The only 4th degree tear I have witnessed happening was in a very young aboriginal girl, about 14 years but looked 20, who birthed naturally in all fours with a student midwife doing her 20th catch. Baby's head popped out a bit fast but I have seen faster birthing of the head without tears, and I could see the rectum laid out flat. The lass was good to work with because she was suspicious of everything we did and asked what and why incessantly and  made up her own mind, based on information supplied, about what would happen. She appeared to recover very well.

The next that I had anything to do with was a primi who had had a home birth and had a 4th degree tear and PPH at home, I looked after her and her baby when they came in. She is a fit gym going woman and she has recovered well but unfortunately has just had a CS for breech. She borrowed my Breech Birth Woman Wise but ended up going for the CS.

Maybe sometimes we can't just blame the hospital and the doctors.

Judy




From: "Vicki Chan" <[EMAIL PROTECTED]>
Reply-To: [EMAIL PROTECTED]
To: <[EMAIL PROTECTED]>
Subject: RE: [ozmidwifery] Julia's birth
Date: Tue, 12 Nov 2002 22:25:06 +1000
Isis...
Over the years attending women birth at home, I have never seen a third
or fourth degree tear...rarely there has been a sizable second degree,
sometimes a small tear, and mostly an intact perineum...
Of my clientele, there have been several women with past very serious
damage... Third degree tears,5 previous episiotomies, a
'shattered'perineum...all these women birthed gently (and ne'er the
word'"push"to be heard) with beautiful unharmed bodies....
There are no guarantees...there is more �t risk'here than your pelvic
floor...there is more to you than your pelvic floor...what is important
to you? What really matters?
listen to your body and your heart...they will guide you where you need
to go...only you can know what is best for you.
I wish you well...
Vicki
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]] On Behalf Of Andrea
Quanchi
Sent: Sunday, November 10, 2002 3:15 PM
To: [EMAIL PROTECTED]
Subject: Re: [ozmidwifery] Julia's birth
Isis, The bit about tearing worse the next time is rubbish. So
continue to trust your instincts and birth your way with your chosen
midwife next time and you'll be fine. I too had a bad tear the first
time, was talked into an elective epis the second time and had a smaller
tear the third time. Even the third degree tear healed better and was
less painful than the episiotomy. I agree that the stranded beatle
position wouldn't have helped and so that is the thing to avoid next
time.
Andrea Q
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