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earlyworm 06-06-2013 09:57 AM

Hello!  I am interested in getting a few different opinions on my situation.  In 2011, I had my son.  He was born at 41 weeks and 2 days, I labored for 19 hours and had him in a hospital with no epidural.  He was 11 pounds even, and I had a third degree tear and anemia from a post partum hemorrhage.  


I had taken a Bradley Class and felt pretty well prepared going in.  But in all honesty, my experience of birth was horrible.  I felt out of control the whole time.  Although I could tell when I was having a contraction, what I felt the whole time was continuous pain.  Yes, pain.  Not pressure, or surges, but horrible continuous pain.  My pain management techniques went out the window when they caught some fetal heart dips on the monitor and made me do continuous monitoring instead of intermittent.  I was stuck pacing in a three foot range by the bed hooked up to the monitor, and later an IV, as I kept vomiting and couldn't keep liquid down.  I did finally ask for IV pain relief, and had one dose of fentanyl.  That lasted 30 minutes and during that time I dilated the last 4 centimeters!  


When I was fully dilated, no one 'told' me to push, but there was definitely pressure to do so.  Nurses saying things like, "you can push any time now" or "are you feeling pushy at all?  How about now?".  Long story short, I ended up reclined on the bed doing coached pushing for close to three hours.  After he was born, I was exhausted and so was my uterus apparently, because the contractions stopped completely and my placenta was just bleeding me out and not detaching.  So they ended up having to reach in and scrape it out in pieces and then do uterine massage for an hour before the bleeding stopped completely, and then sewed up my tearing for two hours.  


Breastfeeding was great, my son was healthy and huge and awesome, but the recovery sucked.  I was very anemic and weak, and couldn't sit without pain, obviously.  I was actually told during my discharge from the hospital to 'not lift anything over 10 pounds' even though I had an 11 pound baby.  Haha!


So, now my little guy is two, and I am expecting my second baby in November 2013.  Luckily, my tearing has healed beautifully and I have no problems from it whatsoever.  I know that I had it MUCH easier than many other births I have read about, but that does not really make me feel very positive about my birth.  I would love to have an easier recovery this time, so I'm really researching my options.  


I feel like I need to avoid pushing until I can't NOT push, I feel like the coached pushing contributed to my tear more than his size!  I feel like if this labor is as continuously painful as my first was, it may be best for me to opt for an epidural so that I can relax and dilate.  I dilated so fast once I had a dose of drugs to relax me and I really feel like the stress of constant pain was keeping me from relaxing.  I feel like I should ask for a transfusion if I'm so anemic from hemorrhage that I can't simultaneously stand up and hold my baby.  :(  


I'd like to hear anyones thoughts on this.  Positive or negative stories of subsequent births after tearing or hemorrhage, or unreasonably large babies.  I am feeling a lot of trepidation about this upcoming birth.  I have interviewed three OBs but have decided to stick with the same one I had for my last birth.  Homebirth is not an option for me, as my husband and I feel too worried about potential complications and living too far from a hospital.  


I know that no matter what, it will be worth it!  But I'd LOVE to have the easy recovery that follows so many vaginal births.  I am not convinced that an induction for an 'earlier smaller baby' is good for me, and I am definitely not interested in a Csection.  But I do expect another whopper of a baby.  I myself was 11 pounds at birth and my younger sibling was 13 pounds, so I am not counting on a smaller baby.  


Thanks as always for the information and kind support I love and expect from MDC posters!  <3

tracyamber 06-09-2013 12:25 PM

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My birth experience was totally different but I just wanted to say thanks for sharing your story. It gave me much insight.

sere234 06-09-2013 12:50 PM

I had a 10lb 13 oz baby vaginally last November and though I did tear, it wasn't bad, maybe 2nd degree? Never wanted to know so I don't ask my midwife! I think your idea of waiting to push until YOU feel like pushing is excellent. I didn't feel the urge to push with DS1 but had to due his head and my cervix were swelling since he was positioned asynclitic for hours. With DS2 I felt like pushing so I was able to work with that instead of alone. Also, push in an upright position or while squatting. And in a birth tub.

Hope that helps!!

demeter888 06-09-2013 04:35 PM

OP: I am sorry you had a difficult first birth, but I am soooo impressed by how you handled it.  Sometimes, like you said, pain is just pain, and pain creates stress, and that is not a good thing for mom or baby. Sometimes, not even hypnosis (like in my case) is adequate for pain relief.  Sometimes medication for pain is a very, very good thing.  Everyone is different and if I have to her one more person tell me my body is designed to give birth I'll tear out my hair.


That said, not all births are the same.  I am due with my second child in September and my first birth was traumatic FOR ME. I have even asked my ob if he will refer me to somebody to help me with the fear of my pending birth that I have, and barring that I am strongly considering  c-section.  I didn't plan this pregnancy and was not emotionally ready to confront having to go through labor again.  


Your next birth is probably not going to be as difficult, but you know from experience to be prepared for anything.  I think you should push if you feel like it.  Not all women even need to push consciously because their body does it for them.  On the other hand, if you opt for an epidural, your body might not do the pushing as effectively.  I think you will know what to do when the time comes.


After 24 hours in labor, emergency epesiotomy, and 5 hours of pushing, it took me another 6 hours to calm down enough go to sleep.  It was mostly excitement from my son, but If I do try vaginal birth this time, I am considering not only pain medication but also a mild tranquilizer, to keep me calm.  

PrimordialMind 06-09-2013 05:21 PM

I know you said you and your DH are against homebirth so i'm not trying to change your mind, but you might still get some new perspective from my story: i birthed alone at home (UC), had a 9 hour labor that i only considered difficult for the last hour or so. My body did all the pushing (fetal ejection reflex), my 10.5 lb baby girl came out in three involuntary pushes. No vaginal tears but i had a few tiny, papercut like tears on the surface of my anus that a little neosporin healed. I attribute how wonderful it all went for these reasons: i was able to do what felt right, like changing positions at will, drinking water, moaning, rocking, biting a pillow, etc, i wasnt distracted by cervical checks or people worrying or telling me what to do, i was able to completely immerse myself in the flow of labor.

In your case, maybe check out birthing centers near your home? They are a more relaxed setting for giving birth and you could also have a water birth, which would help with pain relief. They are also equipped like a hospital in case anything goes wrong, minus the OR, and a lot of the time they are located next to or across from a hospital. This will allow you to move around, change positions, NOT giving birth on your back (this is VERY BAD for large babies, i'm almost certain this is the main reason why you tore so badly, any other position other than flat on your back is best for the birth). Also, in order to experience the fetal ejection reflex, you'll need to be relaxed and non-medicated, which is why i suggested a water birth (that way you have pain relief and a smoother pushing phase), 3 hours worth of pushing is extreme, if you're allowing your body to do the work then it shouldnt take more than 10 or 15 minutes at most (my big girl was out in 5 minutes). If i were you i woudnt go with the same OB unless you can do things differently this time with the pushing stage and possiby a water birth. These are just my personal suggestions, though, do what you're most comfortable with hug.gif. All i know is a big baby doesnt automatically mean tearing, it just depends on how you labor, what positions you're in, how relaxed you are, if you're able to let your body do the work, how deeply you're breathing (holding your breath in labor or taking short, shallow breaths can make contractions hurt worse), and how comfortable you are with the people around you. Here is an interesting article on fetal ejection reflex: Lastly, your placenta will probably come out easily and intact if you let your body do the work (women often have issues with the placenta and hemorraging after a prolonged, flat on their back pushing phase).

Anyitara 06-11-2013 05:42 PM

Yowch, it sounds like you had a rough time of it last time!! I just had #2 and through both have a lot of similarities with your story. #1 was born in 9 hours, under 8 lbs, but I was so out of it by the time I actually had him. There was no urge to push, and my uterus quit so I bled a lot. I basically had an episiotomy to get the kid out of there! The recovery from that one was brutal!! I was so very exhausted and it set me up for some post-partum depression. I didn't realize at the time that it was more physical than emotional reason that I just couldn't keep up! #2 was 10 lb 4 oz. He would have been born at home, but after 22 hours of labor he dis-engaged. There was so much fluid in there that it would have been very easy to have a cord prolapse so we trekked to the hospital. It was a flat on your back delivery, as was the first, but I had so much more energy, could feel the contractions and when to push, and my body was ready. The physical pain and recovery was more difficult for the first week or so, no lie, but the exhaustion wasn't at all the same. I was tired, yes, but not feeling on the verge of death. Here's what I feel made the difference for me: With #2, I was trying to stick to the Brewer diet during pregnancy and was eating very high quality food. My placenta and cord were very, very healthy which likely made a difference in how well the placenta detached. I made sure to have lots of water and to REST the last couple of weeks before baby came. Rest during labor too, as much as you can. There will come a point where you may need to move to get through contractions, but the resting had to help get through that much labor. Take care of you, momma, and you'll likely be fine. Ditto what the others said on positioning. I was pretty weary by the end of my labor and lying down was worth it for the last hour; I could push through it. I did tear, a little, but it's where the episiotomy was for #1. I was able to drink and eat in early labor, too, light and healthy stuff (a little chicken and rice soup, etc) but I'm apparently vomit when I hit transition. ::) Yet another reason to stay hydrated! Random tip: A 2-gal pail with a handle, lined with grocery bags, works wonders for carrying around in labor for vomiting. Even in the car or hospital!

Chloe'sMama 06-11-2013 07:49 PM

All 3 of mine were right around 10 lbs... my first I had an epidural and coached pushing. ... I had a second degree tear. The other two I had at home and had no coaching at all. That saved me. Dd2 I tore, but it was small and only needed 2 small stitches. Ds I didnt tear. I think listening to your body is key. I had involuntary pushing with both homebirths. No one directed my pushing stage at all.

Good luck

earlyworm 06-11-2013 09:31 PM

Wow! Thanks for all the replies! I do think the coached pushing was what did me in for tearing, but as Cyclamen said, it may have been necessary in my case too. I was SO wiped out by that point I really have no idea if/when I would have felt an urge to push. greensad.gif

I will check out the Brewer diet and have some serious talks with my OB about pros/cons of pain relief this time around.

Keep the replies coming though! I'm not due until November and I'm open to ideas! smile.gif

Jefinner 06-13-2013 06:52 AM

Hello fellow big baby mama! :)


My son was 11lb 7oz at birth, and I had no tearing. This is different than the large amount of tearing (along with an episiotomy) with my first (also pushing on my back), and the minor tearing with my second (nuchal hand), and they were both just a bit above 9lbs.


I think not pushing will help. I credit my midwife with my not tearing with my son. I pushed while side laying, and at one point, she told me to stop. She massaged my perenium, then let me know when it was okay to push again. That was the hardest part (not pushing), but it was so worth it.

olaz-b 06-16-2013 07:17 AM

I, too, had prepared for both of my labours, and both times felt traumatized because of my loss of control, excruciating pain (constant no break pain with my first), and just plain old screaming and disappointment in myself for not being able to do it the way I thought I should have.  However, they were fast.  If I have a third, I am considering an epidural.


My first weighed 8lbs13oz, had mild shoulder dystocia and I had tearing and it took at least a month before I felt somewhat healed.  My second was 10lbs14oz, had severe shoulder dystocia, but no tears or stitches and I felt really good within a couple of days.  Maybe if I could have moved around, the dystocias could have been avoided. 


I guess my point is that every birth is different and your plan for your second sounds great.  Be prepared for different things that can happen and don't feel guilty if things go differently.  Oh, I also refused an induction at 40 weeks since everything was going well and an ultrasound showed my second baby to be only 9lbs (yeah right!), he came naturally at 41 weeks. 

violetflapjack 06-20-2013 12:35 PM

I had a pph after my first birth, which left me anemic. The second time I drank a lot of partridge berry tea in the third trimester, especially leading up to labor. I had completely normal bleeding with that birth. I should also say that the first hemorrhage was because of uterine fatigue/atony, but my second labor was about as long and I ate and drank similarly to the first. if anything I was more tired going into it since DS1 had recently been sick and I had been up all night with him. So I think that partridge berry tea really works. I also did a lot of other herbal tonic teas, similar to my first pregnancy, just added the partridge berry to the mix.


also as far as tearing and pain management, I would agree that there is certainly a place for pain medicine and you're not doing anything wrong if that I what you need and what you choose. but I also want to say that I think that water provides REALLY good pain relief. My first labor felt relatively easy, no real pain, just pressure and energy kind of thing. My second labor HURT! No denying it. It was painful. It was intense, like transition level of contractions for about 8 hours, but when I filled up the tub and got in it helped immensely! I could still feel contractions, but it really did take the edge off. it helped me to regroup a little bit. so it's worth a try. it's also supposed to reduce risk of tears.


All that said, I think that you have a good plan and that relaxation and waiting to push until you're ready are key. Upright positions can be great for birthing, but they can also make baby come faster, so I would think to go with the position that your body wants to go into when you feel the need to push...just my thoughts.


hope that helps.

sillysapling 06-26-2013 10:33 AM

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I'm sorry you had such a difficult experience. I agree with you on the "only push when you feel the need to push" and "do waht you need to do so that stress doesn't stop you from progressing".


I had a 6 lb 10 oz baby and, while I didn't tear as badly (I needed 2 stitches), I think I had the same problem wtih blood loss. I couldn't stand and hold my baby at the same time- I could barely stand. It was a home birth, and I now really wonder what, exactly, happened... I lost enough blood that the midwives commented on it to my partner, but no one tested if I was anemic or even mentioned the possibility. I really want to believe that if anything had been seriously wrong, they would have known and we would have gone to the hospital- but I just don't know if I believe that anymore...


I had a somewhat similar experience to you, although not 100%. I labored for at least 23 hours, at least 10 of which was active labor. I had pain in contractions, although there was a distinct difference from during and between contractions, there was still pain between them and I still felt like crap but I at least got a break. I was scared by how much it hurt. The midwife who was there first made me stressed out, didn't help at all or offer any useful advice other than not to push even when my body was doing so involuntarily, and I really think that I didn't progress because of how she made me feel and that "advice". My body wasn't trying to push the baby out- once I got to proper pushing, I could easily have told her that there was an EXTREME difference. My body had only been doing mild pushing to get everything where it needed to be. My mom did the same thing, she had mild pushing for 6 hours before her water properly broke and she was ready to start proper pushing. (Note: I'm not saying water breaking means time for baby to come every time. With my labor, the baby's head was pushed down and prevented the water from properly breaking, because my mom had a UC, although unintentionally, I can't know for certain this is what happened with her but I believe it was the case as well.)


The second midwife gave me far better advice- to go along with the pushes, but not to push harder than my body was guiding me. I was already pushing involuntarily, trying to stop the pushes meant fighting my body's natural progression- so my body was spending energy trying to push to get things to progress AND trying to stop itself from pushing.  I really exhausted myself doing that, I ended up falling asleep between contractions (not fun) and basically the second I'd recovered enough energy, my water properly broke and the baby started coming out.

At the end, I think that I may have pushed more than I should have because I was so exhausted, afraid, and in pain. I just wanted it over with, but I only started properly pushing when my body told me I should.


I think it's wise to do what you need to do to be calm. If that means drugs because you're in too much pain- take drugs. There's nothing wrong with doing that, you aren't a failure or whatever- you're doing what you need to do to give yourself the best labor possible and your baby the best entrance into this world you can.

From what I've read, until the baby's actually making its way out of you, fear stalls labor. It's the body trying to let you get into a safe place to birth, an instinct that was not developed for the modern world.  If you're in too much pain to relax and are super stressed out, labor isn't going to progress as it should. You're going to need pain relief to give your body the break it needs to do what it should do.  As others have mentioned, that doesn't necessarily mean drugs- but drugs are a valid option.


Originally Posted by violetflapjack View Post
 but I also want to say that I think that water provides REALLY good pain relief. My first labor felt relatively easy, no real pain, just pressure and energy kind of thing. My second labor HURT! No denying it. It was painful. It was intense, like transition level of contractions for about 8 hours, but when I filled up the tub and got in it helped immensely! I could still feel contractions, but it really did take the edge off. it helped me to regroup a little bit. so it's worth a try. it's also supposed to reduce risk of tears.

I just want to add my experiences with this- we didn't have a birthing tub and the midwife didn't allow me to try a bath, but I got in the shower, which I've read is supposed to reduce pain up to 50%- it made the contractions SO much more intense and more painful and closer together. Which, if I wasn't so afraid and in pain, probably meant it was helping my labor along (I don't want to think about how bad the contractions would have been without the pain reduction from the shower!), but it did not reduce the overall pain for me.

Next time, when I'll more know what to expect, I'll probably try jumping into the shower as soon as active labor starts and, if it makes them more intense again, riding it out.


I don't think this is normal by any stretch, it's DEFINITELY worth a try, but I just want to point out that water made it more painful & intense for me, so if it happens to anyone else- you're not alone, it can happen.

earlyworm 06-26-2013 09:40 PM

Sillysapling, thanks for your story and your support! I was helped tremendously by being in the shower during labor, but once they started continuous monitoring because of his heart rate, I couldn't be in there anymore. greensad.gif That is the first time I've heard of water making it worse! Labor is a crazy thing.

My OB wants to induce me at 39 weeks for a smaller baby. I really love this OB, but I'm seriously doubting the benefit of this approach. Does this actually make a difference? I'm thinking that any benefit of a smaller baby is going to be outweighed by the crazy strong pitocin contractions. I know she won't push this approach if I decide against it, but I don't want to totally discount her input either; she is the doctor I picked on purpose!

I told my husband he can just go ahead and have the baby this time! I'm over it!! LOL

sillysapling 06-27-2013 05:50 PM

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You could try inducing naturally first. There's a LOT of ways to do so- although whether or not they work is another story. Evening Primrose Oil is supposed to help ready the cervix. Sperm has prostaglandins in it (probably not enough to actually induce labor, but people still try) and orgasm causes contractions, so sex is a common way to try to induce. A pregnancy book I had had a few ways to induce naturally in it. I looked into it just in case we needed to. Talk to your OB about this- natural induction hopefully won't have the same risks as medical induction.


Apparently babies gain 1oz/day late on, so that's about a pound every 2 weeks- a big difference! If you feel comfortable with it, it might be worth considering.

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