Elective c-section after 4th degree tear? Need advice.

sammy520 · March 2016

First off, sorry for the TMI and I hope I don't freak any FTMs out. I'm just in need of advice.

I delivered my son in April 2014 and after 2 hours of pushing, I had an episiotomy, which led to a 4th degree tear. Fortunately, I didn't feel it happen and the doctor who delivered me did a great job stitching me up...I haven't had any issues! But, the recovery was long and painful. I sat on ice packs for a few weeks, took stool softeners for a month, sitz baths daily, and experienced a ton of pain! Sex for the first few times was difficult also (even though my stitches healed after 6-weeks).

My OB/GYN recommends an elective c-section with my second delivery to prevent another tear, and incontinence issues as a result. She said some patients had to have reconstructive surgery afterwards.

At first I didn't think twice about it and thought it was the best decision also. But there's a chance I won't even tear again and could have a regular vaginal delivery with little complications. I'm just worried about the recovery from a c-section and having to care for 2 kids (even though my husband is amazing and I know my family will help if needed). I'm also nervous about the surgery itself! Just laying there, cut open, unable to bond with my baby when she comes out.

What would you ladies do? Am I just psyching myself out? I'd love to hear from STMs and how your recovery from a c-section was.

bearsandbeets7 · March 2016

Oh that'd be a tough decision to make! I had a csection and the recovery was so easy! They used glue instead of staples which was awesome because I could shower right after. I would probably discuss with your doctor how high your chances of you tearing again. Honestly I think reconstructive surgery(if you had to have it) would be more difficult to recover from than a c section. I've also heard that an episiotomy is more difficult to recover from than tearing naturally.

I would just talk more with your doctor before you decide one way or the other.

gadzooks_3 · March 2016

This sounds like a situation in which a second opinion would be of great help. Is your current physician the one who gave you an episiotomy? Does she do an episiotomy for a lott of births? Routine episiotomis are no longer recommended. Perhaps getting a second opinion on this will help you get some data on whether a previous tear makes you more likely to tear on the future.

ThisisNumber3 · March 2016

I wouldn't decide just yet. See how big baby is and your bishops score around 32-36 weeks. Maybe by 38 if it's not looking good schedule something.

texasmama2014 · March 2016

I wouldn't judge you for electing a csection. Episiotomies freakin suck, and mine only needed a few stitches (for those interested, DD was stuck and I pushed for 1.5 hours, she slid right out after the episiotomy and I had less than a centimeter cut in 2 spots.) If it caused you that much pain, and trauma do what you feel is best. A second opinion is probably warranted. I hear planned csection are much easier to heal/bounce back from. My SIL has had 2 planned and 1 emergency csection. She's 4 weeks out and started running already.

sammy520 · March 2016

@liljabee Unfortunately, I had never met the doc that delivered my son. It was a large network of docs, and I hadn't met this particular one. Looking back, I wish I would've said no to the episiotomy. But I was so exhausted and just wanted the birth to be over, so I said whatever you have to do to get him out! I think she opted for the cut bc my son was born right at a shift switch (7 pm). I remember different nurses coming in as I was pushing and trying to get up to speed. Fortunately, the nurse who had been with me the past 12 hrs decided to stick around and help me.

I definitely will ask more questions in the weeks to come, bc I've switched doctors since we moved about an hour from our last home. I've heard there are things you can do to help loosen the muscles, to prevent a tear.

mmclark10 · March 2016

I agree with getting some more information before making a decision. I had a c-section (breech and he had to come out that week because I had been diagnosed with cholestasis at 37.5 weeks) and while recovery from the surgery wasn't that bad, emotionally it was and still is hard to deal with sometimes. I'm glad that c-sections are available because they save so many moms and babies, but would be sure it's the absolute best option for you.

lblu43 · March 2016

I was forced to do a c-section with my DS seven years ago. While we are tentatively* planning a Vbac this time around, my experience with the surgery wasn't negative at all. Getting to that point yes was emotionally difficult, but once he was out it was amazing. They immediately wiped him off and placed him on my chest. The bond was instant, and to my surprise he latched immediately to suckle with absolutely no complications. I agree with the others. Talk to your doctor(:-). Also use your support system. Thanks to my dad, I was up walking on day 2 slowly waddling laps around the unit. They released me day 3 because of it. Most important thing is the health/safety of you and your LO.

cm716 · March 2016

Tw... Yucky details

I have not had a c-section but i have had an episitomy. I have had two kids. With my first daughter I had an episiotomy and the recovery was cake. with my second daughter, my inner labia tore open (during an unplanned natural birth). the recovery was horrendous and the skin didn't heal correctly. I was advised not to seek any correction as i planned on having more kids. I am nervous that another vaginal birth will tear it open again and I will be left with a mess.

so, I guess what I'm trying to say is that if you are thinking about an elective c section to avoid injury/trauma, i totally understand.

SkiChic626 · March 2016

My c-section was easy peezy. *knock on wood* that it is again this time because now that I know it's a boy and he'll probably be even bigger than his sister I'm definitely opting for another c-section. It wasn't planned, but it also wasn't an emergency. I was induced and with almost zero progress after 2 days DH and I agreed that enough was enough and we asked for a c-section - 90 minutes later DD was born - it was a Sunday and I don't think they do scheduled c-sections on Sundays so I didn't have to wait very long. As long as you get up and move as soon as you possibly can - I was up within 12 hours after surgery - you'll recover soooo much quicker. I needed help showering the first maybe two or three times, it honestly might not even have been that many, but then I was totally fine. The hardest part is getting up out of bed when you have to flex your ab muscles, but you figure out how to maneuver. And for BFing, football hold and the mybreastfriend are musts. As for the actual delivery, I'm not sure if it's standard everywhere, but at my hospital they put DD on my chest while they were putting me back together, so it didn't affect that initial bonding or anything like that. She was big, so eventually they did have to take her to for a glucose test, but they would have had to do that with a vaginal birth, too, due to her size. DH was with her the whole time for that, and when they were done they brought her back to me in recovery and then she never left my side again. :-)

rmdavis1014 · September 2016

Just wondering how everything turned out? Did you opt for the C section? How are you recovering? I'm facing a very similar situation. I'm due in 5 weeks and I need to make a decision soon. My doctor said they support me either way but they want to to deliver vaginal and I'm terrified that I will further complicate things. Hopefully you had a better delivery the second time around.

ballofmeat · September 2016

Ooooooh I'm kind of glad this thread was brought back from the dead. I just delivered DD last month and had a delivery from hell. The epidural stopped working as I pushed for almost two hours. I had a 4th degree tear and from what I understand a lot of internal stitches. My OB also recommended I not deliver vaginally again either because of scar tissue and possibility of having to have reconstructive surgery. For my next one I am definitely going with the c section. My recovery has been miserable and I will be 6 weeks PP tomorrow. It sounds like a lot of OBs depending on damage recommend the c section. Glad to know this. I'm really dreading my follow up in another week as it still throbs down there and seems somewhat swollen.

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