Previous 4th-degree tear. vaginal birth or planned C-section for next baby?
I’m in my third trimester and really struggling with whether to have a planned C-section or attempt another vaginal birth. I’d especially love to hear from people who had a 4th degree tear and had to make this decision with a subsequent pregnancy.
With my first, I needed a forceps delivery because of fetal distress and ended up with a 4th degree tear. Recovery took a while, and my biggest concern afterward was whether I would have lasting continence or pelvic-floor problems.
Thankfully, I’ve been fine for the most part since then. During this pregnancy, though, I’ve started noticing some continence/pelvic-floor symptoms again, which is making me much more nervous about potentially causing additional damage.
My biggest priority is avoiding another severe tear and protecting my long-term bowel continence/pelvic-floor function. I’m less concerned about which option has the easier short-term recovery.
My current OB is comfortable with me attempting another vaginal birth, but doesn’t have a lot of experience managing subsequent deliveries after a 4th degree tear. She does not use forceps, which makes me feel somewhat better since the circumstances and assisted delivery with my first may have contributed significantly to the tear.
However, I also saw a pelvic floor specialist who felt that, given my history, she personally would not risk another vaginal delivery.
Part of me thinks my first birth involved unusual circumstances and that a straightforward vaginal delivery this time could be completely different. The other part of me thinks I’ve already had a 4th degree tear, have been fortunate to maintain relatively good function afterward, and am now having some symptoms during pregnancy. I’m scared of taking another chance and ending up with permanent continence problems.
For anyone who has been in a similar situation, what did you choose and how are you doing now especially a few years later?