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Thanks Maxine. It's interesting isn't it how we put so much trust in these professionals and their gadgets and make some pretty important decisions based on the information they provide only to be let down by the inaccuracies that we are not told about. Thanks for your thoughts.
-------Original Message-------
Date: 30/08/2005 2:42:32 p.m.
Subject: Re: [ozmidwifery]3rd degree tears, u/s and birthweight
On a personal note I had 3 ultrasounds at 35 weeks for various reasons I won't bore you with but the best (as in heaviest) weight they guesstimated was 500g less than her birthweight which is fairly significant difference when you are talking about a 2.3 kg bub. Suffice it to say I may have made very different decisions about the circumstances of her birth if it had not been for the scary and inaccurate information from u/s. I have no idea what the research says in this area.
Maxine
----- Original Message -----
Sent: Tuesday, August 30, 2005 9:18 AM
Subject: Re: [ozmidwifery] 3rd degree tears
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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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