This is my first time posting but feel the need to get some opinions. About 9 months after my last birth, I had to have some "repair work" done to my perineum and rectum due to some leakage problems. I am now pregnant again(to my definite surprise!!) and saw my urogynecologist this morning. She said that she doesn't even recommend me having labor never mind another vaginal birth. She said it will most definitely tear and need surgery again. My GYN says it is up to me. This really bothers me as I never thought of having a cesarean birth. I just wanted to see if anyone here knows of any methods to prevent tearing in a situation like this? I have read people suggesting perineal massage and yoga and exercise. But has anyone had success with this before??
The archives at www.gentlebirth.org should also have a lot of good info for you in the perineal protection section.
It seems like its mostly going to depend on how supportive your Dr. is though... You might want to find out in advance what s/he does to help reduce the chance of tearing, so if you dont like the answers, you can either make a few suggestions or try to find another care provider. Good luck!
Have you considered seeing a physical therapist who specializes in pelvic floor rehabilitation? They have extensive training in pelvic floor issues and therapies and would be able to best evaluate your chances of avoiding tearing and preparing yourself for laboring. You can probably google "pelvic floor physical therapy" + "your city name" to get some referrals (use quotes the way I did).
I agree - I don't think a cesarean is necessarily warranted. I had a fourth degree with a repair at 15 months postpartum and I would NEVER consider a cesarean just because of that.
I would focus on eating well, staying hydrated, being able to push when you want in whatever position you want, keep all hands off your vulva/vagina during pushing and waterbirth. You don't have to tear again. If you do tear, you're more than likely to tear along your old scarline, but the good news is that it will be superficial, vs a deep muscle/tissue laceration that is typically found with episiotomies.
Good for you for questioning that advice. Two things that lead to more damage and more surgeries are vacuum extraction and forceps. Be sure your OB/GYN knows that you are adamantly avoiding those two interventions. The forceps tend to damage the urethra and front area, and the vacuum extractor tends to do more damage to the pelvic floor. HTH We will be thinking of yoU!