perenial laceration repair

[b'squestion]

I had my first child four years ago.  I was not cut.  After child birth I was told the doctor let ne tear.  I could not get around for weeks after labor.  At my 6-week check up I was told that some of the stitches had come undone.  I was told that was ok and the area without stitches would heal on its own.  Over the years I feel as if the tear is slowly reopening.  My perineal area is getting smaller and smaller.  At my yearly exam last year I was told not to worry about it.  I am due to go again in a couple of weeks and I would like to know if this is an issue I should take up with my doctor?  If there is anything that can be done now to correct it?  And if I can de directed to any research so I can read about it...  Thank You.

[Christie2004]

If you aren't comfortable with what you are being told by your doctor, it is wise to seek out a second opinion.  Especially since you are having problems.



If possible, be seen by a urogynecologist.  Your doctor should not object to this, if he is confident in his diagnosis.  



I couldn't find any research for you, but you can try Googling perineal repair, complications of perineal repair, breakdown of episiotomy (that's similar to your tear repair), etc.

[Christie2004]

And yes, repair or revision is possible, but often times they want you to wait until you are done having children.  If you are having severe symptoms and need repair now, you may have to have C/Sections in the future to avoid undoing the repair.

[tura]

I'm so happy you had this question.  I kinda had the same problem.  I ripped extremely bad, had sutures come undone and got a pretty bad infection from it.  My daughter is now 4 1/2 months old and I'm still not completely healed.  I was wondering if it is possible to request having a c section with my next baby so I don't have to go through that all again.

[duehring]

Just because you ripped badly doesn't mean you will next time. I have had 4 kids in 6 years. They have all been big babies around 9-10 lbs. The first 2 babies I ripped all the way. I had to have major stitches. Then with my last 2 babies I haven't ripped at all. With one I didn't have to have stitches and with the other I had 2 stitches. They were just as big of babies. I had a different doctor with the last 2 babies and I think that made the difference.



Just to give you a little bit of hope. :0)



I would never have a c-section to prevent tearing. There is pain with recovery with that too I think.

[olinsmum]

I had a really bad experience also with my first child: 3rd degree tearing from an episiotimy (necessary for my delivery as child was pronouncing face first and needed forceps to be helped out).  Nearly all the stitches all ripped apart 3 days later when I had my first BM; according to my ER/ICU nurse mother they messed up both my episiotomy and stitches which lead to the 3rd degree tearing and ripping stiches.  It took me a week to get up after the BM ripping, 3 months to close up, then another 6 months to "fill in" the hole as best my body could.  Before having my second child I had what resembled a deep crater to the side of my perenium and a frequent aching in the area.  

I too was terrified of ripping again and having the same complications all over with two kids to care for this time... luckily I had better care in our small new town.  It took all of 7 pushes to get my #2 out (over a pound larger than #1 as well) My Dr held my perenium for me during pushing and told me the 2nd degree tear i got this time was because the scarred tissue had so little elasticity it gave way during my intense pushing.  but this time it only took two weeks to feel normal down there again.  I'm still being cautious (baby is 19 days old today) but am confident that I'm trhough the worst of it.

So, in direct response to your question.  I would recommend NOT getting a c-section, although you might be able to request one.  That is an even more intensive healing for your body, and guarantees you'll be outta comission for a while.  Do your kegels and the other recommended excersizes, get warm cloth compresses during final stage of labour, take docuset/stool softeners immediately after delivery if you required stitches, and have your DR hold your perenium together while you're pushing... with any luck this will help you avoid both a c-section and the nightmare of healing a re-ripped perenium.  But I am also no doctor myself and they usually know you better down there.  Best of luck with the next one :oP