I saw the obstetrician the other day. She wanted to talk to me about my mode of birth, which was the main thing I wanted to speak about to.
So she started off by wanting to know how I thought my first birth was. I explained that I found th birth fine, but the recovery traumatic, especially with all the tearing.
For anyone new or for anyone who doesn’t remember, I had 3rd and 4th degree tears after delivering Scarlett, as well as an episiotomy.
She asked if I had any long term ‘damage or concerns’. I explained that I saw a physio for nearly the whole first year of Scarlett’s life for urinary incontinence. I told her that I went every week to every fortnight and I religiously did my kegal exercises. I told her that the improvement happened within the first 4 months, and by 6 months post birth I had no improvement at all. I persevered and at 10 and a half months exactly, the physio told me that the incontinence would not get any better and this looks like it’s the best it’s going to get.
So I’ve learned to live with it.
She was concerned about that because at my age, she thought I should bounce back better than that.
So then she read the surgical report, because again, after Scarlett was born I was whisked away into surgery and had to be stitched up for 4 hours in a theatre due to the severe tears.
She was grimacing the whole time.
She asked to then do an internal. I consented.
I got undressed and she explained that she was first going to look with a speculum, then she was going to take it out and insert her finger. If it was sore at any point or if I thought I could feel scar tissue or any areas that ‘didn’t feel right’ to let her know.
She grimaced when she put the speculum in.
Then she pulled it out and started with her finger. It hurt in 2 spots and i probably pointed out another 2 or 3 spots that felt strange… sort of bumpy but also very weak.
So sighed then and pulled her finger out. She explained that I pointed out every bit of scar tissue that she could see. It turns out, the two spots that hurt were where the 4th degree tears were. She even showed me a diagram the surgeon drew and pointed out exactly where he had drawn the 3rd vs 4th degree tears.
I got changed and asked her what all this meant.
She said that since I could feel the scar tissue and it was still sensitive nearly 2 years after birth, it wasn’t a good sign. She said that she could almost guarantee that the 4th degree tears will re tear, but isn’t 100% sure what would happen to the 3rd degree tears.
She said it could go either way. She told me the fact that I could feel the scar tissue was not a good sign, as it indicates a weakness in the vaginal wall. She said because I have so much scar tissue in and around my vagina, it likely won’t stretch and will re-tear. Because where the scar tissue is, they can’t even do a long therapeutic cut so baby boy will have an easier time getting out and so I don’t tear worse the second time around.
She explained that scar tissue doesn’t really have a lot of… I think she said collagen? The stuff that makes the skin stretchy… scar tissue doesn’t have a lot of that and so it usually won’t stretch. She doesn’t think I would develop any more tears, but she thinks the ones I had will re-tear and they will likely be worse this time round (meaning all of them are likely to be 4th degree tears rather than just the 2).
She explained that given the amount of scar tissue and the urinary incontinence, she would not be confident with another vaginal birth. She said that since I had 2 4th degree tears, I was very lucky to not have any faecal incontinence. She said this time I may not be that lucky. She said that about 50% of her patients who have several 4th degree tears require the regular use of adult diapers during the first year after birth because they don’t have the ability to control their bowels and don’t realise that faecal matter has escaped.
She said given my age, this is not something I should have to put up with and would feel much more comfortable organising an elective c section.
After being informed about the chances of what will happen by a medical professional, and someone who does this on a regular basis too, I feel confident trusting her opinion. So it looks like I’m going to be having a c section!!