 lbs, 1 oz.

I think that the Kegels and perineal massage really helped, as well as the fact that I got to push when and how I wanted to. One thing that I took care to do was to breathe thru the contraction when I felt the burn of crowning. That allowed the contraction to slowly push the baby's head down and stretch the tissue, rather than me just pushing it out. At the time his head was born, I still hadn't torn. But when his shoulders were born, he had an arm up by his neck, and that's when I tore. My healing was quite fast. Also, my midwife suggested the use of an herbal peri-wash rather than just water.

Jess ~ RN & student CNM, Blogger (see profile), wifey to T-Rav & momma to sons Buggy ~7/04 & Newt ~1/08 & Tad 6/19/09 & Con-man 1/11!  <3
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#10 of 12 Old 02-23-2008, 11:14 PM
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I had a mild 2nd degree tear with my first (midwife attended home) birth. I birthed semi reclining and that probably helped the tear along.

With the 2nd (unassisted home)birth, I birthed standing up. There was no tearing.

They weighed 7lb 8oz and 7lb 3 oz respectively.

Non Practicing Midwife, going back to school! Mamma to my 3 loves, living each day to the fullest.
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#11 of 12 Old 04-07-2008, 05:07 PM
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Bobandjess, just out of curiosity, are you a redhead?

I ask because I tore very badly (3rd degree, with extensive vaginal tearing and torn cervix, was very close to having a blood transfusion) with my son (standard hospital birth with drugs) and was told by the doctor that redheads just tend to tear (I'm a redhead) worse and bleed a lot.

I'm glad to hear about other people's experiences, whether good or bad. I am terrified of giving birth again and am not even pregnant yet.
I just want to be better prepared next time, to know which way it can go. I am very attracted to the idea of homebirth but still feel like "what if I tear that badly again?".

Anyway, thanks everyone for your experiences. Please keep them coming!
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#12 of 12 Old 04-07-2008, 06:07 PM
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Birth #1: episiotomy against my wishes, which tore an extension. 3rd degree, almost 4th, horrible pain, long recovery process. Awful.

Birth #2: the OB did "perineal massage" that was anything but. I would have preferred for him to leave his hands off my perineum. I tore (2nd degree) right where he was rubbing. Not anywhere near as painful and hard to heal as that episiotomy, though.

Birth #3: lovely homebirth with a midwife who kept her hands OFF my perineum during my waterbirth. Guess what? No tearing at all!

It IS possible to birth over an intact perineum even after previous trauma. Just to give myself the best chance possible, I nourished my perineum with oil after bathing (not really massage, just moisturizing it with the vit-E rich oil) to soften my scar tissue as much as possible. Then during the birth I used water, positioning, and slow and easy descent of the baby (no forceful pushing).

FWIW, I'm not a redhead but I have very fair, delicate skin that doesn't heal terribly well. I was amazed at how a gentle birth made such a difference.

may my heart always be open to little birds who are the secrets of living whatever they sing is better than to know  - e.e. cummings
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