4th degree tear

moniquee19 · August 2015

For my 1st delivery that was 4 years ago, I tore all the way and got a 4th degree tear. Not pretty. This time around they are offering a c section. Which I wanted to stay away from, but then again I don't want to tear again. The doctor said I may not since this baby seems smaller. Has anyone went through this before? Or has anyone had a natural and a c section to tell me the negatives and positives between the two. Any advice will help, just not rude ones. Thank you!

hclzmm14 · August 2015

I had second degree tearing with my first 17 months ago. While I know it's probably nothing compared to a 4th degree tear, it was obviously still painful and I was worried I would tear worse this time. I only had a first degree superficial tear and my doctor said it didn't really need a stitch but DH might be thankful for it later lol... I also took less pushes to get this baby out and she was only 2 oz smaller than the first. So there is hope you won't tear as much! Good luck in your decision!

jessandandy09 · August 2015

the incision for a C-section is much more difficult on your body than the tearing of the perineum (OUCH tho, I was cut 3 times with my first, tore with my second and had no problems with my third. Not only will they cut through your skin and your muscles and fat, they will cut through your uterus. this is very unkind to your body. Each delivery will be different, and I would suggest perineal massage. The doc or midwife should do this during delivery and you can do it ahead of time with a lubricant to practice stretching the skin and muscles. best of luck.

gmd88 · August 2015

I haven't had a tear and although I do not belittle it at and I am sure it sucks and hurts.. i just had a c section and they cut through 7 layers as PP noted.. skin, fat, fascia, sometimes muscle, and two layers of your uterus to mention some. They stich back at least 3 layers that I know of.. the two layers of your uterus and your skin at least. Not sure if they do other layers as well. It's major surgery and you're considered disabled for 8 weeks. I probably would not recommend choosing it over a possible tear (note possible). Have you considered having them cut you down there? I know it is not preferred but given your situation... good luck and have faith in your decision mama!

laineyjewel · August 2015

If it were my decision to make, I would go vaginal. Even though there is a risk to tear, as there is with every vaginal birth, a csection is a guaranteed major surgery. I personally would rather recover from a horrible 4th degree tear than major abdominal surgery.

I would also skip the episiotomy if possible. Evidence based practice has shown thay women who get them are more likely to tear, and to a higher degree, than a woman who is allowed to tear naturally.

GL with your decision. I wish you and your LO the best!

SouthernYankee87 · August 2015

@moniquee19 - I have been in your shoes ... I am in your shoes.

I had a 4th degree tear and cervical lacerations 2 years ago with my first. It took my doctors, 2 hours to stitch my cervix and perineum after delivering my DD. I don't know about your recovery but mine was horrendous. It was a solid 6 month recovery with some complications. I had trouble controlling my bowels for a bit too.

I have spoken with every doctor (7 of them, including a gynecological surgeon) in my OB office about whether to deliver vaginally or have a c-section. Here are some of the stats I was given:

- You are 5x times more likely to have another 3rd-4rd degree tear again

- The size of the baby plays very little role in whether you'll tear again, its more about your body composition

- The risk of bowel incontinence is very high if you tear again and that would require multiple surgeries to TRY to correct

I'm not sure if your cervix tore but because mine did, my cervix is incompetent. I had to do progesterone suppositories and have a pessary ring inserted (which thankfully worked so I didn't need a cerclage). My doctors also said that since my cervix has so much scar tissue it would likely tear again. And, if it did tear again, I might not be able to carry anymore babies without substantial medical intervention.

Because of everything above, I'm having a c-section. It was a ridiculously hard decision for me to make but I'm happy to know that my LO will be delivered in a controlled environment by a routine procedure. And, my recovery time should be substantially less than last time which I am so thankful for.

I know a lot of people would probably disagree with my choice but I've weighed all of the pros and cons with my doctors and we've all come to the agreement that this is a much safer choice for me to avoid probable life-long problems. I certainly don't want to be 31 years old and pooping myself.

Good luck with your decision. If you are on the fence, I'd set up an appointment with your doctors to discuss both options in great detail. Every appointment I had, which was weekly because of my crap cervix, we discussed vaginal versus c-section deliver

Saratiff · August 2015

FTM here so no experience but the post right above me sounds like the one I would go with :-)

Bickey11 · August 2015

I'm actually really surprised they are offering a c-section to prevent a tear..i tore all the way thru. While it was not pleasant i dont imagine having your stomach and muscles cut open is a better alternative. I had no restrictions with a tear, c-sections Leave u up a creek for a few weeks. Your doc frightens me...

augboy · August 2015

Same situation as you, I had horrible tears with 3 deliveries and my bladder control was non existent. One baby even got stuck and became stressed and had problems during birth. So this time since this baby was so much bigger they offered c section. I gladly took it. I couldn't go through tearing again. Especially since my baby got stuck and this one was so much larger. I would choose c section recovery any day. I was literally up like a normal person the evening after. I could sit without pain. The c section staples hurt less than a 4th degree tear. I had the best c section experience ever. I was having anxiety attacks about the birth when I thought I had to do it vaginally again. It's a good thing I had the section because my other babies were around 8.5 lbs at full term and this baby was almost 10 lbs at 38 weeks! Ob said I probably would've ended up with emergency section anyways since my smaller one was stuck.

augboy · August 2015

Btw I have been doing my normal routine since a week pp. and I've resumed sex since 3 wk pp. the only issue I've had at all is hemmoroids. But only for the first 2 weeks

klirwin82 · August 2015

I'm perusing from July. I've only had 1 baby and it was by c-section so I can't compare to vaginal...but why risk another serious tear? I heard all kinds of horror stories about c-section recovery but I experienced none of it. C-section was smooth, didn't have to go through labor pain, recovery has been fine (I'm 6 weeks PP) and tomorrow at my appt I hope I'll be cleared to ease into working out again. Not nearly as bad as people talk about. Not even bad enough to push for VBAC next time, I'll gladly have another section.

BabyD316 · August 2015

I had a 3rd degree tear with my son 2.5 years ago. My recovery was rough. I had my twins 2 weeks ago and only had a 2nd degree tear and my recovery as been easy. I don't envy you having to make this decision. Good luck! I hope you have an easy and safe delivery no matter what you chose.

SouthernYankee87 · August 2015

@augboy- just wanted to say that reading your post helps put my mind at ease a bit. I'm so happy to hear that your c-section recovery was better than your tearing recoveries!! Thank you for posting about your experience!

moniquee19 · August 2015

Thank you everyone for sharing your experiences and kind words.

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