C Sec or Vag Birh After 4Th Degree Laceration

I had a c section with my son and it wasn't that bad. I was up and around again in about a week and fully back to normal in about 2 1/2 - 3 weeks. Probably you will need someone o be with you for the first week and then after that you should be fine.
Good Luck!

I had a c section with my first (and only) child because she was breach. I was very disappointed especially after completing child birthing classes ect... My experience was better than I could have ever hoped! I bounced back within weeks and could even start working out again. It has been almost 2 years and my scare has almost disappeared and my muscle tone very good.

My husband are trying for baby # 2 and my doctor said there is no reason why I couldn't have a vaginal birth, but I might just opt for another c section!

I had a large lateral wall tear after my first baby and it took over a year until things were somewhat normal again. I had a c-section the 2nd time and the recovery was 1000 times easier. I would never have a vaginal birth ever again as it was such a horrible experience. I wanted a c-section and my dr. recommended it as well due to the previous problems. I bounced back quicker from the c-section than I did after a vaginal birth. I know every one is different, but that's my personal experience.

Hi M.

I have experienced the best of both worlds, and I can honestly tell you that there is really no difference in recovery time between the two, after my vaginal delivery, I had just as much pain as I did with my c-section. If you think about it, you will have stitches either way, if not in your abdomen, they will be in your bottom, and as long as you have stitches, there will be soreness and pain, there is really no way of getting around that. However. I was very greatful that I got to have a vaginal delivery my 2nd time around, because it was very important to me, and if it is important to you as well, go for it.

I had a fourth degree plus with my one daughter....it was pretty bad, it was from stem to stern and side to side...the reason was that she was caught up in her cord and literally had to be pulled out! My second one was a breeze, no problems, no episotomy, nothing. Did he say why he wants to do a c/s? I was afraid of having problems with the scarring, but it wasn't an issue. I had some pelvic floor issues that mad pushing a bit harder, but it was fine.

I have never had a vaginal birth; however, I had two c-sections. I was ready to be back and going within a week. I did lots of walking the second that they told me I could get up and just had the mind set of I can't stand just sitting around, I have to be up doing something. C-sections are not necessarily a bad thing (just like any surgery). My c-sections were due to the babies needing to be taken because of heart rates and not dialating.

Hi,
I used to work in a hospital on the surgical floor before we moved here. I would go Csec. if it were me. the main key to bouncing back after surgery is, when they tell you that you can start walking(usually after 24 hours) do it. no matter how uncomfortable it feels at the moment, & keep control of the pain, don't wait until it hurts too much to move before you take any pain meds, your doctor can give you something that can take the pain away without causing you to be graugy so you can actually enjoy being awake & with the baby. i would talk to your doctor about the risks & benifits of both. after 4th deg. lacs. you probably have alot of scar tissue in your womanhood and if you tear again on or near the same place it could make it harder & take longer to heal. i pray everything works out for you, good luck & god bless. oh yeah...CONGRADULATIONS!!

I've had two c-sections, and was up out of bed the next day from both of them. I was sore for about a week, and have a little numbness right at my incision spot, but I felt great very soon after with both c-sections. And no pain with intercourse.

Having a baby vaginally depends on a few factors. One of those factors is how big, wide and shape of the pelvic bones. Some women, even though they are taller, can only have an 8 pound baby safely while other women, though very petite, can have a 10 pound baby safely. You want to ask an OBGYN about that. If your doctor can't answer the questions effectively, think about getting a different doctor. I personally do not like doctors that push C-sections so much. I think it's because it's more convenient and makes them more money instead of a safety issue as they claim.

I'm not sure what a 4th degree laceration is. I am wondering if the doctor had done an episiotomy if the laceration would not have been so bad. Additionally, if your labor moves along quickly, your skin may not have time to stretch inside and outside, so the lacerations and tearing are more likely.

For instance, I pushed for about 30 minutes for my first child. I tore a couple inches and had stitches. That was not very comfortable. It was rather tender for quite a while.
For my second son I pushed twice and he was out. I had severe tearing on the inside. I hemmoraged quite a bit. Had two emergency surgeries, blood transfusion and was anemic for quite a while. It took me longer to get over the second birth because of the anemia. I couldn't keep up with breastfeeding and pumping because I had no energy and it took up all my strength just trying to keep up with my 1 year old and the household things.

Thus, I think there are several things to discuss with your doctor for why the 4th degree lacerations occurred in the first place. Figure out what the contributing factors were. Perhaps those things will not happen again. Every birth is completely different.

I have had a vaginal birth and a c-section. You are right in thinking that the healing time for a "normal" vaginal birth is less painful and shorter than that of a c-section. I had to have an emergency c-section with my second because of heart rate and dilation issues. I will probably go for a vbac if I have another. However, it sounds like you had nowhere near a normal vaginal birth the first time and your chances of having a similar experience are probably pretty high. If you hated the 14 month healing time with your first you do not want to risk that again! If I were you, I would go with the c-section. The surgery wasn't bad at all and if you follow your doctor's instruction you should be doing fine withing a few weeks. That is a way shorter time than 14 months! Good luck with your decision and God bless.

If you decide to have a vaginal birth be sure to do perineal massage, here is a great link
http://parenting.ivillage.com/pregnancy/plabor/0,,midwife...
my dr had to do this the whole time i was pushing but i still tore, inside and out:( i really suggest the massage though, it doesn't feel good but if you do it while pregnant, it should reduce your chances of tearing.

Tough call. I have had both a vaginal and csection. I would rather have another vaginal anyday! That is my personal opinion though. After my first child I was sitting criss cross in the hospital bed. I felt "great" if you can say that. Anyway, after my c sec I was in pain for at least two weeks. It was extremely uncomfortable and MAJOR abdominal surgery. But, again, this is how my experience was. My kids are almost 4 years apart too. It was a tough call. The benefit to a c sec....no labor pain!!!! No pushing and getting lovely hemmerhoids! Good luck! Whatever decision you make....the pain is just a mist of memory!

I had a C-section with my son because he was breach through most of the end of my pregnancy, and he wouldn't turn around when my doctor tried to turn him by pushing my belly. It was actually a good thing we did the C-section because he ended up being a big baby (8 lbs 4 oz, which was big for me, since I'm very slender and didn't gain much weight with my pregnancy), and the umbilical cord was wrapped around his neck (which prevented him from turning). The C-section was my first major surgery, and the first few days in the hospital were very hard on me, especially trying to get up from my bed to go to the bathroom. However, I found that the more I got up and moved, the faster I healed (it helps to have a husband who is an OB/GYN, as well!). By the end of the first full week, I (barely) walked around the block near my house, using the baby's stroller as a walker. I think I was fully healed by a month or two. My doctor was very surprised at how well my scar healed, as well. I found out later that he was glad we went ahead with the C-section because he believed that even if the baby did turn, and I labored, I probably wouldn't have been able to deliver him vaginally anyway. We haven't decided on when we'll have our next baby, but when we do, we'll be thinking about VBAC versus C-section. My husband will have some input I'm sure, but I think it will depend on whether or not I go into labor naturally (I never did with my son because he was breach), and the size of the baby. Good luck with your decision!

I just wanted to let you know that my first birth also resulted in a 4th degree laceration (a table was set up for a c-section, but they gave me 1 more try). I had to sit on a donut for a long time. I eventually healed & had my 2nd child vaginally with no tears. My first child was 9# 3oz. & I also fractured her collarbone. The doctor advised inducing me a week early since my 1st child was so large & how the delivery went. My second child was 8#, 1oz, so that helped. I had my 3rd child vaginally & she came just 3 days before her due date & she weighed 8#, 15oz. My daughters are almost 17, 14 & 12. Today I have a problem with being able to hold a lot of fluid in my bladder. If I have a full bladder, I cannot laugh a lot or sneeze. I also cannot wait until the last minute to urinate. I'm sure this is attributed to the 4th degr. laceration. I try to do the Kegel exercises when I think about it, but life is so busy that I tend to forget. Enjoy your life now because it gets even busier as the kids get in elementary, ms & hs.

Well, I've never had a VBAC but I did just have a c-section this past August. My experience was horrible so I'll keep it brief....I was in labor for 52 hours and then pushed for 1 1/2 - 2 hours before they finally rushed me in for an emergency c-section. Because of the long labor, pushing and then surgery it took weeks for me to recover. My sister however, had a planned c-section 1 month later and she was up and walking around the next day. I asked her doctor why she was up moving around and it took me so long to recover? He said it's because my body experienced so much trauma. In the future I will take all this into consideration because I know that I will definitely not want to go through the whole laboring process again just to end up with having to get a c-section. I hope this helps.

www.ican-online.org

http://www.childbirthconnection.org/article.asp?ck=10166

I've had both a c-section and a 4th degree tear and I'd choose the tear any day. If you are worried about bladder issues here is something to think about. Pregnancy is what causes the stress on your bladder NOT the vaginal birth but in a c-section they have to cut your bladder away from the abdominal wall to get to your uterus. Check out that second link I sent you for sure as it lists out both the risks of a c-section and the risks of a vaginal delivery so you can compare the two.

A vaginal delivery is very doable. Perineal massage is a GREAT suggestion. It helps to prepare the perineum for delivery. Use some oil and stretching the skin each day until it burns a bit. You'll notice that it becomes more stretchy in time and doesn't burn as quickly.

And, another suggestion (that many might not at all consider, but it's a good one) is to go with a natural birth. I tore with my daughter because I had an epidural and couldn't follow my body's cues for pushing. With my son, I still tore, but not nearly as bad (and wouldn't have at all if I had delivered in a different position) because I delivered him with no pain medication. I was able to follow what my body wanted and pushed accordingly.

You can also try pushing in different positions. If you are concerned about tearing, I would suggest not squatting or being too upright. Delivering on your side or on your hands and knees can help a great deal in relieving pressure from your perineum.

I hope all this helps.

God bless,
A.

Sounds familiar. My tears with my first were 3rd degree but I, too, experienced much pain and issues with intercourse for well over a year. I even was sent to physical therapy to try to help my pelvic floor muscles and improve the "stretchability" of my vagina because I had so much scar tissue. It was very difficult and disappointing. I definitely planned to have a c-section with my second, but my doc encouraged me to try vaginal again. She said that it would be better the second time and that things could loosen up after the second child passes through. (One of my big issues was tightness). Well, things were way easier with the second but I still had 2-3 degree lacerations. It was a much easier, recovery, however. It's been 2 years since my second child and I think things are finally back to normal. I did not require therapy after the second.

If I were to take a guess, I would say that the second vaginal birth helped my issues from the first but time could be the other factor that I can't take out of the equation. If I were to do it all over again, I'd probably do the same thing.

If my issues weren't "tightness" I'd definitely go for a c-section if I were to do it all again. My only motivation to do vaginal again was to give the doc a chance to sew me up looser the next time so penetration didn't hurt.

I definitely feel for you. It's scary carrying a second child after such a brutal experience with the first. So many women don't relate to this kind of pain and slow recovery. I had people wondering why I wasn't up dancing at a wedding we attended just 8 days after my baby was born. Little did they know it was incredibly difficult for me to just stand or sit that day.

Take care and talk about this with your doc.

K.

I had a tear like that too....I know what you mean about the pain, but it does go away. I had a vag birth and tore again with my second, but it wasn't nearly as bad....infact it just took me a few months to recover. Good luck!

With my first daughter I did not tear but the doctor gave me a 3rd degree episotomy (sp?). I healed in about 4-6 weeks so although I didn't experience quite the same I can relate. Well anyway, with my second daughter I did not have to be cut and I only tore a little bit (I had to get 1 stitch). Also with baby number one I pushed for about an hour, but with baby number two I only pushed for 12 minutes. I guess I said all of that to say having a baby is invasive (sp?) enough on your body don't endure a c sec unnecessarily. Goodluck!

Dear M.,
Just because you had a 4th degree laceration the first time, does NOT mean you will have another one. I am a doula (childbirth assistant) and I have one client that had a C-sec first time, 4th degree tear 2nd time, and her 3rd time was a beautiful birth with very minimal 1=2nd degree tearing that barely even bothered her. There are some things you can do during your last trimester such as perineal massage/stretching and controlled breathing and minimal pushing in an upright or on your side position for birth. My client was VERY apprehensive about that next birth, as you appear to be. Very understandable. I urge you to look into the risks involved for a C-sec birth before you make that choice. It is a major surgery. Look on my website for some good childbirth links on the links page....feel free to contact me if you have any other questions, I wish you all the best. I would also consider making sure your dr is willing to help you with controlled pushing/perineal support during pushing and if not, switch care providers.
All the best
D. Easthon CD(DONA), LCCE, ELCS
www.heart2heartbirthmatters.com

Go with a midwife!!!!!!!!! They are much more patient and it is likely that you would not tear at all. c sections are way more risky than they tell you. A woman in Michigan died recently after her 1st pregnancy from them cutting the wrong artery... It also takes longer to heal & is more painful. I tore really bad the first time & decided on a midwife for my other two. I was so excited when I didn't tear.. the recovery was sooo much better. Blessings to you as you decide what is right for you!

I also had a level 4 tear with my first daughter. I know just how miserable that is. I had my second child 14 months later. I tore so little that it did not require stiches (Dr. said he could do 1 or 2, but would be more irritating than helpful with healing). My recovery was SO MUCH BETTER!!! I know everyone is different, my second daughter was almost 2 pounds smaller than my first.

Good luck with your decision, just know that the second time could be VERY DIFFERENT. I know it was for me.

S.

Have you considered finding an OB (or a midwife!) who thinks it okay for you to have the baby in a position other than lying flat on your back where you are - surprise! - much more apt to tear?? Gravity takes effect whether you are squatting (it helps pull baby out) or lying on your back (it helps keep baby inside). Talk to your current OB about squatting, or getting on all fours when the time comes to actually have the baby. You may find that you don't tear at all or, if you do, barely any.

C-sections carry much larger risks for baby and mom. I can totally understand why you would not want to have one.

i tore pretty bad with my first baby and decided to go c-section with my sec and my recovery time was quicker with c-section cuz i had to take care of my first one. within two weeks i could pick up my first baby without any pain, but its your choice to do c-section or not.

I'm sure that, while your doctor may be willing to do a c-section for this reason, it is not medically advised.
Did you prepare your peranium before the first birth? Doing Kegals and massage go a long way in preventing tears. Also, the doctor should be massaging your peranium with each contraction with either a warm compress or their fingers and KY jelly. If you have an older doctor, they may not be up on this newer practice. Ask him/her if she knows about it and if not, have him/her look in to it. My friend had a 10 pound baby with a 16 inch head and didn't tear because her midwife knew to do this. Also, letting your body tell you when to push and how much to push helps because you aren't forcing the baby out too quickly for the area to stretch well.
Good Luck!

With my c-section I was back on my feet in less than 2 weeks--completely. That's a lot better than 14 months of pain and recovery from a tear!! The chances of tear in the same spot...and it be worse increase the second time around. I wish you the best of luck in making your decision!

I guess you could try another vaginal birth but after tearing that bad and being in pain that long I would opt for a c-section. I had 2. You heal within 8 wks. after having the c-section and it sounds like medically that would probably be your best option. You said you were in pain for over a year with the c-section you'll pretty much be back to normal in a couple of months. They will restrict you from heavy lifting and some household cleaning chores such as vacuuming. It really isn't that bad. I had stitches with both my c-sections but some people have to have staples instead. Good luck and I wish you the best and congrats on baby #2! My oldest was a vaginal birth and it was horrible for me too although I didn't tear like that. He just go stuck so they had to suction him out.
D.
I am 31 and have been married for almost 12 yrs. My husband and I have 3 boys ages 10,7 and 4. The 2 youngest were c-section. Opt for the bikini cut should you choose the c-section.

Dear M.,

My suggestion would be to read a little about the cause of birth trauma and/or fourth degree lacerations so you can optimize your birth experience. Difficult births are almost always caused by medical management, such as inductions, epidurals, coached pushing and/or forceps. Allowing your baby to align itself allows him or her to be born with greatest ease and without trauma to your perineum. Patience is the key!

You need a Nurse Midwife that is skilled in normal birth. Obstetricians are specialized in disease and surgery. Both are important roles, but each serve women very differently for very different needs. If you want a normal, healthy vaginal birth... a midwife is your best choice!

Blessings, P.

I had a fourth-degree tear with my first baby also. I healed more quickly than you did, however. My doctor didn't consider a c-section for my second child. He said that births are often "easier" the second time around since your body has done it once before. The birth of my second baby was quicker and easier. The doctor who delivered her thought that I would not need an episiotomy. However, when her shoulders came through, there was a third-degree tear. I had a few weeks of discomfort, but nothing too major. It healed up pretty well. Of course, things are never the same after giving birth, but I wouldn't hesitate to have another vaginal birth. I would think that the healing from a c-section would be worse. Good luck!

I know you have to decide for yourself and each person is different and all that... but with my first I had 4th degree lacerations too and the problems that went along with it. I had no problem with a vaginal delivery for my second. I did have a little bigger gap with my kids than you will have.... My oldest was 4. You probably need to find out if you can, why you had 4th degree. Was the baby too big, Did they do a bad appeaseotomy (spell?) For me, my eldest had a big round head, and they were using suction which came loose, so I am not certain which is to blame for my tear. Prob a combo of both?!

Whatever you decide - God bless!!

I recommend learning about 'stretching' before you deliver -- email me if you want more info, but I'd rather not post the details on here ;0) ANd also about different birthing positions. The 'traditional' position is NOT the best way for the body.
Also, going with a midwife verses a regular Doc can be such an awesome thing! I had Doc the first time (had one stitch for a tiny tear,but I had been doing the stretching, and did the right birthing position, though the Dr. was a little weird about it!)
The 2nd birth I had a midwife and LOVED delivery! She helped so much, even gave suggestions for birthing positions that would work best for our specific baby/situation, and I only had 2 pushes and NO tearing! Also, the midwife was willing to do things to help me that a Dr. doesn't know to do (can also give details if you want, message me.)

Wish you the best!

M.,
Good luck to you. I too had a 4th degree laceration after my doctor insisted on giving me an episiotomy with my 1st child 6 years ago...I went on to have 2 more vaginal births...my sons are now 2 and 3 and those births were not only vaginal, they were without any medication at all...I would recommend it over a C-section to anyone I know. I felt great and I was happy that I just trusted my body like I should have with my first child...I should have said no to that episiotomy, because it caused me to tear so badly...I hope that whatever you choose, you listen to your body and trust what it and you, can do!
C.
Toledo, Ohio

I had a 4th degree tear with my daughter. She was facing the wrong direction and came out with her arm up by her head. I also had trouble having intercourse for at least 6 months after she was born. I just had my son in Feb, and only had a 2nd degree tear. It was a breeze this time. Things are completely healed and going well this time around. Good luck with whatever you decide!

I had 3rd degree tears with my first and was insistant on a C-Section with my second, because 1) my first was a girl and #2 was a boy (so should be bigger) and 2)my 1st was 9 lb. 8 oz and she was early so I could only imagine what my little boy was going to be. My OB's swore that the 2nd delivery would be much easier than the 1st and that they would induce me (for based on ultrasounds) if my son went to term would be over 10lbs. I ended up being induced a week early, and had him vaginally and only had a small tear. He literally fell out. It might have been because I was in labor for 10 hours vs the 3 hours with my daughter so my body had more time to prepare, but it was so much better and I healed so much faster. I was terrified, as you were, but this was my experience. Good luck.

I don't think it would take 14 months to recover from a c section.

i recommend perenial massage daily in the last month or two with some oil. (almond oil, massage oil, etc) rub the oil in and stretch apart with two fingers until it burns a little bit. a little stretching each day gets it more and more supple. i know, it's not the funnest thing, but it sure beats tearing!! it totally prepares your perineum for birth. it worked for both of my deliveries-- no tearing and easy recovery!!!

you can also take some oil supplements-- it's been a while so i can't remember off the top of my head but i think evening primrose oil or flaxseed oil?? they will also help. i could look it up if you're interested...

and remember to hydrate!! drink lots and lots of water constantly and that will also help!

best of luck with the birth and good luck with the transition to two kids!

I would not risk tearing again. Sounds like you had quite the experience, and a long recovery. Unfortunately, some people continue to have problems, particularly in middle age. Usually the second baby experience is a lot better than the first baby experience anyway.

The key is perineal stretching!!! It works wonders! My last midwife recommended it to me and I delivered a 10lb. 3oz. baby (he came so fast that my midwife missed his birth and my husband and I delivered him at home by ourselves!) with absolutely no tearing at all. Feel free to contact me and I can get you in touch with her or give you her website info and she'd be delighted to help you.

E.

I delivered my 2nd by c section, but it was an emergency. It hurts, and it takes 6 weeks to totally heal. You can't lift anything heavier that the baby for at least a month, so if you do opt for a c section, make sure you have help at home with cooking, cleaning and childcare. It was nice to cuddle my first and read to her while I healed, and I had help from both grandmas and my DH. I can understand your fears, and do what feels right for you. If you do have a section, you can get an epidural right away had have a pain free delivery!! Bonus!!!

I had a c-section (my second) on Tuesday. It is Friday now. I am planning to be way past healed at 14 months! Goodness! The first two days weren't fun, but it is going okay now. I can't imagine being willing to tear like that. Why is a vaginal birth so important to you? Good luck!

M.,
congrats on baby number 2. i also had a 4th degree with my first delivery. i did not have as much trouble but did encounter little feeling at that point. but when i had my second child i delivered naturally. i actually had a larger baby and only ended up with a second degree lac. my ob never said anything about a c/s for delivery although she did want a epidural in place so if i had an extensive repair it was easier ( i declined the epidural). i felt wonderful after this delivery and bounced back very quickly. i also am an ob nurse and i do not recall ever doing a section due to a 4th degree but every person and doctor is different. well hope all goes well. H.

M.:

I had a 3rd degree tear after the birth of my 10lb son. I didn't have the healing issues you have had, but I too had trouble with sex etc. I just delivered my 2nd baby- a 9lb girl. I am happy to report NO TEARS! I did a lot of keagles after my first baby, and labored slow- I was induced 10 days early and started from a finger tip. My Dr. said your body remembers from the first one, who kind of "Paves the way" for the rest. Hope this helps, S.

Hi M.-

I have had both a c-sec and a v-bac. I was in alot longer recovery from my v-bac then I was from my c-sec. I was feeling great in 3 weeks from my c-sec and from my v-bac it was like 12 weeks. I also tore in many places and had many stiches. I know it is a hard decision but do what you feel in your heart. Your next one will be much different I am sure. I am not a very big person and did not gain much weight with my first child the doctor told me that helped a bunch. Good Luck regardless of the recovery you will have a beautiful baby girl as the end result. When I look at my son I do not think of the pain I think of what a blessing he is and how wonderful he is to have. Thank God we heal!

I've never had a vaginal delivery, all three of my were sections, but here's what I can tell you. With all three of my daughters, I was back to almost completely normal by two weeks post partum. I also noticed this time (my youngest is just over two weeks) that it was much easier to get up and get moving. The only problem I've ever had with my sections is going poop within the first couple of weeks. Because of the meds they give you during surgery and the oral meds you're on for pain for the first week or so, you can get a bit constipated. But really, it was nothing that a little colace didn't take care of. I have had nothing but good experiences with my sections. Good luck!

I would suggest the C-Section. I have 5 children and I tore with the first 3. Not to the degree that you did but after 3 different times it ws really bad after my third child. Then I ot pregnant with my twin girls and was planning on a vaginal birth but one of them flipped so I had to do a c-section. Where I was in pain for a couple of weeks it was nothing like tearing with my third. I recovered perfectly and now they are 4 months old and I am completely pain free. I do have a numbing sensation where my scar is but that is it. Oh and also I had a bikini cut instead of up and down from my belly button which I think was alot better too. Either way it is completely your decision and I hope everything works out for you. Congrats on the baby too!!