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    Posting Addict renee24's Avatar
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    Default tearing ?

    A friend of mine had her baby a few months ago and we were talking about births and she mentioned that next time she'll be getting a c-sec. When I asked why I was surprised at the answer. According to her OB she had a 4th degree tear and if she were to tear again she'd be unable to have more children. That just didn't sound right to me, esp as tears heal and such, but I thought I'd ask for other opinions here.
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    My sister had 4th degree tearing with her 1st and then went on to have 3 more children vaginally with minimal tearing.
    IMO she can absolutely have another baby, who is to say she was tear that badly, or at all, next time?
    If I were her I would question her OB and seek a second opinion.
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    Posting Addict renee24's Avatar
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    that's what I was thinking and told her, but she doesn't want to risk it. Unfortunetly I know I come across as a crazy anti-c-secer at times and I think she takes what I say with a grain of salt. I mean I wish people would educate themselves sometimes so I don't come across as a person who thinks all docs are out to get you into the OR. Its not my fault I'm slightly more educated and know when I've been lied too, or at least have had the thruth stretched. Sorry, I'm just getting tired of people looking at me strangely. Ok done with my venting, sorry
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    I've also never heard of such a bad tear that wasn't preceeded by an episiotomy and/or directed pushing. My midwife says women generally won't push so hard to tear that badly.
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    I had a 4th degree tear with DD1 with no episiotomy or assisted delivery. It's been 22 months since and I still have complications from it. At some point I will have a 2nd reconstruction done to hopefully help alleviate some of the problems. I did a bit of research on this prior to becoming pregnant again. Unfortunately there are no controlled studies, but there are several retrospective studies. Having a 4th degree tear increases your chances of it happening again by about 7x. Since the chances of it happening the first time is only about 0.5% or less, it's still a very low risk. However if it does happen a second time, the chances of a full recovery of the anal sphincter is only about 50%. I have consulted with several OB's (I worked in a hospital at the time) regarding recommendations and the consensus was pretty much the same - a c-section should be offered to the mom but it is not 'necessary'. In addition I've talked with 3 OB's at my new practice and they basically said the same things. The choice is up to me for how I deliver #2 as long as I know the risks/benefits of both types of deliveries. I don't think there is any reason why she wouldn't be able to have more children if it happens again - that was never mentioned once to me by the doctors or in any of the studies that I read (Of course she may not want to!). Many women choose to proceed with vaginal deliveries after a 4th degree with no issues and some have minor to severe tears again. I would recommend she get a second or third opinion even if she decides to get a c-section. I would also have her try to find a doctor that has experience (if possible) with delivering vaginally after a 4th degree tear to help take precautions against it happening again. She should not be forced into a c-section if she doesn't want it as long as she knows the increased risk of another vaginal delivery.

    Now all that being said, I'm choosing to deliver via c-section for this baby but in addition to the tear I had several complications along with it and still am not back to 'normal'. In my situation this is the better delivery option for me (and I do strongly believe that vaginal deliveries are the best) and it is my choice.

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    Posting Addict renee24's Avatar
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    thanks for the info. Honestly I doubt she'd care how she delivers, but I just don't know.
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    Quote Originally Posted by renee24 View Post
    thanks for the info. Honestly I doubt she'd care how she delivers, but I just don't know.
    I couldn't imagine not caring how I delivered. My birth experience is so important to me. Especially after my last birth, I strive for a peaceful birth with a 2nd baby.

    I hope your friend gets the information she needs and does what is best for her.
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    My ex MIL had the worst tear you could get with her first.... i mean this woman had something like 166 stitches down there.... her baby tore her from her clit to her butt hole *excuse my french* and she went on to have 3 more baby naturally... i how ever had a episiotomy and my doc had to cut me 3 times... his head was 36cm and my cut was something like 1 to 1 1/2 inches long... and i had my second naturally and didnt tear or need an episiotomy at all...

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    I wrote an apology to my friend in case I came off as a bit of a nut to her and she responded that I wasn't offensive (thankfully) and that it'll be a while till they try for #2 at which time she might have a different OB who could tell her something different and she's right. And she also said that her OB said she healed really well.
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