STM - VB Worries

natjac1525

Couldn't see where this had been discussed, first time posting so apologies if I missed it...

I will be a STM...had a VB the first time around and it did not go so well. Things were touch and go as to whether I'd have to have a C-Section anyway due to baby size (we induced 3 days early to avoid this as I wasn't progressing, baby ended up over 9 pounds with a 99th percentile head circ...ouch) but we were able to make it work with baby coming out healthy but me with a 3rd deg tear. It was not an easy recovery coming back from that, and to be honest it still doesn't feel right even today.

I want to have another VB but I'm really nervous about having the same tear situation (or worse!) again. I've heard so many conflicting things - OB saying that usually the tear is less serious the 2nd time around, nurses I know saying the opposite...This baby is measuring very similarly to my first, so my question to all the mommas who have done this more than once is - was your experience the same/better/worse? Would you go full term but push for a C-Section if the measurements looked big closer to due date? I just want both of us to be safe and healthy with at least kind of a smooth recovery.

TIA!

lilpoots

I didn't create one this last week, because holiday weekend, but we usually have a vbac check in post weekly.

natjac1525

Hi! Sorry if the above wasn't clear, I didn't have a CS the first time so this wouldn't be a vbac @lilpoots

lilpoots

Ah ha! Sorry, I guess I either didn't read it thoroughly or made assumptions about your abbreviations. 

Eta: yes totally my fault. Reading comprehension fail. 

ColoradoHiker

OP, I had an episiotomy with DS1, and after a year of issues, finally asked my MW if there was something we could do about it.  Specifically, I had a nurse or resident that was new to stitching up post-birth, and it left me with a lot of pain from it not being done properly.  Have you talked to your OB/ MW about if there's a way to have your problems corrected?  I'm going to talk to an OB in my group, and see if I can have them fix it immediately after DS2 is born.  

No one is really going to be able to tell you if you're going to have the same, better, or worse result this time around.  You have every right to consult with several OBs to get a general opinion, and see what their recommendations may be.  What does your doctor recommend that you do at this point?

lap018

I'm honestly torn on what to tell you, usually I say not to go by ultrasound measurements for a c section for a big baby since they can be off by 1-2 pounds, but since you have a history of large baby it's a toss up. I don't think I would push for a c section in any case simply because the recovery is longer and more painful. Usually you tear less the second time. You're basically weighing pros and cons of the pain from a surgical incision that extends through the muscle and fascia and uterus vs another 3rd degree tear... I'd go with the tear personally. Does your doc seem to think you need a c section this time? Have you brought these concerns up with him/her?

lilpoots

Vaginal or c section, a smooth recovery is never a sure thing. You may want to consider looking at statistics on the csection risks and complications. I have never had a vaginal birth, so I can't say if tearing is likely to happen and how bad the second time. I did have a c section and it didn't go as planned, even though it was scheduled. My recovery was lengthy and I also believe my body will never feel the same again.

tfrangul

3rd time mom here and my 2 previous experiences were very different. My first was born 3 weeks early and was a peanut at 6lbs even. Ha she's still my peanut! I had very minor tearing. My second was over 8 pounds, had a nice sized head, and came super fast at 2weeks early! I had no tearing at all with him. I was very surprised to be honest but I guess that's typically how it works with multiple births? I'm just going off what my OB said. 

jessieR358

I had a 2nd tear and had a lot of issues with it healing. Estrogen cream really helped a lot eventually and I'm going to ask for that right away this time. I reluctantly had an episiotomy with my son and I am really going to push to not have one at all this time. my OB said I would have to push for much longer without one (pushed for almost 2 hours) so I said ok. I was given the option for a c section this time for other issues and after meeting with a specialist said no. I personally wouldn't have a c section to solely prevent tearing.You can do perineal massages starting now. That may help with the elasticity.  

efrey1986

3rd time mom here too. I had VB for both. For the first I ended up getting an episiotomy after pushing for over 2 hours. The recovery was horrible. I had pain for a year and it seemed like it was never going to be back to normal. For my second, I had a different OB and he let me tear instead of cutting me. I am so thankful b/c the second time ( with still 2nd degree tears) was a breeze. The recovery was a lot less painful and it seemed like it heeled very quickly. I'm not sure if it's because it was my second time and my body knew what to do or if it had to do with the episiotomy compared to the tear, but I definitely wouldn't opt for a C-section instead of a VB! Good luck!  

sarahufl

I had a vaginal birth with DD. She was 9lb, 5oz. I had an extremely long, painful labor (40 hours, a lot of it back labor). Not the most pleasant sensation or recovery, but I would never opt for a C-section just because I was afraid of another large baby or uncomfortable delivery. A C-section is major surgery and, while I would have one if I had to, I would not choose it.

msashley2010-2

DD was an 8lb baby and I had a vaginal birth. They were concerned about the prospect of tearing but instead of doing an episiotomy my OB used warm oil to sort of stretch my skin around DD's head right before I pushed and it helped a lot! I'm going to request the same this time around because it helped a lot. Has your OB made any recommendations for either a VB or a c section? 

kaylaakosua

My first was small measuring 25th percentile This baby is with a new partner and measuring 75th percentile. I have a very small frame and my FI is larger and taller than my ex. This baby is going to be bigger and he already is a fair size. With all that said I would never consider a c section  based off of predicted size of baby. That is a major medical surgery and if not medically necessary isn't worth the risks IMHO. The also do not do episiotomies here and will let you tear which has a better healing process.   

natjac1525

I totally did (and do) not mean to trivialize a C Section, I realize it's a very serious abdominal surgery with its own risks and recovery time. My fear is getting into an emergency situation during labor where baby gets stuck due to his size - I've been hearing some real horror stories recently about what that can mean both during and after delivery for baby and mom! I asked the question to see if anyone had some insight about differences between first/second births, etc to gain some perspective. Like all mommas, I just want us both to be safe and healthy on delivery day and beyond.

As far as what my OB has to say...well, that would be nice to know but I haven't gotten to actually SEE her recently

kaylaakosua

Just remember for every horror birth story there is a complete opposite story but people just never remember those (and/or scared to tell them)

mc123mc

I had a c-section the first time so I can't help with the tearing issues you had but I just wanted to step up and say that my C-Section wasn't that bad. I was up and walking the next day as soon as the epidural wore off and by the time I was home I was feeling OK. Yes, it's major surgery and yes complications can happen but clearly complications can happen with vaginal births too. 

Just do your research. Talk to some mom's who have had c-sections after VB and see what they say. 

From my perspective, the healing with the c-section is painful but if you stay on top of your meds, you will be OK. Get some help from family to help with your first, if he/she still needs to be carried. And within a few weeks you won't even know you had surgery!

lilpoots

mc123mc said:

And within a few weeks you won't even know you had surgery!

I have a very hard time believing that. Seems like a totally unreasonable expectation. Your abdomen is numb for a long time, good recovery or not. Glad yours was easy. 

TLooney17

This is baby #3 for me. Both of my previous births were unmedicated. My son was 8lbs 15 oz and I had an episiotomy with additional tearing. I pushed for 3 hours. He was also born face up which I don't think helped matters. The recovery was pretty hard and I was sore for a long time ( sex was painful for a year). The Dr actually said he had a hard time sewing me back together. Baby number #2 was 8 lbs 12 oz. I had a water birth with no episiotomy, but I still had quite a bad tear. I only pushed 3 times, so I do think the second one comes out easier. I also felt like the recovery was easier the second time ( maybe due to tearing myself versus being cut?)
Anyway I am nervous about this birth as well. I think I am more afraid than before I had my first just because I know too much now. Lol!
I do not think I would opt for a c section unless your Dr thinks it is medically necessary. This is just my opinion, but I do think you will find it easier to deliver a second baby than a first. Also you might look into alternative pushing positions that could help reduce your risk of tearing.

lilpoots

Is anyone experienced with not pushing? A lot of the birthing material I have been reading has been about not actively pushing like you would do when you go to the bathroom, but breathing the baby out. AKA pushing with your diaphragm instead of pelvic muscles and it is supposed to reduce tearing. This will be my first attempt at vaginal delivery, so excuse me if this is standard knowledge. I'm also going to try perineal massage to hopefully help.

natjac1525

@lilpoots nope but I would totally be interested in reading about it - do you have any recommendations on things to look at? With my first, if I'm remembering right they told me to bear down like I was going to the bathroom but I'm not sure if every momma is told that.

lilpoots

@natjac1525

Here are some of the resources I've looked at.

https://www.givingbirthnaturally.com/pushing-stage.html

https://www.birthrelaxationkit.com/hypnobirthing-techniques-avoid-tearing-during-pushing-phase-of-labor.html
Hypnobabies encourages breathing and letting your body do the physical work of pushing.

mc123mc

lilpoots said:

mc123mc said:

And within a few weeks you won't even know you had surgery!

I have a very hard time believing that. Seems like a totally unreasonable expectation. Your abdomen is numb for a long time, good recovery or not. Glad yours was easy. 

Just sharing my experience. I've had several surgeries and my C-Section recovery was the easiest. Yes, it's major surgery but 30% of births go that route (ask your hospital for their rates) 

Once I was off pain meds I felt fine. By 4 weeks I wanted to exercise and I was cleared to do so at my 6 week check up. 

I feel like so many women are dead set against C-Sections. It's a reality all pregnant women should be comfortable with and while you may not actively pursue one, if you have one, you still end up with a baby at the end! 

lilpoots

mc123mc said:

lilpoots said:

mc123mc said:

And within a few weeks you won't even know you had surgery!

I have a very hard time believing that. Seems like a totally unreasonable expectation. Your abdomen is numb for a long time, good recovery or not. Glad yours was easy. 

Just sharing my experience. I've had several surgeries and my C-Section recovery was the easiest. Yes, it's major surgery but 30% of births go that route (ask your hospital for their rates) 

Once I was off pain meds I felt fine. By 4 weeks I wanted to exercise and I was cleared to do so at my 6 week check up. 

I feel like so many women are dead set against C-Sections. It's a reality all pregnant women should be comfortable with and while you may not actively pursue one, if you have one, you still end up with a baby at the end! 

The OP of this post is not dead set against one, nore am I, as my first pregnancy required a mandatory c-section. I was lucky to have that medical option. I'm also very happy for you that you had such an excellent out come. My experience was not typical, but it took me 4 months to go back to work. My doctor is advocating for a vbac due to the complications of my c section and believes it is the safest option for me. It is not my desire to push my own choices on anyone, I simply am aware of the seriousness of abdominal surgery and I suggest that anyone considering a c section that is not medically necessary to educate themselves about possible risks.

jessieR358

lilpoots said:

@natjac1525

Here are some of the resources I've looked at.

https://www.givingbirthnaturally.com/pushing-stage.html

https://www.birthrelaxationkit.com/hypnobirthing-techniques-avoid-tearing-during-pushing-phase-of-labor.html
Hypnobabies encourages breathing and letting your body do the physical work of pushing.

I am doing the home study course with hypnobabies. i had an epidural with my son but it was pretty much gone while I was pushing. It's such an overwhelming urge to push I'm not sure how you can breathe the baby out. Now I haven't gotten to that class yet in my book, but Im still skeptical of this working. 

Sugargirl1019

I want to try hypnobabies... How do I get material for it?

Edit: omg the home study course is $170??? I feel like I don't have any birthing knowledge, and I'm not up for paying $170 Other recommendations to prepare for labor?

lilpoots

@Sugargirl1019 you might be able to find a mom on a bst group that is giving her course/cds away. I'm in California and my hospital charges $275 for their birthing classes and they aren't teaching any birthing techniques. It is crazy! 

JNR6510

Have you checked your local library? Ours has a copy of hypnobabies that someone donated. A lot of libraries participate in an inter library loan program too. So you may be able to order it from a different library.

ColoradoHiker

jessieR358 said:

lilpoots said:

@natjac1525

Here are some of the resources I've looked at.

https://www.givingbirthnaturally.com/pushing-stage.html

https://www.birthrelaxationkit.com/hypnobirthing-techniques-avoid-tearing-during-pushing-phase-of-labor.html
Hypnobabies encourages breathing and letting your body do the physical work of pushing.

I am doing the home study course with hypnobabies. i had an epidural with my son but it was pretty much gone while I was pushing. It's such an overwhelming urge to push I'm not sure how you can breathe the baby out. Now I haven't gotten to that class yet in my book, but Im still skeptical of this working. 

I'm with Jessie on this one-  once you are ready to start pushing, your body takes over.  I had nurses telling me to stop pushing, and I was like, "I hear you, but I have zero control over this."  I'm not sure breathing the baby out is possible!

BostonBaby1

So I had a c section with dS and the healing was an incredibly smooth experience. I absolutely did not push myself though and was able to really take it easy physically for the full 6 weeks.

Now that I am expecting #2, my outlook has changed a bit. I'm guessing that healing will be more difficult because I cannot just rest and take it easy. I would love to try for a VBAC.

I agree with pps that you should get in to see and speak with your OB about your concerns. You can always put a plan in place to try for x amount of time and if not successful, have a (hopefully non emergent) section as a last resort.

lilpoots

ColoradoHiker said:

jessieR358 said:

lilpoots said:

@natjac1525

Here are some of the resources I've looked at.

https://www.givingbirthnaturally.com/pushing-stage.html

https://www.birthrelaxationkit.com/hypnobirthing-techniques-avoid-tearing-during-pushing-phase-of-labor.html
Hypnobabies encourages breathing and letting your body do the physical work of pushing.

I am doing the home study course with hypnobabies. i had an epidural with my son but it was pretty much gone while I was pushing. It's such an overwhelming urge to push I'm not sure how you can breathe the baby out. Now I haven't gotten to that class yet in my book, but Im still skeptical of this working. 

I'm with Jessie on this one-  once you are ready to start pushing, your body takes over.  I had nurses telling me to stop pushing, and I was like, "I hear you, but I have zero control over this."  I'm not sure breathing the baby out is possible!

I think the hypnobabies idea is to allow your body to do the pushing for you, instead of pushing when prompted by dr or nurse. Breathing the baby out is suppposed to allow your body to open up for transition and delivery.

jessieR358

lilpoots said:

@Sugargirl1019 you might be able to find a mom on a bst group that is giving her course/cds away. I'm in California and my hospital charges $275 for their birthing classes and they aren't teaching any birthing techniques. It is crazy! 

The one I ordered doesn't come with CDs. Only digital downloads that are good for one time. So if you look in to it, make sure you don't buy one with downloads and you can't listen to anything. My doula said you need to have 6 weeks to start it.
Shes a hypnobabies instructor so I figured I'd give it a go. It's super time consuming and I'm half doing it at this point. I don't have an hour every night to listen to audio and then another 30 minutes during the day to do other audio stuff. I work long hours and have a toddler. not happening! 

Sugargirl1019

jessieR358 said:

lilpoots said:

@Sugargirl1019 you might be able to find a mom on a bst group that is giving her course/cds away. I'm in California and my hospital charges $275 for their birthing classes and they aren't teaching any birthing techniques. It is crazy! 

The one I ordered doesn't come with CDs. Only digital downloads that are good for one time. So if you look in to it, make sure you don't buy one with downloads and you can't listen to anything. My doula said you need to have 6 weeks to start it.
Shes a hypnobabies instructor so I figured I'd give it a go. It's super time consuming and I'm half doing it at this point. I don't have an hour every night to listen to audio and then another 30 minutes during the day to do other audio stuff. I work long hours and have a toddler. not happening! 

I have 4 weeks until induction! Boo. I really missed the ball here.