Two Under 2

? about 2nd labor if you had a 4th degree tear/epi the 1st time.

and it's a little TMI.

So, I had a 4th degree episiotomy and it took a while for me to heal (like 3 months instead of 6wks). My ob says that there is such a small space between my rectum and vagina that it might tear again, but usually most moms don't have another 4th degree with their second.

So, because of this issue with my first labor, she has offered a c-section. I would prefer to deliver vaginally again, but if anyone has any insight I would appreciate it. I don't know anyone who had this issue, so I don't know who else to ask.

TIA!

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Re: ? about 2nd labor if you had a 4th degree tear/epi the 1st time.

  • I had a 4th degree tearing (I specifically requested that they not do the episi) and it took a long time to heal also. I was warned that I would tear again, so I expected the worse. But the second time around was SO MUCH easier -- in every way, labor, delivery, tearing and healing. I did tear a bit, can't remember the degree, but I healed so much faster this time around. I'm actually kind of surprised your OB suggested a possible c-section. 
  • First time I had an episi and 15 stitches.

    25 months later with number two, it was completely natural, no tear, no stitches.  I was shocked.  I was hardly even sore afterwards.

     I think it depends a lot on your baby.  #1 had a big round head, that just wouldn't come out.  I pushed for 1.5 hours.  With #2 she had a smaller head and came out in 4 minutes.

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  • I had a 4th degree tear with DD.  She was sunny side up and weighed 8 lbs 2oz (I am very petite, 5 ft and 100 lbs).   The doctor used forceps after 3 hours of pushing. Not only did I have a horrible recover (my tear reopened) but DD was sick at birth because she got stuck in the birth canal.  She went on O2 for 24 hours after birth and then another 24 hours of observation, so the whole time I was in the hospital, she was in the nursery.. it was all horrible.

    With DS1, I had the option of a c-section also.  My doctor monitored me and the baby very close.  He was in the correct position and measured smaller on u/s.   I had a good vaginal birth.  He ended up being 7 lbs and 7 oz.   

    And as luck would have it my second son, measured (much) smaller, he was 6 lbs 5 oz.  With my boys, I did not have any major tearing.   Overall, I am glad I went for vaginal births. 


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  • I had an episiotomy(unnecessarily) with DS...not sure the degree but it took a while to heal and was very sore for a few months. DS was preemie and weighed 5lbs but after 45 minutes of pushing the doctor did an epi without my permission. Because DS was early I was taken to a different hospital with a NICU and the resident and attending doctor not my OB delivered DS...still not sure why they did an episiotomy and my OB was not happy at my 6wk pp check up.

    17 months later I pushed DD out who weighed almost 7lbs out just fine in less than 30 minutes and only tore enough to have 1 stitch.  I was also warned that because I had an episiotomy instead of tearing naturally that I would tear much easier with #2 but that was not the case for me. 

    GL with labor/delivery #2

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  • 3rd degree w/ first baby and 2nd degree w/ second...  doc said it looked like it was in the same spot as before just not as bad.  didn't seem nearly as bad when healing.
  • I am pretty petite and had an 8lb baby with a rather large head (like his daddy!) and I pushed for over 2 hours. She ended up cutting me and I still needed the vacuum to get him out.

    So, I am just hoping that I can deliver vaginally without the same thing happening again - I'm ok with some tearing and know it will probably happen, I just don't want to deal with another 4th degree tear/epi. Especially if I have to be chasing a toddler around.

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  • i had a 2nd deg episi with DS, vaccuum, 2 hours of pushing...it was hell since my epi wore off...he was 8lbs 5 oz

    DD was 7 lbs 1 oz, came out in 5 pushes, I was comfortable and needed no assistence and no stitches.

    MUCH better the 2nd time.  

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  • Thanks ladies, I'm gonna try to go for another vag delivery. Unless they estimate a 10+ baby (and even then, I know they can be off) I think I'll be ok.
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  • I had a really bad tear with DD1 (not sure if it was 4th degree, but it required stitches and a lot of healing). With DD2, I only had a tiny tiny laceration (and I don't think it was in the same place where I tore with DD1) and didn't even need stitches. DD2 was almost a full pound and a half bigger than DD1 too.
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  • I had an episiotomy with my first. 

    this time around I went natural and didnt need an episiotomy or didnt tear either.  healing this time around was much easier, than the first. 




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  • This is interesting.  I had a 4th degree tear - the dr. worked on me for over 2 hours after my deliver, and I am still crossing my fingers to avoid further surgery!  He basically "told" me (I could refuse, but you know what I mean) that I have to have a c-section next time - that the risk of doing virtually irreparable damage is so high that there's no point in chancing it. 

    I guess I'm the only one who got this advice? 

  • Wow, guitaristsgirl, that sounds horrible! It took over an hour to stitch me back up again, and around 8 wks pp, my ob thought I might have needed surgery. I did like 4 sitz baths a day and it healed wonderfully.

    She didn't push the c-section, but said b/c my perineum is soooo short (almost non-existant) that it's possible to tear again into my rectum - super fun!!

    She said we'll cross that bridge when we get to it though. I'd rather have a vaginal delivery, but we'll see.

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  • It seems generally that the 2nd time isn't quite as bad, I hope not, anyway.  I had an episiotomy with Peyton, she just wouldn't fit & the MW said I was too 'muscular' to tear on my own.  I had over 40 stitches and ripped some out a few days later/got an infection. 

    I hope this time goes much smoother because I remember how much it hurt to sit/get up. 

    DD1(4):VSD & PFO (Closed!), Prenatal stroke, Mild CP, Delayed pyloric opening/reflux, Brachycephaly & Plagiocephaly, Sacral lipoma, Tethered spinal cord, Compound heterozygous MTHFR, Neurogenic bladder, Urinary retention & dyssynergia, incomplete emptying, enlarged Bladder with Poor Muscle Tone, EDS-Type 3. Mito-Disorder has been mentioned

    DD2(2.5): Late term premie due to PTL, low fluid & IUGR, Reflux, delayed visual maturation, compound heteroygous MTHFR, PFAPA, Bilateral kidney reflux, Transient hypogammaglobulinemia, EDS-Type 3


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