Tear v.s c-section??

mqm418 · March 2016

My DS was born 10.8 lbs... Leaving me with a 4th degree tear. This time around I have a new doctor (who will actually believe the Ultra Sound Tech on baby's size) who and has given me the option of a c-section.
Any input ?? What's worse?? Anyone delivered naturally after a 4th degree tear?

virginiaham · March 2016

Hi @mqm418! There's actually a few other big questions I'd have first and forgive me for my limited experience with 4th degree tears. First, I'm so sorry to hear about what you went through with the tear. Recovering from that with a newborn had to be so challenging. It sounds like you're really worried about experiencing that again. Did you have known or maybe suspected GDM with your son and was it controlled? Also, has your doctor offered any alternatives to maybe lower the risk of such a serious tear (e.g. perineal massage)? Or is he thinking the scar tissue will increase the chance of another tear?

mqm418 · March 2016

Hi @virginiaham
No GDM, I was 9lb and my DH was 9.3lbs when we were born.
Both baby and I were both very healthy.
I have only met my new OB once, and I shared my story and fears with him for a future delivery... Now that it's a reality, I'm sure more options will be discussed once I get an appointment.
I swore to myself I would never deliver naturally again because the pain and recovery process was so horrible.... but I also don't know when I'd be getting myself into with a c-section...

atcwag · March 2016

Were you allowed to move around during labor with your first and utilize various positions during delivery or were you stuck on your back? Sometimes bad tears are just bad luck and bad positioning and sometimes they're because of big babies. My son was only 7 lbs. 1 oz., but had a 15" head. No tear. I haven't had to recover from a CS or tear, but I'd take the tear over a CS.

Jmccabe12210 · March 2016

I had a third degree tear with my first and I remember the discomfort. I'm sure it was worse with a 4th degree but I do remember that I was up and walking around and overall way more comfortable than my sister in law who had a c-section around the same time.

mqm418 · March 2016

I was able to move around. Actually my back was the most uncomfortable position for me. It was a long 3+ month recovery for me.. That's good to know about you and your sisters experience. Thanks!

SRJR2013 · March 2016

The perinum is "designed" to tear, (I had a 3rd degree that all the stitches came out of and remained open for 6 months. Effing brutal) a c-section is a major surgery with risk. I will try deliver vaginally again, even though it wasn't a whole lot of fun. I feel it's a better option for me and my wee one.

NatashaSprout · March 2016

I had a 3rd degree tear with my first (7lbs 6oz) and no tear with my second (8lbs). Think I'll take tear over a c-section any day.

Edit: they are only 13 months apart so I am surprised I healed so well and didn't tear again. Both natural, no pain meds. Hope this provides a positive spin for you.

muybueno · March 2016

I had a c section with my first and a 3rd degree tear with my second (VBAC). I would take the vaginal delivery over major surgery ANY day. And I was epidural free, so you know I mean it

Especially with other kids at home to take care of. I couldn't get out of bed or sit up to nurse on my own for almost a week and it was months of pain and wound care. Also, you can't lift your other kids for awhile. In my experience, the tear didn't compare.

KilgraveMadeMeDoIt · March 2016

Because of my risk factors (different reason than tearing) I'm opting for a c/s this time even though I probably could have a vaginal birth if I pushed for it. After talking to plenty of women who had scheduled caesareans, as well as lots of obstetricians, it really doesn't seem nearly so bad as all that, particularly when it is planned instead of emergency. Recovery for most women I've talked to was fairly quick (considering how badly I did after my vaginal births, it'd be hard pressed for a c/s to be worse!) and well managed pain-wise. I think C/S are demonized a lot, but they have their uses and preventing permanent damage to mom is one of them.

Good luck with deciding.

2undertwo2bee · March 2016

I had a c section. I was so tired after wards but I'm pretty sure that's because I spent two days in labor. As far as recovery. It really wasn't terrible. It was my first child so that may be why for me it wasn't so bad because I was able to just lay in bed and rest. I only took my Percocet while I was in the hospital and never even used at home. Now in the hospital the first 3 days was hard. They want you walking. And the first couple times is literally the hardest thing ever. I continued to wear the support band the hospital gives you and that really help. I'm even thinking about getting spanx or something this time to hold all my insides in. It really makes it feel better. But yeah sorry for rambling. I don't know what a vain all recovery is like so I can't compare but I would say c section is rough the first 2 weeks then it get significantly easier and better.

Meether · March 2016

I had 3rd degree tears with both my girls and did not notice any extra pains?!? The concern for us was that my older daughter had shoulder dystocia (she was 7-12 at 38 weeks) because she was apparently too big for me. With the second, they had a team on board and there was no shoulder dystocia (she was 8-6 at 37 weeks), so it helped knowing that it was possible. I personally haven't had a 4th degree tear but would take 3rd degree tears over a c/s. Everyone I know who has had a c/s complains about the recovery (my friend had a vaginal then breech c/s and then her third, she was determined for vaginal because the c/s was a lot more difficult), so that would deter me. Just the thought of major surgery scares me, and while you will not have a 4th degree tear, you will have a slit in your tummy. Maybe your doctor can work with you on how to approach labor differently? I am not sure

talkthewholetime · March 2016

I had 3rd degree internal and external tearing. It took longer to sew me back together than it did to push the kid out in the first place.

Obviously if a c-section is medically necessary, you go for it. I wouldn't jump on that wagon right away though - the recovery is brutal, and you have 2 kids now - you won't be able to lift or care for your older one for a few weeks.

Even with the worst vaganus of a tear, I think it's still better than having your abdominal wall cut open, insides rearranged, and sewn back together.

laurenlalap · March 2016

I have been thinking a lot about this question recently. I had a 10lbs baby who got "stuck" and needed vacuum assistance. As I result I had a 4th degree tear and i also poped a blood vessel while pushing which caused a lot of bleeding before he came out.
Because he was so big and came out so fast with the vacuum I suffered from uterine atony which resulted in massive pp hemmoraging and a 3 day hospital stay without my baby (the hemmoraging took place a week after delivery)
I have gas incontinence and a small fistula which I will look into getting repaired after this baby because of the 4th degree tear. I am learning to manage with both. It's minor and I can control it so I don't embarass myself in public.
I actually had little to no pain during this whole ordeal but my doctor says I'm at significant risk of tearing again, worsening my incontinence and fistula and I'm at risk of hemmoraging again.
I'm still not 100% set on a csection as I was in very little pain physically, but like I said, my doctor strongly recommends it.
Sorry for the thread hijack, but I wanted to share what my OBGYN recommended and why.

fiscally3 · March 2016

I've only had c-sections, but have had friends who had equal or worse recoveries after a bad tear. I know my one friend had a 4th degree tear and her OB didn't even give her an option to not have a c-section. I was pretty surprised, since they were fine with me having a VBAC. I don't know how big your practice is, but I went to each doctor to discuss my options to decide how I wanted to deliver my second, the internet tends to be full of scary misinformation and I felt a lot more confident in making a decision after talking to real people. A scheduled c-section is a very easy recovery IMO, which I had with my third. I practically had no bleeding, and was able to drive about 10 days later (while caring for a newborn, 19 month old, and 3 year old).

laurenlalap · March 2016

^^ I have had girlfriends very surprised at how easy their csection recovery was. All of them gasp at my horror story.
I think a pp said it right - there's a huge difference between a planned and emergency csection

RaeJ004 · March 2016

I had a 4th degree tear with my oldest, it basically went all the way through to my backside and my poor doctor was down there stitching me up for well over an hour. With my second, not one stitch. Nothing. So just because you tore with your first does not mean that you will absolutely tear with your second.
And although I've never had a c-section I would avoid it at all costs. I loved being up and moving around right after I delivered.

laurenlalap · March 2016

RaeJ004 said:

I had a 4th degree tear with my oldest, it basically went all the way through to my backside and my poor doctor was down there stitching me up for well over an hour. With my second, not one stitch. Nothing. So just because you tore with your first does not mean that you will absolutely tear with your second.
And although I've never had a c-section I would avoid it at all costs. I loved being up and moving around right after I delivered.

I'm glad to hear you didn't tear again. I thought it was almost a given that you tear again the second time around.

Chcaggie1 · March 2016

I actually had an emergency csection but my labor up until the csection was not grueling or stressful really. I haven't really even considered vbac this time. My csection recovery was just fine. I can't imagine a vaginal recovery would be much easier than my csection recovery. I suppose everyones experience is different but I definitely wouldn't discourage a csection because of the recovery it's really not a big deal.

mrsasolomon · March 2016

With my first I can't remember if I had a 3rd degree or 4th degree year and it was internal (that's what the midwife said) whatever that means. Not a pleasant recovery but better than a c-section recovery in my opinion. My second was actually 5ozs bigger than my first and I had a natural delivery, no tears, much better recovery than my first. But even if I had torn again I would have chosen that over a c-section.

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