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Out of curiosity...... does anyone have any experiences of vaginal birth following previous 4th degree tear? I've just recently met a woman who wants to give vaginal birth a go - has new partner (says old one was huge!). She is smallish person - 60kg, last babe 10lbs (1st baby). What do you think. She will be birthing in hospital. I've asked her to get a copy of her obstetric records from previous hospital. Still in early pregnancy so can't gauge size yet. Is a later ultrasound a good idea for a gestimate on the weight? I know they can be so inaccurate.
Kiwi Kim,
-------Original Message-------
Date: 29/08/2005 11:10:23 a.m.
Subject: [ozmidwifery] 3rd degree tears
Hi,
I've just returned from a clinical placement in SA where I spent a mindblowing three hours in an incontinence clinic in an outpatients unit at a major hospital.
The mindblowing element was the following statistics (copied from one of the handouts):
- 39-49% women tear or have an episiotomy needing sutures
- 0.5 - 2.5% have a 3rd or 4th degree tear after vaginal childbirth that is visible
- 25-35% after first vaginal delivery have a concealed or closed 3rd degree tear, not visible
Listed as contributing factors were:
- 1st vaginal birth
- forceps/instrumental delivery
- long second stage >1 hour
- big baby >4kgs
- tissue type, short perineum, epidural, uncontrolled pushing, rapid delivery, midline tear or episiotomy
The nurse practitioner stated this was all evidence-based information and recommended c/sections to women who had had previous 3rd degree repairs - these were the ones who knew about their tears obviously.
The handouts do not give references and as yet I have not had time to begin researching.
Are you all as mindblown as I am??
What do you think - are 1/4 - 1/3 of us walking around with damaged anal sphincters and not aware of it??
Where does this sort of information lead us - if our bodies are so inept at giving birth then all first babies and subsequently all babies should be born by c/section.
Sue
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