I had a rubbish first pregnancy where I was in and out of hospital from 25 weeks with high blood pressure, and preeclampsia from 30 weeks. I’d also been measuring 2-3 weeks small for dates throughout, although scans showed an average sized baby. It became unmanageable at 37 weeks so we called it a day and I got induced. Everybody on the ward expected my induction to take a day or two but it was far from that! I was induced at 1230 and was in active labour from 1630. At this point I was given an epidural which unfortunately failed miserably… it was too late to fix it as at 1752 I gave birth to a healthy 7lb 9oz baby boy. The midwife checked me over and wasn’t sure about the damage so got a doctor to check too – they decided I probably had a 3rd degree tear and that I’d need to go to theatre for a repair… Only they changed shift and the new staff said they thought it was actually a 2nd degree so the midwife could do it in the room.
Recovery was pretty painful… I remember trying to walk from the ward to the restaurant a couple of days after I gave birth… big mistake! At the half way mark I REALLY needed to give up – there was nowhere to sit and I was seriously considering getting my husband to grab me a wheelchair. At my final midwife check, she said my stitches were gaping and that I needed to see the GP for antibiotics, which I did, and that was the only time my wound was ever checked after birth.
Fast forward two years and I was nearing the end of a perfect pregnancy. I went into labour naturally at home and was feeling awful bone-crunching contractions. Contractions were close together immediately so off we went to hospital. We arrived at about 1600 and I was guttingly only 4cm – the reason it was so painful (aside from the fact I was in labour!) was that my boy was back to back. They walked me around to the delivery suite where the midwife said she could tell from my voice that it wasn’t going to take long. I asked for diamorphine.. she said she didn’t think we’d have time as you have to have two antisickness tablets 30mins apart before you can get it. She gave me the antisickness anyway but she was right… she examined me again, probably only about 20 minutes after I was 4cm and I was now 7cm. Very soon after that my body started involuntarily pushing… with all the will in the world, there was no holding back. She told me to just go with my body, and I remember shouting back “but I don’t want to tear”! I gave in and let it happen – she kept telling me if I went on all fours he’d come a lot quicker but I felt paralysed. After a few minutes I agreed and they helped me turn around. She was right… my healthy perfectly healthy 8lb 11 (and 3/4!) oz son was born quickly at 1842 with no pain relief.
My midwife quickly established that I’d torn but “don’t worry, it’s not as bad as last time”. We were left for a few minutes to bond whilst they changed shift. Soon enough the new midwife came in to examine me… she said it wasn’t looking good and she needed to get a doctor. Straight away a doctor came in… at this point I got really worked up and didn’t want anybody anywhere near me. In the end they used a load of local anaesthetic to examine me and the doctor broke it to me by saying “the good news is….. you’re not going to feel a thing. The bad news is you’ve either got a 3c or 4th degree tear and need to get to theatre”. They prepped the consent forms and off I was whisked away from my husband and new baby.
Once the spinal anaesthetic was in place they were allowed to join me. They offered the baby for me to hold but I was so shaky I didn’t trust myself. The consultant doing the surgery invited two doctors in to watch the surgery as they’d never seen a 4th degree tear repair before. They were lovely and spoke to us throughout the whole time in theatre. I was told they’d be concerned if they saw more than one case like mine per year in the hospital – this hospital delivers around 8,500 babies per year, so that’s when it really hit home how bad it was. The worst things about the operation were that 1) although I was awake, I was struggling to keep my eyes open or even turn my head, when all I wanted to do was admire my new baby, and 2) after all that pain giving birth without pain relief, I had to have a spinal anyway… if only I’d known before, haha.
Once we reached observation ward it was about 2300 and my husband wasn’t allowed to stay. Thankfully the baby was pretty quiet and didn’t really need anything overnight, and when I did need help, there was always somebody on hand. After about 8 hours being watched I was moved up to the regular ward. The doctors told me I could only go home once I’d wee’d and poo’d and that everything was coming out of the right place… how worrying… that was the last thing I wanted to do, and all I wanted was to get home to my toddler. At first I was refusing the lactulose that they prescribed me as I really didn’t want to go… but last thing the day after he was born I agreed, as it was the only way to get home. A couple of hours later I had the shock of my life when I needed to go but it was so urgent. I literally had about 30 seconds before needing to go and it coming anyway – there was no holding it! At least everything came out of the same place, but this REALLY panicked me… what if that was my life now?!
Before I went home they got a physio to see me and I was told I couldn’t pick up anything heavier than the baby, I couldn’t drive and that I must rest as much as possible, all for 6 WEEKS. My husband had 2 weeks off work, but what was I supposed to do with a newborn and toddler after that?! I don’t even know, but we did manage somehow. I was also told to do pelvic floor exercises very regularly but not to overdo it.
I had a couple of blips where upon checking the scar, we found holes, which had to be checked by the doctors but thankfully they weren’t deep so they left them. And thankfully as the days when by, the urgency to use the toilet grew less and less. Overall I feel like the recovery was easier than that with my 2nd degree tear.
The only advice I went against was the ‘resting’ part – in fact, I did the opposite and I really think it helped my recovery. Sitting down hurt to begin with – moving around hurt less so, so I found myself going against the advice.
I’m now 8.5 months post partum and I’m almost completely symptom free. I’m quite happy to live with the way I am, but I truly hope that things don’t change for the worse as I get older. I’m so thankful that, at the moment, I don’t have much to be concerned about. So many others have masses of complications with their 4DT, so I count myself as one of the lucky unlucky ones!
Every day I wonder if my 4dt (or at least a worse tear) happened with my first instead of my second, and it just went undetected. My brain keeps replaying the midwife saying to me that it wasn’t as bad as last time, and the fact that I was nearly taken to theatre the first time around, but when they changed shift the new staff disagreed. I guess I’ll never know!
Kim S. ~ UK