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#1 of 5 Old 07-06-2007, 06:59 PM - Thread Starter
 
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Did any of you have one...and how do you want things differently this time?

I had a fourth degree with my first delivery.

I didn't have an epidural with him. And I'm not sure if I'm going to go that route again. Simply because my midwife and I have discussed this issue again and again. My midwife is game for whatever I choose. But she has suggested an epidural because it can be a controlled, slow delievey of the baby. Also, you can "labor down" with an epidural. Meaning,when at a "10", don't push... turn down (or turn off) your epidural..wait till that babe is really far down, in a good station....so there's only minimal pushing. With much talking with her, I see what she is saying. And I LOVE MY MIDWIFE!!! But I'm conflicted. Being a doula, I see how an epidural can interfere with the second stage. I've also seen the benefits too. But it's the risks of a forceps/vacuum that gets me kind of edgy. I'm open to an epidural but I'm just not set on it. And I'm not set on not having one either.

What do you all think?

Has any of you had traumatic tearing...and have had little/or no tearing with the next birth? What was different?
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#2 of 5 Old 07-06-2007, 11:17 PM
 
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I didn't have a tramatic first birth but I understand why you would be concerned. Do you know of any reason why you tore so badly with your first birth? My friend ended up with a very bad tear but had an epidural. I have read a bit about using side lying positions or hands and knees to slow down the desent and crowning phase without having to use an epidural. Best of luck to you for the upcoming birth

Christina, mama to A 10/05, E 09/07 and S 01/11; Spending my time as a wife, mama, teacher and student. Loving every minute of it! Life is so good!   joy.gif
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#3 of 5 Old 07-08-2007, 10:51 AM
 
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from what I have read, many times the difference between tearing alot and a little bit (or not at all) can be a combo of a few things...I am not so sure that getting an epidural is a good way to prevent a tear though!!
To me epidural signals MORE of a reason that you might tear, because of positioning etc.

I have read that tears can be worse depending on diet...that alot of it is about skin elasticity, so if it were me, I would focus on nutrition that focused on helping your skin be more elastic #1.

#2 is, you can start to prepare your girlie bits WEEKS before labor begins. By using a gloved finger, either you or dh can rub Vitamin E oil on your perinium, back and forth in the swishing mode the way the m/w would when you are pushing. As you sweep across the perinium, apply a little bit of pressure each time, so as to stretch those muscles in preperation ( I did this last time and tore only a very very very tiny bit.) etc.

The thing of it is, once you have a tear/cut in one area, you are more likely to have it there again. BUT...it will be lessened with these techniques #1, and #2, it gets easier (to recover) trust me!! I had an episiotomy with baby #1 and have torn at least a tiny bit along that same line with EVERY SINGLE ONE of my kids. However, the tears have been much less worse than my first episiotomy (which was HORRID!) AND the 2nd childbirth where they did NO support on my perinium.

Thats the other thing and I am assuming its a given seeing as you have a m/w, but LOTS of warm compresses during pushing,

Also, positioning...I have heard that being on hands & knees while delivering can fascilitate less tearing because it lessens the pressure on that area.

GL! I Hope I gave you some info to go on.
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#4 of 5 Old 07-08-2007, 01:02 PM
 
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I can only share my experience. I don't know how much it will help you in your decision because our situations were pretty different.

I had a very bad tear the first time -- I don't know what degree it was, but it took a looong time to heal. I had a very intervention-heavy labor and did have an epidural (two of them, in fact.) After many hours of difficult labor, dd was having some distress, so they used a vacuum extractor to help her out. She was posterior too, and I think all of those factors combined to making her exit rather rough. As bad as it was, for me, the tear was the least of my trauma. (Of course with an epidural, I didn't feel the pain of it initially.) My bigger problem was that I felt really helpless and disempowered by the whole process -- even a little violated. I had difficulty bonding with my dd at first as a result, and I had a lot of regret and even guilt about that.

So for me, my second birth was more about affirming my ability to birth normally, than about not tearing again. I practiced birthing hypnosis, which was helpful. I did manage to have a wonderful, natural childbirth. I had a few minor interventions for reasons that don't matter now, but no pitocin, no drugs, no epidural, and no vacuum -- yay! I felt really great after that birth, and in spite of some lingering regret that my first baby's birth wasn't the wonderful memory that I wish it had been, I have healed significantly from that experience.

I *did* tear again the second time, but not as badly. It didn't bother me greatly, and my recovery was much faster. We did do some of the perineum massage during the 3rd trimester that the pp described, and my mw held warm compresses to my perineum during delivery, so those things may have helped. DS was also born face up, so perhaps some tearing was inevitable. My doctor says that some of the tendency to tear is a factor of your skin's elasticity -- some women just stretch more than others. That's not to say there's *nothing* you can do to try to avoid a tear or make it less severe, just that minor tears need not be seen as abnormal or some sort of failure.

Whatever you decide, I hope your second birth is much less traumatic. Keep talking with your mw, and if you do opt for the epidural, try to avoid any *other* interventions. It seems to be those cascading interventions that really cause the problems.

Stephanie
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#5 of 5 Old 07-10-2007, 12:39 AM
 
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I'm not sure an epidural is the best way to go to avoid tearing... I had one with DS, and I'm hoping not to this time, and I'm hoping it will avoid tearing. Basically if you have that epidural there is ONE position you can use to push (on your back with your knees by your ears...). And it's basically the most ineffective position there is.

I only had a 2nd degree tear, but that seemed bad enough. This time I'm hoping to minimize/avoid tears by lots of perineal massage prior to delivery, and during delivery, and using positions to minimize tearing based on my midwive's recommendations at the time.
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