Would you ask about a C-section?

alaskanmomma · November 2012

We have a (almost) 3 year old daughter. She was 7 lbs 11ozs. I received a 3rd degree tear during labor with her. The scar is STILL uncomfortable and painful-during certain sex positions (tmi!).

Well I was just reading about tearing on another baby website, and it said that women who have had had a bad tear (3rd or 4th degree) are much more likely to tear the same or greater during childbirth. Now Im kind of freaked out by this information-I hadnt brought up the tear or anything with my doctor or my fear of tearing this time either, but I definatly will bring it up at my next appointment. But it said that women who have had those tears should have the option of having a C-section.

Would you ask about having a C-section? The thought of tearing that bad again literally terrifies me-but I dont know if Im really comfortable with the idea of a C-section as well. Just looking for other opinions

holly321 · November 2012

I personally wouldn't, but that is from the few of someone who had an awful experience with my csection. And for what it's worth, my csection scar is still tender, and sometimes it does hurt during sex.

nanabanana06 · November 2012

I really don't understand this. You don't want to tear your vagina, but would rather get cut open? I had a C/S with DD. It was the worst experience of my life. It took weeks to recover, had to have blood patches, and I still don't feel around my incision site. I would take vagina stitches over surgery.

alaskanmomma · November 2012

Umm..No. I didnt NOT say that I wanted to have a c-section. I read on webmd that the chances of tearing that badly are the same or greater, and that most of the time its recommended that a women has a c-section if she has previously had a 3rd or 4th degree tear. I read that there are risks to tearing that badly like having to use a coloscopy bag (Dont think I spelled that right-forgive me!) and having to have surgery (sometimes years) to correct the damage done to the colon etc.

I was just asking IF you would ask about it. I do not want to have a c-section. I know that is MAJOR surgery. We were planning a natural birth-but ever since reading this it has got me kind of nervous.

AimeeL85 · November 2012

Nana_Osaki06:
I really don't understand this. You don't want to tear your vagina, but would rather get cut open? I had a C/S with DD. It was the worst experience of my life. It took weeks to recover, had to have blood patches, and I still don't feel around my incision site. I would take vagina stitches over surgery.

You only know your own experience, though. I'm sure recovering from a c/s is more painful than recovering from some tearing, but not across the board. 3rd and 4th degree tearing and complications that can arise from it can be worse than you may think. It's not always as simple as a few stitches. Nearly 2 years later I still have pain from the tearing I had and the horrible hematoma that resulted from it. I was close to having blood transfusions at the time.

I don't think I'd opt for a c/s next time because I don't know what that would bring, but recovering from extreme tearing can be a lot more painful than those who haven't had it would think. My friend had c/s with both her kids and said she felt back to normal by the end of the first week. Everyone's experience is different.

sbevmc09 · November 2012

I would avoid a C/S if possible, but honestly I haven't experienced a 3rd degree tear. I don't think it hurts to explore your options, but I don't know that I would approach it as wanting a C/S, but rather what are the chances of reopening that tear? Are there ways to prevent that from happening?, etc.

Also, there are definitely ways to reduce the risk of tearing that would be applicable whether you've torn in the past or if you're a FTM. Things like perineal massage with oil, perineal support during crowning, pushing in a more favorable position than on your back, mother-directed pushing, delivering in water, warm compresses, controlled pushing during crowing, etc.

pitterpatter129 · November 2012

alaskanmomma:
Umm..No. I didnt NOT say that I wanted to have a c-section. I read on webmd that the chances of tearing that badly are the same or greater, and that most of the time its recommended that a women has a c-section if she has previously had a 3rd or 4th degree tear. I read that there are risks to tearing that badly like having to use a coloscopy bag (Dont think I spelled that right-forgive me!) and having to have surgery (sometimes years) to correct the damage done to the colon etc.

I was just asking IF you would ask about it. I do not want to have a c-section. I know that is MAJOR surgery. We were planning a natural birth-but ever since reading this it has got me kind of nervous.

I would definitely bring up your concerns to your OB at your next appointment. There are huge risks with a csection and I agree that mine was no picnic, but it sounds like you have valid reasons to be concerned about this too. I personally am going for a vbac because I really don't want to ever have a csection again, but of course I really wouldn't want to tear through my colon either! I would ask your OB what they feel would be right for you, do some research on csections, and make the best decision for your situation based on what you find out. Some people have very easy csection recoveries and some people have terrible recoveries (me!) I think a lot of mine had to do with having natural labor for 30 hours and dialating and pushing beforehand too though, so I was bascially recovering from both kinds of births + I had a fever! Good luck on whatever you decide.

littlemac1117 · November 2012

Nana_Osaki06:
I really don't understand this. You don't want to tear your vagina, but would rather get cut open? I had a C/S with DD. It was the worst experience of my life. It took weeks to recover, had to have blood patches, and I still don't feel around my incision site. I would take vagina stitches over surgery.

This. A c/s is major surgery. It effing sucked and I would never have one again so long as I have the choice/option to not have one.

Also, tearing your vag doesn't pose a risk to your internal organs.

Lucky_N_Love · November 2012

sbevmc09:
I would avoid a C/S if possible, but honestly I haven't experienced a 3rd degree tear. I don't think it hurts to explore your options, but I don't know that I would approach it as wanting a C/S, but rather what are the chances of reopening that tear? Are there ways to prevent that from happening?, etc.
Also, there are definitely ways to reduce the risk of tearing that would be applicable whether you've torn in the past or if you're a FTM. Things like perineal massage with oil, perineal support during crowning, pushing in a more favorable position than on your back, mother-directed pushing, delivering in water, warm compresses, controlled pushing during crowing, etc.

This!

saturdaynightdoubletree · November 2012

I would talk to your doctor about your fear. Would an episiotomy help not tear as much? I had a bad episiotomy with DD, and csection with DS. Both recoveries were very different, but similar pain scale. The difference was with the episiotomy sex hurt for a while after 6 months, but with the c section 2 years later it still occasionally makes me grab my stomach in pain when I sneeze or bend funny, and it created a nasty fold in my skin. Honestly though, I would do c section as a last resort. For me having a vaginal birth and then a c section I cried for hours after giving birth sitting in the recovery room alone, no DS, no DH. I felt like they just plucked him out of my tummy and that was that... No pushing, no effort, and just a total buzz kill feeling. Maybe that's just me tho. GL whatever you decide!

hmontty · November 2012

My C-section was horrible, and I would give my right arm to be able to birth this LO vaginally, even with the idea of tearing.

That being said, I haven't experience a third-degree tear, so I might be speaking in ignorance.

My only point is that C-sections can be really, really awful. Just like vag births, some are easy, some are a nightmare.

Given your particular options, and given that vaginal is better for baby unless there are overriding medical concerns, I would go vag.

hmontty · November 2012

sbevmc09:
I would avoid a C/S if possible, but honestly I haven't experienced a 3rd degree tear. I don't think it hurts to explore your options, but I don't know that I would approach it as wanting a C/S, but rather what are the chances of reopening that tear? Are there ways to prevent that from happening?, etc.
Also, there are definitely ways to reduce the risk of tearing that would be applicable whether you've torn in the past or if you're a FTM. Things like perineal massage with oil, perineal support during crowning, pushing in a more favorable position than on your back, mother-directed pushing, delivering in water, warm compresses, controlled pushing during crowing, etc.

All this. Before asking about a C-section, I would take some classes and read some books about natural birthing and all the many, many things you can do to avoid tearing -- which you can start to do weeks before you even go into labor.

jess9802 · November 2012

Nana_Osaki06:
I really don't understand this. You don't want to tear your vagina, but would rather get cut open? I had a C/S with DD. It was the worst experience of my life. It took weeks to recover, had to have blood patches, and I still don't feel around my incision site. I would take vagina stitches over surgery.

You do understand that a third degree tear involves the muscles in the anal sphincter? And that a tear of this nature can have some pretty nasty side effects, like bowel incontinence, that may not show up until much later in life? The OP is not being vain or silly for wanting to avoid a similar (or worse) tear.

OP, I was initially told by the nurses that I had a third degree tear, and I was really upset with that - on another site I post on an OB/GYN recommended I talk to my doctor to consider an elective C-section for my next pregnancy. My OB confirmed I actually had a second degree tear and a C-section isn't necessary, but you should absolutely talk to your doctor about your concerns. They are valid, and a maternal request C-section before you go into labor may be the right choice for you.

nanabanana06 · November 2012

jess9802:
Nana_Osaki06:
I really don't understand this. You don't want to tear your vagina, but would rather get cut open? I had a C/S with DD. It was the worst experience of my life. It took weeks to recover, had to have blood patches, and I still don't feel around my incision site. I would take vagina stitches over surgery.
You do understand that a third degree tear involves the muscles in the anal sphincter? And that a tear of this nature can have some pretty nasty side effects, like bowel incontinence, that may not show up until much later in life? The OP is not being vain or silly for wanting to avoid a similar (or worse) tear.
OP, I was initially told by the nurses that I had a third degree tear, and I was really upset with that - on another site I post on an OB/GYN recommended I talk to my doctor to consider an elective C-section for my next pregnancy. My OB confirmed I actually had a second degree tear and a C-section isn't necessary, but you should absolutely talk to your doctor about your concerns. They are valid, and a maternal request C-section before you go into labor may be the right choice for you.

Yes, I do understand that. I also know what the risk factors are for both having a vaginal birth and C/S. I would rather tear than have the possibility of damaging internal organs, infection, increase of miscarriage risks, longer recovery, and ultimately death or a hysterectomy. I didn't choose to have a C/S with my first, and I wouldn't of. I had a choice with this pregnancy as well. I switched doctors, hospitals, ect to avoid a C/S. They really do suck. The people who say they felt amazing 2 days PP from one is probably a big fat liar or lucky as heck.

Mrs.DeliaMarieP · November 2012

A nasty tear...a c-section incision...honestly, I don't think that one is going to be better or worse than the other (I had both an episiotomy and a c-section with DS).

Because I already had a c-section, and we had a nasty unexpected complication with DS, I am not a good VBAC candidate and am having an RCS.

If I had only had a tear or episiotomy, then I would attempt a vaginal delivery, hands-down. You may not tear as badly this time, whereas with a c-section, you will DEFINITELY have an incision and major surgery.

I would ask your OB about doing an episiotomy if it looks like you are going to tear and whether that would be more beneficial than letting you tear.

And finally, it certainly can't hurt to ask about the c-section, but if your OB hasn't mentioned it already, then he/she is probably not going to suggest it.

choppinbroccoli22 · November 2012

Mrs.DeliaMarieP:
A nasty tear...a c-section incision...honestly, I don't think that one is going to be better or worse than the other (I had both an episiotomy and a c-section with DS).
Because I already had a c-section, and we had a nasty unexpected complication with DS, I am not a good VBAC candidate and am having an RCS.
If I had only had a tear or episiotomy, then I would attempt a vaginal delivery, hands-down. You may not tear as badly this time, whereas with a c-section, you will DEFINITELY have an incision and major surgery.
I would ask your OB about doing an episiotomy if it looks like you are going to tear and whether that would be more beneficial than letting you tear.
And finally, it certainly can't hurt to ask about the c-section, but if your OB hasn't mentioned it already, then he/she is probably not going to suggest it.

Delia, I like that you point to a third option.

I also happen to know that the internet can be a good resource, but often provides a lot of (scary) misinformation. Your doc will have the best research and the benefit of experience to share with you.

jennygirlmt · November 2012

I can't speak from my experience but MIL was just telling me tonight that she tore so badly with DH that it was a zigzag in all directions. She had tons of scar tissue. She had sil four years later and her doc said he could fix it. He somehow guided the tearing with Sil and then spent an hour fixing her up. Mil said she had no idea how much pain and discomfort she had been living with until she healed properly from sil.

So while I wouldn't definitely choose a csection I would absolutely bring up the tearing/scar tissue I assume your doc has seen the damage and ask about methods to repair or at least prevent the possibility of it happening again, as well as possible complications and then ultimately if a csection would be a good choice.

Good luck with this delivery!

RissKay · November 2012

sbevmc09:
I would avoid a C/S if possible, but honestly I haven't experienced a 3rd degree tear. I don't think it hurts to explore your options, but I don't know that I would approach it as wanting a C/S, but rather what are the chances of reopening that tear? Are there ways to prevent that from happening?, etc.
Also, there are definitely ways to reduce the risk of tearing that would be applicable whether you've torn in the past or if you're a FTM. Things like perineal massage with oil, perineal support during crowning, pushing in a more favorable position than on your back, mother-directed pushing, delivering in water, warm compresses, controlled pushing during crowing, etc.

This is what I was thinking. Have you looked in to these other ways to increase your chances of lesser tearing?

sararn2004 · November 2012

I can just tell you from my experience I would not choose a csection. I've not had a csection but I've recovered from open abdominal surgery with the incision in the same area and I could not fathom having to take care of a newborn while dealing with that kind of pain. I have however, had a "3 and a half "(the doc said it was almost a 4th) degree tear. It started with an epesiotomy, and I almost think the initial episiotomy contributed to the tear, but at least it made it a clean tear as opposed to a jagged one. The doc took 45 minutes to stitch me back up. Well, that was my first. With my second, no tearing whatsoever. Perhaps the risk is there to tear again, but I can tell you it does not always happen.

mgade001 · November 2012

I really feel for you. A 3rd degree tear sounds absolutely awful. I didn't read every response on here, but I wanted to mention that apparently there's a lower risk for tearing with controlled pushing. This is one of the areas I think that newer physicians/OBs lack training.

Was your first a precipitous birth-- when it came time to push? Either way, perineal massage can really help! And you can start doing it soon. I know a lot of women that do it for themselves or have their partners do it in the last month of pregnancy using oils to soften the skin as well.

I really hope this doesn't happen to you. And I certainly understand your concerns. I don't think there's enough awareness about the pelvic floor trauma associated with birth. Some women do end up with colostomies! But that is not going to happen to you.

LoveBeingAWife33008 · November 2012

FWIW, I loved my csection and am glad I am having another one. No complications here!

emd79 · November 2012

I personally would avoid a c-section at all costs. I had a 4th degree tear with my first son (doctor had to use forceps). With my second son, I barely tore at all. Both of my sons were 7 lbs. 2 oz. and they were 3 years apart so I had plenty of time to heal in between deliveries.

itsmevkb · November 2012

I tore quite badly with my first and then although I did tear again with my second it wasn't as bad and with my third I honsetly don't remember if I tore at all. So, sometimes just the fact that your body has already been through a labor and delivery can make it easier to deliver subsequent babies. However, I would definitely discuss it with your doctor. A third or fourth degree tear can be an awful thing and I agree that many, many people who criticize women for even considering a c-section rather than risk tearing like that again fail to understand how serious and long-lasting the effects of such tears can be. Does that mean c-section don't carry serious risks? No. But I feel each woman should be allowed to weigh the options, the risks and the benefits and decide for themselves and with their doctors how they feel it is best to proceed.

lindseywinsemius · November 2012

I had a C-section with my first, and while it was a little traumatic because it was unexpected, I healed quickly and have few complications. I am considering it with my second. I would definitely ask and consider it as an option. It sounds like many of you had bad experiences with C-sections, but it really depends on alot of factors (just like natural labor) in determining how well your body handles it and the aftermath. My incision is a little uncomfortable from time to time, and I have a few numb spots, but it sounds like having a third degree tear is equally, if not more, painful. I had a friend who had a bad tear that totally ruptured the wall between the vagina and anus, and its taken her two years of surgeries, specialists, and painful rehab to get back to relative normality. I would see what other options you have. Good luck!

shibby00 · November 2012

I think the opinions here are great, but you need to talk about all of this with your doc! I had a c/s and the recovery was great, but I wouldn't choose that way to deliver. Talk to your doctor about all of these concerns!

[Deleted User] · November 2012

Honestly I wouldn't depend on WebMD to get my information about pregnancy or childbirth, I'd talk to my OBGYN if I had a true concern. Has your doctor suggested a C-section as a way to avoid tearing? Probably not, right? Talk to your doctor about your concerns. He or she can inform you way more than the internet can.

stever · November 2012

I wouldn't. I had a 3rd degree tear with DS1 and tore, had an episiotomy, then tore some more with DS2. Sounds horrible, but the recovery after DS2 was no worse than after DS1 and preferable to c/s recovery, IMO.

st.augbride · November 2012

My c/s was unplanned and was a very easy recovery, and planned c/s are usually even better, so if it is something that might make sense for you, then you should definitely bring it up and ask your doc their opinions on it. I am trying for a VBAC this round, but am fully anticipating another c/s. To be honets, my recovery was so easy that I worry the vaginal birth could be more traumatic.

MintBerryCrunch · November 2012

As other people have recommended, talk to your doctor about your options! I'm an OB nurse and I've seen people with histories of 3rd or 4th degree tears have c-sections, and some give birth again vaginally. Some tear more, some don't, and as other people mention, there are ways to avoid major tearing, so it's really important to discuss these things with your provider.

A friend I work with who had a 4th degree and later had to have additional rectal surgery to repair damage chose to have a c/s for her second baby and was thrilled with her recovery. Everyone is different so there is nothing wrong with considering all of your options and trying to decide what will work best for you. C-sections aren't easy and have major risks, but a lot of people recover from them very well, especially if they are planned. Of course, an uncomplicated vaginal delivery is optimal, but that isn't an option or isn't probable for some people. Recovery after a traumatic vaginal delivery can be very bad for someone people, as I'm sure you are aware. Everyone has different perceptions of experiences and while some people would prefer to always give birth vaginally, others will decide not to go through the same experience again and risk the same results. Hopefully your doctor will be able to give you some insight into your delivery options and will help you understand your risks with either method.

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