Recovery after c-section vs episiotomy/ tear
I suffered a 3rd degree tear after my last baby, the recovery took more than 3 months and was extremely painful. I am expecting my third baby in early July, and am leaning towards a c-section for several reasons:
1) Research (RCOG UK) shows that VB after a previous 3rd degree tear can result in a worsening of incontinence issues is 17-23% of cases. While I am ok now, I definitely haven't gone back to what I was before the last birth, and I definitely dont want any worsening 'down there'.
2) even if symptoms dont worsen immediately, the risk of problems with incontinence post menopause is much higher if I have another VB, even if I dont tear this time.
3) I am much older now than I was with my last two babies, and I dont think I'm in good enough shape to 'bounce back' from VB easily.
I understand that a c-section is a major operation with risks, and of course, I wouldn't choose it for no reason. however, I feel that the long term risks of another VB are very high in terms risking my quality of life. I also feel that 2 weeks of pain and discomfort would be easier to manage than 3 months of the same, and caring for the wound/ stitches on my tummy is easier than after a severe tear, where even going to the toilet is an issue.
I have discussed these concerns with my Dr in previous visits, and she has agreed that the risks are real and that I am entitled to ask for a c-section. At my apptmt yesterday, I asked her about provisional dates for scheduling the section and she wants me to wait until 38 weeks, and if baby is engaged, not too big etc, to try for a 'controlled VB'. ie she breaks my waters, induces contractions and delivers naturally, most likely with an episiotomy. I left the apptmt feeling quite distressed.
Dr's main argument was that as I have had 2 natural births 'with no complications' (!), it would be 'a waste' to have c-section for the third just to avoid possible tearing. She said she has managed to deliver many patients naturally after 3rd degree tears, and some without any need for episiotomy.
I am also not keen on an induction as this usually leads to stronger contractions and a faster birth, which was the most likely cause of my tear last time (baby shot out around 2hrs after contractions started, we didnt even get to the hospital on time).
Doc also seemed to think i was underestimating the pain and recovery time with a section, although I figure it has to be better than what I went through last time? If I'm going to be cut anywhere again (and an episiotomy is very likely), I'd rather have the cut and stitches on my abdomen.
she also doesnt seem to take into account possible further damage to muscles that could cause problems in 10-15 years time.
I am feeling v unsettled, and will probably see another OB/ GYN for a second opinion. In the meantime, if you have read this far, I'd appreciate any feedback from people who have had c-sections about recovery/ healing as I suspect it is easier than what I went through before. Also those who have had VB after 3rd/ 4th degree tear.
thx
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