4 Degree Tear - BTDT Moms

SouthernYankee87 · July 2015

If you previously had a 4th degree tear and cervical lacerations, what is your delivery plan for this baby? What are your doctors recommending?

A little background: I had a 4th degree tear and cervical lacerations with my DD 2 years ago. I had a horrendous recovery that took about 6 months. I have a lot of scar tissue and still have some lasting issues. I am high risk this time around due to an incompetent cervix from the tearing. I am terrified of delivering again. I've had many conversations with all my doctors about the best way to deliver. The majority of the doctors are worried about permanent damage that could occur if I tear again. Even if I only have a 2nd or 3rd degree tear this time around, I might end up with bowel incontinence which would require multiple surgeries "to try" to fix. My cervix is very damaged and I might not be able to carry anymore babies should my cervix tear again. Of course, they also say I might not tear but because I have so much scar tissue, there is a very good chance that I will.

I'm really struggling with whether I should deliver vaginally again or opt for the c-section. My doctors have discussed the pros and cons to both options and are basically leaving the decision up to me. I really don't want to have a c-section but the potential of tearing again and having life-long affects (possibly pooping myself uncontrollably, no more kids) are incredibly scary.

I guess I'm just looking for your thoughts on how you will handle your delivery. I know this is a decision that I have to make, I just want to make sure I'm looking at it from all angles.

mrsrfwii · July 2015

Hmm, that's a tough decision. In general I try to do things naturally so it would be my nature to opt for a vaginal birth. However, knowing the possible long term consequences of possibly tearing again, I think I would probably lean towards a c-section. If you think you would like to try to have more babies in the future and to possibly avoid future surgeries because of tearing, I'd go for a c-section. But that's just my opinion. Good luck with whatever you decide.

puccagirl77 · July 2015

Based on your description, I would go for the c section. I know its no picnic, but it sounds like the best option for you.

Jones071507 · July 2015

If it was me I would do the c section.

sjnarry · July 2015

Given what you described I'd have a hard time making the decision. I can tell you I had a 4th degree tear w my first, but it healed very well and quickly with no complications. With my second I had a 2nd degree tear with again no complications.

Robin910 · July 2015

I've never been in a similar situation but to me, the risks you mentioned of the vaginal birth aren't worth it, I would opt for the C-Section.

amylianne · July 2015

I don't have any experience delivering vaginally at all, but I can say that I can't imagine my recovery from a c-section being any easier. I had DS at about 11 at night and walked myself to the bathroom the next morning with very little pain. With all the long term risks, I'd opt for the c-section too. But, like I said, I don't have any experience with natural births.

Miz_Liz · July 2015

If I was in your particular situation that you described, there would be no choice for me, I would be having a c-section. I understand how scary major surgery sounds and that there are risks associated with it as well; however potentially having permanent damage and not being able to control my bowels would be enough for me to say that the benefits of a c-section outweigh the risks. At the end of the day though it is a decision you need to make with your Dr's. Good luuck!

sandrabrooke · July 2015

C-section!!!!! Honestly, it sounds like regardless of your choice, you'll end up with some sort of major surgery (either now or later). Csections are scary and major, but at the end of the day, are fairly routine procedures.

Best of luck in your decision!

jesselayne8 · July 2015

As much as I would love a VBAC personally, if I were in your shoes I would choose csection over possible bowel surgery. Especially if you don't feel your family is complete and you don't want to risk any more damage to your cervix.

Nickisiebert · July 2015

I haven't had any tearing, as I've only had csections, but my recoveries have been cake walks compared to what you've been through! Even with some complications! I would seriously consider the C. It sounds like tons of risk to deliver vaginally. A Csec is not defeat, it may save your downstairs!

lethanne · July 2015

I would choose a csection if I was in that situation.

moxykel · July 2015

I'd opt for the c/s! Sounds like the better plan in the long run.

hclzmm14 · July 2015

I would think about the misery of needing bowel surgery and not being able to control my BMs. You don't need to be some kind of hero trying for a vaginal birth and then doing worse damage; vaginal birth or c section you are still amazing for bringing a life into the world! I would go for the c section personally. Good luck with whatever you choose though.

laylababe3 · July 2015

Wow, I'm sorry that you even need to make such a tough decision.. I have zero experience, but based on your description of possible outcomes, I would opt for the c-section. Good luck with whichever you choose!

mjones0721 · July 2015

Personally I would opt for the c section. To me it seems like the lesser risk from what you've described. Good luck with whatever decision you make!

kettlekitten · July 2015

This sounds like a huge decision. I'm pro-vaginal birth where possible as I'm sure most are, but this sounds like a situation where it would be very risky. Obviously I can only give my opinion on what you've described above, but I think I would also opt for a c section as the other PPs have said. It seems more of a 'known' risk than vaginal birth in your case. Good luck with your decision!

drummondst · July 2015

C-section, no question!

mamaloaf · July 2015

I thought I've heard that once skin has been torn, it's weakened and predisposed to tearing again. Because of that (and the other serious potential complication you may face), I'd opt for a section.

Not to make jokes about your very serious situation, but reading this made me pucker my butthole a little bit :P. Please let us know once you and your doctor decide what will be the best course of action and best of luck to you!

SouthernYankee87 · July 2015

Thank you all so much for your thoughts. I have been leaning towards a c-section and think that is what I'll choose, which the vast majority of my doctors recommend too (seems a little less scary since it's controlled and "routine"). I just wanted to get some unbiased opinions.

Thank you again.

@mamaloaf - you made me laugh. and yes, pucker your butthole and don't ever take that for granted!

nks27 · July 2015

I had a forceps birth with my first, which resulted in "3rd to 4th" degree tears. I also had a horrendous recovery and still have issues from the birth to this day. My colorectal surgeon was adamant that I should have a c-section so I'm scheduled for a week and a half from now. Honestly I'm relieved by it. I way prefer healing from a c section than going through what I did with my first.

SouthernYankee87 · July 2015

@nks27 - Thank you for sharing your experience! Good luck with your c-section. I hope it goes well and you have a speedy recovery.

I had a doctor appointment today and met with the gynecological surgeon. He was pretty adamant about me having a c-section as well and said the data from studies shows I'd be 5 times more likely to have a 3rd-4th degree tear again. That is no joke. So, I'll be scheduling my c-section.

And I'm high risk of going into labor early due to a short cervix and he said even if I go into labor early I just need to call the office and let them know so they can get an operating room.

I'm feeling pretty at peace with my c-section decision. Knowing I won't have bowel incontinence is a huge relief!

Thanks for all of your feedback!

neludelu · July 2015

The alternative sounds so scary that I would consider cutting into myself. I'm not sure why anything but a c section is on the table for you.

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