4th degree tear- healing time?

Thanks!

A related question...I see in your signatures that you've both had more babes after the tear. Sorry if this is too personal, but, were those vaginal deliveries? Did you tear again? DH and I are obviously not planning another babe for a good long while but my care provider mentioned that given my history a c/s might be a better option in the future. There is NO WAY I could plan a c/s so I'm just wondering...

thanks again!

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My following three were born vaginally. DS1 (same size as DD - both 6 lbs) was a 2nd degree tear (which was like a piece of cake compared to the 4th), DS2 (8 lbs 3 oz) had a teeny thing that didn't need stitches and DS3 (5 lb 12 oz) even smaller teeny thing that needed no stitches. Those last two were essentially skid marks.

The only impact the 4th degree tear had on my subsequent births was that just after DS1 was born, before even knowing the sex, I asked the OB if I had torn, lol! Then, my midwife for DS2 was a little worried about my scar just as he was crowning (but wisely didn't say anything to me until after) but she was a relatively new mw back then. And with DS3, the OB was surprised to see such a scar but my mw assured her that it was okay - that I had only torn that badly with my first. Of course the OB asked just as DS3 was crowning though - wouldn't have thought to save it for later. Thankfully she was just standing around and my mw was actually doing all the work.

I had never heard of c-sections being recommended for births after 4th degree tears until the past few months, when someone posted here about it. No one ever said anything to me at all about it. I still don't understand it. Hopefully your care provider is more open-minded when you are next expecting.

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Thanks! I just couldn't plan a pregnancy if I "knew for sure" it would be a c/s.

My careproviders this time round are insanely pro-VBAC and pro-natural birth (trained on the Farm with Ina May and had their first child there as well) so when one of them brought up a c/s in the future they were really apologetic. I think in general the reasoning behind the c/s suggestion is that if you heal well from a serious tear you may not want to risk tearing again and (due to the combined trauma/scar tissue) not healing well the next time. But considering the serious and potentially long term physical risks of c/s I don't know that this arguement really holds water! I know too many mamas with bladder control problems and nerve damage from c/s.

In my specific case, my first dd's head circumfrence was 17 inches and she was posterior and asynclitic...after a very long labor she had jammed herself completely into my pelvis and there was just no way to get her out vaginally. My VBAC babe had a head circumfrence of 14 inches and her head got caught on my pelvic bone for several hours (with some really funky molding, her head literally folded around the bone!)...the vacuum got her head free but then the shoulder dystocia caused the tear. So I think my care providers are worried that if a future babe has a "big head" then a planned c/s would be less "risky" than a second VBAC given my track record or babes getting "stuck". But given that just walking round the block is uncomfortable, I can't imagine DH and I will be baby making anytime soon!

I'm going to cross my fingers and hope that I'm one of the mamas who will be mostly healed by my 6 week visit...my 2yo has figured out that mama isn't moving very fast these days and she's pushing her limits (and mine!) to see what she can get away with.

I had a third degree tear, but it resulted in a small fistula - which I have not had repaired. I've heard the same things about encouraging a c/s in my case, but like a pp said, I don't know that I could purposely get pregnant again, knowing I would need a c/s. But I wouldn't want to live with a colostomy bag for the rest of my life either...
Anyway, after my son's birth, it was probably 4-6 weeks before I felt comfortable, and 2-3 months before I felt "normal". Although, with the fistula, "normal" no longer applies...
I hope you heal quickly...

I think for me I felt a lot better around 4 weeks, but then around 5 weeks bad hemmorhoids started and that was NO fun. I would recommend drinking aloe juice if you can; it is really moisturizing (even just 1/4 cup a day in a smoothie or mixed with more tasty juice) and drinking at least half your weight in ounces of water every day. Try the "water cure" too - anything you can do to keep yourself hydrated will keep the tissues moist and able to heal better. I was really dry at my 6 mo checkup and did the water cure rather than apply premarin as the OB recommended, and a month later dryness was not an issue. So drink up!

Also, I don't think I realized how serious a 4th degree is since it didn't really seem to hurt THAT bad (you know, compared to birth it was cake!), so I did more than I should have early on. Rest as much as your 2yo will possibly let you, and take as much help from anyone who offers as you can get!

I have a fistula, and I'm not sure if it is from my birthing experience or if it developed in the weeks following because I didn't rest up enough and do things right to get my tear healed. And trust me, you don't want that!

I had a 3rd degree with my first birth (standard American birth.) It hurt like hell the first 2 weeks where I couldn't sit. I had to nurse laying down. The pain of sitting pretty much went away at about 4 weeks. I didn't dare have sex for close to 6 months. It was nine months before sex stopped being painful. It was 18 months for sex to feel good. 13 years later and 2 repair surgeries later, I am still having problems with fecal incontinence.

However, I have had 2 more babies. With the 2nd, the doc cut an episiotomy because I made too much noise during crowning so she cut me to shut me up. That cut did not extend. With my 3rd, I had a waterbirth in an unplanned location. (I planned a waterbirth in a birth tub, but the labor was so fast that there was no time to fill it.) I ended up giving birth in my 1960's era bathtub. My daughter's head came out just fine - no tearing. However, due to the small size of the tub, she started to surface before the rest of her was out. So my midwife had me turn to keep her submerged until she was completely out. As I turned, I tore on her shoulders. That was a 2nd degree lac.

After I had my "pelvic makeover" (cystocele, rectocele, and anal sphincteroplasty), I was told that I should have a c-section if I have more kids. We weren't planning on any more, but if we did, I am not sure I would have abided that recommendation. Now that the surgery has turned out to be a complete failure, I certainly would not go the c-section route.

Ellen
wife to G, homeschooling mom to ds13, ds11, dd7

I had a 4th degree tear with DD 10 months ago. It was a very fast labor with a compound presentation (hand at head). I took motrin pretty regularly for 2-3 weeks (??? I think that's right). A nurse told me that it was much better to keep the pain in check than to try to get it in check. I took the advice to heart. I was terrified about the tear at first, but in the end it was no big deal. My Bradley instructor had said motrin was fine to take. I did an unmedicated birth and di a local for the stitching (which still hurt like crazy). I was also given a prescription for vicodin that I never touched.

I could walk up and down stairs many times a day w/o pain from the start. I did a 6 hour car ride to visit family at 5 weeks post partum with no pain or issues. I refilled the motrin just in case but never touched it. I then did a drive from TX to LA to FL at 8 weeks with no issues. I never had any fecal incontinence - it hurt/stung for a very short while. I did find needing to go to the bathroom to be more suddenly urgent, but I never had an actual issue.

Sex (or attempted sex) was crazy painful at 9 weeks ( : why did I think that was a good plan : ). It took easing into and lots of lube (by the way, I adore my new Firefly lube and wish I'd had it much earlier) at 4-5 months. By 6 months my drive was back. Now at 10 months it is better than before DD!

My SIL, a L&D nurse suggested that next time I would probably need a c-section. If this tiny baby (5lbs 14 oz) caused a 4th degree tear than any slightly bigger baby would just never fit : I told her that I firmly believe that any baby I can grow I can also birth. She said "Oh, no, we have babies get stuck all the time" : I will not be birthing at her hospital. My aunt had 4th degree tears with her 1st and 3rd babe and no tear with her second. She did all vaginal births. I plan to have another baby in the near-ish future. I'm not afraid about the birth or recovery.

HTH,
Sage

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I was given the option of a C/S with baby #2 because of the shoulder dystocia. She was posterior and asynclitic as well and weighed 8lb 13oz. With baby #2 they were watching her size closely and guesstimated by U/S that she was about 8.5 pounds a couple days before I had her. After my first delivery I was really scared cuz her birth was so long and horrible.

So I went into labor with baby #2, she was properly positioned and labor was just a little over two hours. She was 7lb 10oz and I pushed her out in 7 minutes, very very easy in comparison to my first's 4 hours of pushing. I did have a tear that required some stitching but it was relatively minor. I don't think I would have torn but the OB's had me so scared of another shoulder dystocia that they had me pushing with all I had and then some so she came out too quick.