Ask a STM+ (April 2023)

acamomma18

I’m currently 33 weeks pregnant with DS and am concerned about birth. I had a fourth degree tear with my 2019 DD and am now facing a decision: try vaginal or elect a c-section. I’ve been very adamant all along about going vaginal… I’ve been going to physical therapy for months, trying to build up my pelvic floor. But I do have lingering concerns about worse fecal incontinence. 😔 (it’s gotten worse lately with DS pushing on my bowels!)

So my question - has anyone tore previously, and what’s your plan this time? How did you make this decision?

(I hope I’m using this board correctly; please tell me if this is better for a different thread)

jeep4x4mom

I didn’t have a 4th degree only a 2nd degree in 2015. But the area where you tear for me never healed correctly, I still have tearing and I’ve also done pelvic floor therapy and even had surgery to try and fix the issue. I still tear to this day I tear but minimal. I opted for a C-section this time for a few reasons. Tearing, tube removal and with my girls their heart rate dropped during delivery and I paid for the operating room. 

I wanted a C-section with my second daughter but my doctor at the time was persistent that my tearing would be fixed. It wasn’t. So I’ve made it this far with almost fully being healed, I don’t want to go through the pain and the strain it had on my marriage. 

Your fear is a valid reason, you had trauma. Follow with what you want. If a C-section will put you at ease I’d say advocate for yourself. 

acamomma18

Thanks for sharing your story! I wish there was more education on this… and we could foretell the future. I really want vaginal, partly to avoid major surgery and partly for ego TBH. I’m stubborn AF but also scared about poop leaking out without control for the rest of my life. The potential downsides of tearing seem to outweigh those of a c-section.

I swear my poop has been more liquidy lately too… hormones? Sex has also been painful at first, but we’ve found ways of helping it. 

You noted marital strain… was it in the physical department? We had some of that too when I never wanted to be intimate 😔 

jeep4x4mom

Make a pros and cons list. It might help ease your mind on choosing. Not too much longer and baby will be here 😱

They say if you do vaginal stretching before birth it can help avoid tearing. So that might help you and your fear if you start it soon it might help. I understand the serious surgery part. I am a bit afraid myself and the pain that can come with it. But  it’s a shorter healing process for me physically/mentally considering my past. 

Its hard to want to have sex when you know it’s going to be painful. For a few years I had to use numbing cream and had to wait 20ish minutes for it to work. Nothing says sexy like having my husband put numbing cream on me (while also causing pain 😔) then to pause for 20 minutes. So it takes a toll because you fear the pain and say no to sex more often. Men don’t feel loved or as connected as before. But now I’m about 90% healed and next to no pain, I’d like to keep it that way. But that’s why I opted for C-section I don’t want to go through that and put my family/marriage in a bad situation again. 

acamomma18

That makes total sense / the strain on relationships is REAL. I’m glad that you’re 90% healed and have next to no pain 💪🏼 Sending lots of love mama!

BourbonBiscuits

I've torn each time with all 3 deliveries - always in the same place and to the same degree. Mine was only a second degree tear though, so not nearly as bad! I have had friends who had terrible 4th degree tears and absolutely breezy second deliveries with no tearing at all. 

Which I'm realizing is not at all helpful advice. Have you talked to your OB about it at all? I wonder if there's anything about the location of the tear that could predict a repeat tear?

acamomma18

That is helpful, as it gives me hope for a successful vaginal delivery this time around! Yes, we’ve started talking to the OB about it… her take is there’s no reason to plan on a c-section yet. I have another growth scan at 36 weeks to assess his size and position (currently down!). She’s also going to look at my perineal body to get a sense of how much “room” I have. Will be doing perineal massage soon 😅 I think I’m suspending decisions until I have more info at 36 weeks.

caro9318

I had a 4th degree with my son. It was a lot for me at the time but things did heal as best as possible. Now I’m pregnant with twins. I was also going back and forth but my doctor and I decided on a C-section to avoid it happening again or anything worse. I think it’s best to talk with your doctor about baby’s wt and position and see what they recommend.

acamomma18

Well our growth scan showed 97% head diameter and 71% head diameter… and my perineal body “isn’t great.” After much discussion, it’s very clear that it’s in my best interest to pursue the c-section. I don’t think I’d regret it in the way that I could with another vaginal birth. (First baby was small… was 6.8 at 40 weeks; this one was estimated at 7.4 at 37w3d). Feeling sad and frustrated, but coping with the new reality 💙 

ashleyp625

@acamomma18 I’m so sorry you aren’t able to have the birth you wanted and planned for. If it’s encouraging at all to you, I had to have a CS for breech positioning that I originally really did not want, and things went way better than I could have imagined. I hope they do for you as well! 💜