4th degree tear

Akeen444 · June 2014

So I had my son on 6/2/14 vaginally and ended up with a 4th degree tear. My doctor told me at my post op appt that I am healing fine but she doesn't recommend me having another vaginal birth in the future and will recommend a c-section. Has anyone else experienced this?

katekat8721 · June 2014

I haven't, but that sounds freaking painful, I'm sorry.

drby126 · June 2014

Im so sorry! I also had a 4th degree tear with DS1 but didn't hear anything about having a csection. DS2's EDD is next Sunday and I'm planning a vaginal birth, though I did talk with my mw about sidelying positions to avoid tearing again. You might bring it up again at your next dr appt.

lifeisbetteronthered · June 2014

I had a 3rd/4th degree tear with DD 17 months ago. I was offered a csection for this delivery, and it would have been more of a recommendation rather then an offer if my tear had been a true 4th.

My understanding is that the risk of getting a second 4th degree tear with your next delivery is low-ish, but it if is to happen the likelyhood of suffering lifelong fecal incontenence is very high. Doesn't sound fun. And if you already have any degree of sphincter dysfunction (even if asymptomatic) after the first tear then the risk of that worsening is also very high.

As you heal and plan for future pregnancies, continue to talk to your doc about it, including testing of your anal function to assess for any asymptomatic dysfunction to give you the best assessment of your risk.

Julie&Micah · June 2014

I had a 4th degree tear with my DD who is now two, and I did end up with a c section for my DS who was born two weeks ago, however the past tear was only one factor in deciding for a c section. The reason I most likely tore so bad with DD is because her head was so huge and she just really didn't fit out very well. (Stitching me up from the tear alone took longer than my entire c section took!) She was an average size/weight baby though despite the big head. With DS, I had the tear history (so likelihood of incontence was higher even though DD 'paved the way' so to speak) we knew he had a big head, and he has always measured very big (we've had several growth ultrasounds this pregnancy). He ended up being 10lbs and 3oz with a big head and broad shoulders so the recommended 'preventative' c section ended up being the right choice for us as we would have most likely ended in that scenario or an emergency.
I think you will probably just keep in conversation with your dr for upcoming pregnancies and your risk factors. I don't think 4th degree necessarily = c section, but there are things to think about/keep in mind!

Julie&Micah · June 2014

Oh another consideration was how many more kids we probably wanted. If there would be several more, dr would have recommended attempting a vag delivery first, as c section scarring can add up and cause complications of its own. Since we are most likely done, it didn't matter to us. Another thing to keep in mind

justme04 · June 2014

I had a c-section this time after experiencing a 4th degree tear with my second child. I also had a csection with my first. Personally I think the recovery from a csection is a million times easier than recovering from that level of tearing. Also, after tearing that bad it was 6 months before I could comfortably be intimate with my husband.

My csection this time was completly my perogative. I was told that a 4th degree tear was no reason to have a csection if you dont want one. But if you decide not to I was advised to make sure during delivery that medical interference is minimal and to reduse the use of forceps or a vacum

kriati03 · June 2014

I just joined the ranks of 4th degre tear two days ago with DS. When we asked about future births, the OB said we would probably be able to attempt a vaginal birth (given good healing), but that he would consider starting with a medial lateral episiotomy so as not to repeat the tear into the anus. Sounds wonderful doesn't it? I will have to see how recovery goes before thinking that far ahead...

Akeen444 · July 2014

Was it explained to you why an episiotomy was not done before letting you tear that bad? I asked my doctor and she said it is a guarantee 4th degree if she does an episiotomy and only a chance if she keys the mother see how far she can stretch. I have had 2 post op appointments and everything has healed like it is supposed to, with no complications.

enpowers · July 2014

@Akeen444‌ just a question about your tear, and anyone else who had one- I also had a 4th degree tear and I am almost 4weeks PP and I am still pretty sore and it's still super painful to poop. When does this get better??

mikenjess113 · July 2014

@enpowers‌ I am 4 weeks PP with a 3rd degree tear and still in a good amount of pain. One of my stitches fell out and I had my husband look to see if I was looking like I was healing and he said I was still torn...yikes!

Wondering how long until I heal completely.

allrightmeow · July 2014

enpowers said:

@Akeen444‌ just a question about your tear, and anyone else who had one- I also had a 4th degree tear and I am almost 4weeks PP and I am still pretty sore and it's still super painful to poop. When does this get better??

@enpowers Did they by chance give you a Sitz bath to take home? I had some tearing, nothing as bad as a 4th degree but my sitz bath helped sooo much.

enpowers · July 2014

@allrightmeow‌ they did give me a sitz bath I've only used it a few times bc until now it's hurt too badly. I actually took some time out last weekend to use it. I even drank a glass of wine.....this is how I spend an exciting Friday now....

BabyCurtiss2014 · July 2014

I'm so sorry ladies! Recovery from CS was painful but sounds better than tearing that bad!! Hugs!

Akeen444 · July 2014

My pain was very minimal by week 5. My doctor gave me estrogen cream to apply that is supposed to help with the healing. I also used the sitz bath. Hope u feel better soon!

allrightmeow · July 2014

@enpowers With DD I used it at least three times a day. I swear it helped me heal so much faster. My doctor was impressed. Id go into the bathroom with a magazine and just veg out.

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