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I personally (and i haven't ever given birth! so this may not mean much) would go for the c-section. I have a friend who had a terrible first birth and tore a lot and has had ongoing problems with it. She was offered a c-section for her second child and she has NO regrets whatsoever about it - said it was definitely the best decision and enabled her to look after her second baby better than she was able to with her first because of all the pain she was in the first time. It sounds like big babies run in the family, and if I were you I would be much more worried about my vagina then when my baby's birthday is (hope that doesn't make me a bad mum-to-be!!!)
I have suffered from anal fissures all of my adult life. I can go a year with at least one, but sometimes up to three, never healing.
I also suffer from something similar in my vaginal opening.
I will DEFINITELY be having a C section.
@londongal: Nope, definitely doesn't make you a bad mom to be :):)
I am just afraid that people will think I took the easy way out if I have a scheduled C-Section. Even though I didn't really have a lot of pain or anything from my 4th degree tear and was up walking around the next morning, I am still afraid of the problems that could develope later in life. I don't want to have to worry about having an "accident" if I cough or sneeze or laugh.
I see the OB again tomorrow and we are going to discuss it more in detail. Hubby couldn't be there for the last visit and doesn't understand the risks involved in the vaginal delivery. My first 2 are from a previous marriage and Hubby thinks it ruined his chances for our kid. He didn't realized that even if this were my first we could still have complications. My OB is going to "school" hubby on a few things :)
Former L&D nurse here... A lot of tears are caused by the position of the baby and how quick they come out. Size is often off in those ultrasounds, even by a pound or more.
I think I would try to avoid the tearing and avoid the surgery. The surgery can cause it's own set of issues too, so I would weigh them carefully. That being said, it sounds like you have already made up your mind, but there are definitely ways to avoid tearing. I helped deliver many babies over 10lbs without any major tearing happening.
Here are some links to avoid tearing:
http://midwifeinfo.com/articles/episiotomy-and-how-to-avoid-it
http://www.modernpregnancytips.com/pelvic-health/5-ways-to-avoid-vaginal-tearing-in-childbirth/
http://www.ehow.com/how_4934015_avoid-tearing-during-childbirth.html
@MapleBecky: Yea, that is why I am not sure about the ultrasounds later in this pregnancy. I had one at 36 weeks with my 1st child and they said she was weighing about 5lbs and to expect a nice 7lb baby. They were definitely off!
I would really prefer to deliver vaginally, I really would. I think it is the fear of tearing again that has me leaning C-Section. With my 1st child, I had a family doctor deliver her. With my 2nd one, I had an awesome OB who is retired now. My OB I have now, I absolutely love. Probably a bit biased because I also worked for him. He isn't pushing me for a C-Section but has planted the seed that I need to think about one.
I definitely plan on having an epidural. That's not up for discussion :)
Personally, I would try to delivery vaginally. A c-section is a major surgery and I would never choose major surgery unless my life or the baby's life was in jeopardy.
@Mrs.KMM: I would really like to try to deliver vaginally and then if need be, have a C-Section. I am anxious to talk to the OB tomorrow about that plan.
My fear about tearing badly again is because of all the complications that can come from it. When working at the OB office, we had a mom deliver a 10lb baby vaginally, had a 4th degree and require immediate reconstructive surgery to repair the damage. She continued to have problems with a bladder prolapse, fecal incontinence and urinary incontinence.
If they will let me labor down for as long as I need to, and push when I am ready to help avoid any tearing, lets do the vaginal deliver.
I would try to deliver naturally and know that c section is there for a back up. I just feel like You did it once, you did it twice, and had less of tearing, and although tearing is bad, I know it sucks trust me, but at least your not having major surgery. You already have two kids to run around after, not to mention a new born. That will be so stressful on your body if you had the surgery. I would just think about it. People are always there to help, but nobody does it just like mommy :)
If I have another child, I plan to opt for a c-section. When I gave birth to my daughter, a healthy almost 8lb beauty, I had 2 cervical tears and a 3rd degree tear requiring emegerency surgery right after she was born. My gyno has said that everything has healed up nicely, and I should be able to deliver naturally with no problem. I don't want to take the risk. I've haven't had any lasting complications, but I'd rather play is safe.
Also, I should mention that it has been almost 10 years since my last delivery.
I personally really want the whole nine yards natural birthing experience. I would totally go for a home waterbirth attended by a midwife.
However, when I get pregnant, we are going to be watching those ultrasounds like a hawk, because FH was HUGE when he was born (and there's a 10 inch difference between us in height now), he had a gigantic head, and his shoulders almost killed his mom (literally). So I definitely know that a c-section is a possibility. I really don't want one, but we'll see what happens.
If your doctor reccomends a c-sectiong i would listen and take his advice.
The only reason you would prefer NOT to have a c-section is because of choosing the birthday? Truthfully, I don't think that's enough to put yourself and your baby at risk, knowing all the complications that can arise, especially since you've had complications before. If your doctor recommends the c-section, I would recommend following his or her advice. Maybe your baby will be ready to come earlier anyway, and he/she will pick their own birthday afterall.
@tracylesq: That really is the only reason I prefer not to have a scheduled C-Section. If I have to one, I am fine with it. I'm not worried about it being major surgery or anything. I will do whatever is safest for baby.
I just don't want people saying that I took the "easy" way out and had a scheduled C-Section.
I am more scared of the complications that can come from having another tear. That is what is making me think about the C-Section. If they would let me just go into labor naturally and then do the section that would be perfect.
Trust me, c-sections aren't the easy way out! It's major abdominal surgery. It takes a long time to get those cut ab muscles back.
FWIW- I have had very few patients with 4th degree tears, in fact, I only remember one and it was a forceps delivery and the baby's heart rate crashed, so it was an emergency delivery.
I, personally, would never "choose" for a c-section and I would have to have pressing complications that calls for one to be necessary to have one. Like a pp said... c-sections are MAJOR surgery and can have some wicked healing processes.
I had an un-nessecary c-section with my DS and can say that the days and weeks following are not the easiest.. especially with a new born.
Also, if you plan on or think that you may be having any other children, many places have moved to requiring c-sections deliveries after a previous section... so if ya'll think you may want more children then I would also think about how that pregnancy and l&d would go as well.
There are things that can be done in the weeks leading up to labor and then in labor to help you stretch and reduce risk of tearing... maybe look up some natural birthing techniques that cover some of these.
@mrskisstobe:I am just afraid that people will think I took the easy way out if I have a scheduled C-Section.
I don't think any man or woman has a right to judge how you birth your baby. You have to do what is right and comfortable for you based on your doctor's advice. Is there honestly a woman out there that thinks having a baby in any fashion is easy? :P
(I will have a c-section or nothing at all for various personal reasons).
NO to C-section, especially if it is your 3rd...instead I'd be getting a new OB
@mrskisstobe: Don't have the c-section if you don't want it. If you plan on not having an epidural, don't push until your body tells you to push. If you do plan on having an epidural--have your ob wait until your baby has descended enough or maybe turn down some of the epidural.
Mrs. DG has talked about laboring down can prevent some tearing, perhaps you could run this past your OBGYN. Perrineal massage has been suggested as helpful and some women choose waterbirths and the warm water helps them stretch and is great for buoyancy and pain management but most hospitals don't allow that. You could see if it does though or wait to labor at home mostly in the shower/bath, and drive to the hospital in transition.
EDIT: I wanted to add, have you thought about going under a midwife's care? They may help prevent some tearing.
If your doctor is suggesting a c-section because of complications, I would definitely listen to your doctor.
There are lots of things that come into play with childbirth that no one wants - c-sections, epi's, etc. but sometimes they're necessary. If your doctor thinks it's necessary, I would listen to the medical professional over anyone's opinion, maybe even my own.
I'd also go over with them 'what if's' involved if you do want to try to deliver vaginally and see if they are willing to help you through that.
@mrskisstobe: You have legitimate/valid fears and no one has the right to judge other mothers on the method of giving birth to their children. Just know that if anyone does (which is none of their business and I doubt most women will care) then they're jerks, and if they ask questions perhaps saying "Why is it any of your concern? I birth the way I wanted to." should be enough to shut them up.
I've never been in labor, and I've never had surgery...so a c-section sounds terrifying to me. But so does tearing. = ( I wish I could give you advice either way.
Screw what other people think. Do what's best for you and the baby. If you've got a good OB that you trust, talk to them about what they recommend for you and make your decisions based on that. (And if you don't trust your OB, get a new one. :)
@Elvis: "And if you don't trust your OB, get a new one."
Totally agree with this! :)
Thanks everyone for all the great advice and ideas. I really really appreciate it. I have an appt today with my OB and hubby and I will more in depth about what would be best. I do love my OB. He is probably one of the most kind and caring dr's I have ever met or worked for.
Hopefully little man doesn't get too large and I get to have another vaginal delivery, but in the event it's best for a C-Section, the OB I have is one of the best :)
I am confused aobut something here. Maybe I just had a really good midwife the first time, but she gave me an episiotomy so I wouldn't tear. Why hasn't anyone mentioned that? Is that only possible the first time? If you want to go vaginally why can't you request an episiotomy before you get to the point of tearing? My son was a pumpkinhead, if she hadn't cut me then I would have ripped badly.
@Storm0075: I had an episiotomy and still tore really bad with my first. :)
I'm in the medical field too. All I can say is: if there's a relatively safe chance at using your vagina, use it! It's there for a reason! As many others here have stated, c-sections are a major surgery. Even if you manage to heal up fine in the next few months, your uterus has been cut and there's the chance for uterine rupture and internal adhesions (scar tissue) mucking up your insides for the rest of your life. So there are things that can go horribly wrong with both vaginal and c-section births. Thus I know I'd want to try vaginal before all else if I were given the opportunity! And if your OB doesn't want to give you the chance, try to get a second opinion. Some doctors just prefer c-sections because it's relatively easier on their schedules.
I am just afraid that people will think I took the easy way out if I have a scheduled C-Section
A c-section is NOT the easy way out. It is a major surgery. The recovery period is MUCH longer and they ARE MOVING YOUR INTERNAL ORGANS AROUND. ewww. our vaginas are made to have babies. our bladders are not meant to be moved out of the way. i would try to go vaginally. I had second and third degree tears. I got over it.
@mrskisstobe: Its no ones business what you and your husband choice to do. Major surgery isn't the easy way out. Don't concern yourself with that, do what you think is best for you.
I think you and your husband should decide, I opted for a C-section with my first child and I have no regrets. I didn't feel a thing and I went in for surgery and 15 minutes later my son was born. So C-section aren't near as bad is probably they use to be. But in the end I feel sure you and your husband will make the PERFECT decision. Good luck and CONGRATS to the both of you!
Thank you for saying that.
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So I was at my OB appt a few weeks ago and he asked me if I was thinking of doing a C-Section this time due to the fact that I had a very bad 4th degree tear with my 1st child. I also had a 2nd degree tear with my 2nd child. I hadn't really thought seriously about a C-Section until he brought up the complications that could still arise from the tear I had previously and that my chances of tearing again are now greater. My 1st child was 9lbs. Hubby was 10lbs when he was born. I am not afraid of delivering vaginally again, but I am terrified of tearing again. I would like to avoid incontinency issues later in life and all the other complications that can occur from having a tear like I did.
My OB said he would do ultrasounds to make sure baby is not getting too big, but I know those aren't the most accurate either. My biggest reason I prefer not to have a C-Section is because I really don't want to pick my baby's birthday and if I choose a C-Section than it will need to be scheduled at 39 weeks. If I could just let myself go into labor naturally and then have the C-Section that would be ideal but I don't think that is an option.
My other fear is that if this baby is larger than 9lbs, I fear he may get stuck or have other issues coming out vaginally.
So my question is, would you try a vaginal deliver and risk having a tear again and causing problems or just schedule the C-Section.