Hi Leanne,
The fear factor for this woman of pushing out this baby will undoubtedly
be huge, As a student Midwife am I missing something? surely if the babe
is happy the slower and gentler she births the better it will be for her
mind and her peri. 
Cheers, Julie Garratt 


-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of leanne wynne
Sent: Thursday, 12 August 2004 12:21 PM
To: [EMAIL PROTECTED]
Subject: [ozmidwifery] 4th degree tear

Hi All,
I have an antenatal client whose first birth was an emergency C/S for
APH. 
Seven years later (2003) she had a VBAC but had a forceps delivery and 
consequently a 4th degree tear. Now she is pregnant again and the 
obstetrician is scaring her with the possibility of another 4th degree
tear 
and therefore a higher chance of suffering faecal incontince as a 
consequence.
Does anyone have any evidence-based information on the liklihood of
another 
4th degree tear and subsequent faecal incontinence.
What frustrates me is the fact that the forceps delivery was because the

obstetrician put a time-limit on how long this woman was allowed to
'push'!!
I appreciate any info anyone can give me.
Thanks,
Leanne.

Leanne Wynne
Midwife in charge of "Women's Business"
Mildura Aboriginal Health Service  Mob 0418 371862

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