Im just wanting to hear some ladies opinions on this. Brief history my Obstetrician has given me a choice of either an elective cesar or an early induction the main reason is because with my last baby i had a bad third degree tear as he was 9p 7 so a good size and a postpartum hemmorhage, so to avoid this again she has suggested either inducing at 38wks or a cesar im confused have no idea what to do. My question is what would you do in my situation. This is my third baby so im thinking third time lucky? Thanks in advance.

Neither...but that's me. LOL

If I had to choose between the two though I'd personally go induction first over a c-section any day of the week.

Usually tearing or not can be something as simple as the position you are in, baby flying out unexpectedly, or forceps/vacuum extraction etc. So knowing the WHYs can sometimes help avoid that happening again. I actually found giving birth to DS2 was heaps easier and he was 1lb 7ozs bigger than DS1 and his head was 3cm bigger.

Same as Hippie - preferably neither.
But if those are the choices then I would choose an induction over major abdominal surgery any day!!
I've been induced with both mine, and pretty much expect to be induced with this one too and it's not fun, but it's not that bad either..
Good luck - and make sure you get stuck into gently stretching your perineum!!

Well an induction would be more painfull innitually (i was induced) but a c-section would be alot more painfull after and has a long recovery where as with an induction you'ld be able to get up straight away. Theres also more risks in the long term with a c-section and problems that can arise if having anouther baby.
Personally after putting things into perspective i'ld preffer an induction instead of a c-section if I was in your possition but its your desisition at the end of the day what you do and no one can decide it for you.

I wish someone could decide, the obstetrician just scared me a little and said the chances of me tearing just as bad again was very high but a cesar scares the life out of me.

Get another opinion. Seriously, does she have some magic crystal ball that tells her what YOUR birth is going to be like before it has even happened? From what I have read about these kinds of tears they can't be predicted; so just like we can't say it won't happen again, equally your OB can't say it will.

There are heaps of things you can try to prevent from tearing again, and depending on WHY you tore last time things you can try and avoid to mitigate a repeat occurrence. This link might be an interesting read for you and if you google preventing vaginal tears in childbirth you'll probably come up with heaps more stuff. LOL One of the biggest things you can do to prevent tearing is your pelvic floor exercises. I did mine religiously both pregnancies and I had slight 1st degree tears but they didn't require stitching; DS1 was an hour of pushing, DS2 is down as 9 minutes but none of it 'active' (well I didn't feel like I was pushing all that much) and we actually didn't know his head was out till we looked down and there it was. LOL

Like I already said, if it were me I'd pick neither but if forced to pick one based on the risks involved I'd still pick induction over a c-section every time.

Hi, if this is your 3rd and the other two have come naturally if a little late, I'd be inclined not to worry too much about an induction - if you look at the stats (hospitals don't always make them available but they are supposed to, I'm not sure where you can get them from otherwise though) but most issues with inductions happen with first time labours/pregnancies. (I didn't know this until I was scared out of my wits about being induced with my 2nd).
If you have laboured before, and if you are even slightly dilated (very common to be 2 or 3cm to start with, with 2nd and more pregnancies) they can break your waters which can be enough to bring on labour "NATURALLY" (thats all I needed in the end) but make sure your dr is on your level with timings (make an appt prior to find out their timeline - even ask their reasons, because they are often a bit unreasonable - in that they may give you an hour before syntocinon 'due to infection risk' but you could push for a little more if you are confident)
I know heaps of people who've been induced with a drip and not even needed drugs so don't be too concerned, it may not be the best thing but then it may save you all the tearing and pain after.
Oh and I would avoid a caesar unless it was life or death for me or bubs (which is what they are supposed to be there for!!!)
Perhaps get a private midwife or doula if you aren't confident in your knowledge but want someone on your side in there (who knows when its too long and needs sore drugs etc)
Feel free to ask questions if I haven't made sense!!!

Posted by: angelbubs
I wish someone could decide, the obstetrician just scared me a little and said the chances of me tearing just as bad again was very high but a cesar scares the life out of me.

I think you need to ask yourself what are you more scared of:
a chance that you may tear with a chance you could be perfectly fine or going through a c-section and everything that comes with it?

Also have you tryed to do things to soften the skin down there to prevent a tear?

No with my last two pregnancies i could not reach down there and this time i have already told my husband if i can not reach then he just has to do it for me lol.
The only reason why i tore last time was because of his size and presentation, he had his fist up to his chin with arm outstretched if that makes sense im not sure of the propper name. Wow only a week ago i was convinced i was having a c-section but now after the info you all have given me i think i need to change my mind plus both my last 2 labours were all natural no drugs etc, so if i was to have a c-section im just not sure weather i could emotionally cope.
Also thanks for the link im going to check it out.

No with my last two pregnancies i could not reach down there and this time i have already told my husband if i can not reach then he just has to do it for me lol.
The only reason why i tore last time was because of his size and presentation, he had his fist up to his chin with arm outstretched if that makes sense im not sure of the propper name. Wow only a week ago i was convinced i was having a c-section but now after the info you all have given me i think i need to change my mind plus both my last 2 labours were all natural no drugs etc, so if i was to have a c-section im just not sure weather i could emotionally cope.

That tells me you could definitely do it!!! And maybe just keep thinking and talking to bubby about coming on a date 2.5wks early and that way what you are worried about may never come to pass!

I've had 2 totally drug free - my 2nd was induced though, and this time I am positively waiting for my placenta to move up (sort of) so I don't have to have a caesar - it is quite daunting isn't it, and I don't blame you for your concern - as I said I was reaaly worried about my induction but going in prepared is very helpful. (google Ina May Gaskin; she had some extremely alternative read: very natural, ideas that we used in labour to speed it up to reduce further interventions, like open mouth kissing and eye contact - I would have tried anything but those two worked magically) feel free to PM if you want more detailed info about that - it is a little TMI but happy to share if it helps!

Ohok I can't remember what you call that ethier, I have it in a book somewhere all the types of positions.
The thought of a c-section scares me too, I don't handle operations well and don't think I could handle being awake whilst its happening.
I have had an epidural and it was really good.
I think it is probably a little safer being induced then having a c-section and better long term and of course if you did end up needing a c-section whilest in labour they can give you one.
I have been induced and although it was full on and painfull (i'm not going to lie to you, this is why I had an epidural) I would much rather have anouther then have a c-section if I was given a choice.
Its a quick recovery too.
I'm sure your ob is monitoring bubs size and won't let him get to big for you to handle before inducing you, I don't think he would give that option if he felt it would endanger you in anyway.
good on you for telling your husband he can rub things down there to help, there are some products on the market that are meant to be really good.
Thank god things have advanced so much when it comes to pregnancys, labour ect and we don't have to go through what our great great grandmothers did.

Ok, so all this sounds very strange to me.
Just to get it all straight in my mind. You had a third degree tear during your last birth - you have been told that this is due to the size of bubs (which was big if I am guessing correctly) and an awkward presentation. Your OB has given you two options a c/s or an early induction.
The reason I am confused is because your OB doesn't seem to be giving you the most obvious option. That is a normal vaginal birth at term, that is active and without intervention, incorporating all the things that evidence tells us will help prevent tearing. Those things include: active second stage positions such as squatting or all-fours, birthing in deep water which helps to soften and stretch the peri, placing warm compresses on your peri during second stage (if on dry land), avoiding interventions that lead to assisted delivery such as induction, epidural etc. The list goes on and on.
I would suggest going back to your OB and telling him that neither of these options is satisfactory!!
I would also suggest you read, read and read and inform YOURSELF about how to avoid a tear. Your birth is your own responsiblity and therefore you need to take some control back over your birthing experience and make informed decisions. clearly your O?B is not going to provide you with all the inforamtion you need to have the birth experience you desire!!

I'll be in the same boat next time. I had a 3c tear with Elodie, tore right to the back iykwim? so I've had two Drs recommend a c-section next time. Elodie was only 6lbs 6ozs but she came out fairly quickly.
I was induced at 39 weeks because of GD using cervidil and I actually was really happy with my labour, 8.5 hours and drug free. I was scared of the induction aswell beforehand but I'd happily do it again using this method.
I have no basis for comparison but I didn't think the tear was too bad. They took a long time to stitch me up but I was distracted by my new little girl and I was sore for a couple of days after but nothing too bad. I'm sure a c-sect would be worse.
I was also told to deliver on all fours if I did try for a VB but I'm guessing I'll have GD again and will have to be on the bed being monitored.

Good Luck!

I have had 3 c sections the 1st one after 26 hours of intense labour. the 2nd was due to placenta previa an the 3rd due to a very thin uterine wall.With my history and only because of that I say c section. Also, an induction could still lead to an emergency c section
[Edited on 09/02/2010]

I cant give an opinion on a vb as im am one of the rare women who cant give birth that way, ( for the naturalists its a medical fact in my case that its impossible and life threatening) ive have had two c/s and i recovered well with both, i was awake for both, one was a epi and one was a spinal, both very effective i didnt feel a thing and i was up and about the next day with both and i left hospital on the 3rd day, the after pain was manedged wiht pain meds and i didnt need those after about 5 days, on the 5th day i was out walking with the baby, gently of course... for me if i had the choice ( if my body allowed me the choice) the threat of the postpartum hemmorhage would make me think seriously about the c/s, if you bleed very badly that was and if it took them some time to fix, to me if the ob thinks that its a risk to wait till term id be going wiht his reccomendations, not sure about other obs but mine is very good and he only reccomends intervention if its obsolutly nessacary. you could make another appointment with your ob and ask more questions about both options and if he thinks you will hemmorhage again or not and take it from there, i think the hemmorhaging part is more worrying as thats the bit that can become life threatening

The average blood loss in a vaginal birth is 500ml, anything over that is classed as a haemorrhage. A c-section averages a blood loss of between 800-1000ml so technically speaking by having a c-section you are guaranteed to have a PPH where if you have a VB you might not.

Yes a PPH can be life threatening, but then so is pregnancy in some instances and you have to decide what risks you are willing to live with. Considering a c-section usually results in MORE blood loss anyway, I'd personally risk a VB and the potential for a PPH than a c-section.

I agree with what a PP mentioned, do heaps of your own research and if you've got questions then ask them. Most people never think to question health professionals, but if you go in and have NO idea what they are talking about IMO you put yourself at a disadvantage. To the OP, I suspect that alot of what happened with your last birth was because of his presentation more than his size (there is a member here who has birthed bigger babies vaginally with no tears so it can be done) and the likelihood of the next baby presenting like that aren't that great I wouldn't have thought; in fact I can't say I have ever heard of ONE woman giving birth to multiple babies in a 'superman' pose before.

Hello Anglebubs,

I had my 3rd baby 4 months ago and I was told all the way through the pregnancy to expect the birth to be the same as the my first 2 babies naturally and quick. It wasn't to be, I was induce after my waters had broken 13 hrs prior then my baby wasn't in a hurry to come into the world and the induction did nothing so I had to have an emergency C section.
I certainly wouldn't be affraid of the induction. I was more scared and worse off having the C section and dealing with the mental and physical aspect of it still. But I suggest to go with the flow if you can and avoid the c section if possible. Have faith and trust in your obstetrician. As long as you and you baby are healthy at the end of the day that is all that matters

I recently was asked to make the same decision. I had a nasty 3rd degree tear with DS1 and a long painful recovery. When I gat pregnant with DS2 I saw an Ob who gave me the same choices as you. I went with the caesar (it turns out he was breech so had to anyway). I have absolutely no regrets and my recovery from caesar was so much quicker. I had very little pain and was up abd about day 2. Good luck with whatever decision you make.

Posted by: Rumina
Ok, so all this sounds very strange to me.
Just to get it all straight in my mind. You had a third degree tear during your last birth - you have been told that this is due to the size of bubs (which was big if I am guessing correctly) and an awkward presentation.

I think your confused, the last was an arkward presentation and big. Because shes already had a big baby and this one is looking like its going to be big she has been given the option of have a c-section or being induced early before bubs gets too big (needs to be done before due date), This is a very common practise expesially for people of small build or those whom rip easily, a friend of mine just recently had to be induced at 34 weeks as bubs would have been too big and dangerous for her to birth. As she also had a hemorage which is life threatening she can't have a natural birth when bubs comes in his own time thats just crazy!

Only thing I want to add is that I was induced with my second DD and ended up having an emergency caesar... which can be (and was in my case) a consequence of being induced.

From what you've said I'd try for a natural birth.

neither. some obs are just plain stupid.

its your baby- some people can go waaaaay overdue and have a totally different birth to the first ones.

get another opinion or stand up for yourself. dont be intimidated.

I agree with pps, you don't just have the choice between c/s or induction. It's your body and your baby, get a 2nd opinion if you're not happy with the "choices" you've been offered.

I was induced and ended up with an emergency c-section & complications, I would tear anyday to have my babies naturally - unfortunately this will never be an option for me now. I would decide how long you can go over for, then go for the induction as it would probably be successful for you not being your first.

[quote][b]Posted by:[/b] BlaBla_152 I think your confused, the last was an arkward presentation and big. Because shes already had a big baby and this one is looking like its going to be big she has been given the option of have a c-section or being induced early before bubs gets too big (needs to be done before due date), This is a very common practise expesially for people of small build or those whom rip easily, a friend of mine just recently had to be induced at 34 weeks as bubs would have been too big and dangerous for her to birth. As she also had a hemorage which is life threatening she can't have a natural birth when bubs comes in his own time thats just crazy![/quote Mmm, um, no I am not confused... small women can birth big babies and commonly do without tearing or complication. Sure, sometimes tearing is not preventable but I think it is less to do with a woman's body 'not being built to birth vaginally' and more to do with poor management of the women's labour. I would suggest getting your hosptial records and asking an independent care provider to talk them through with you. this will give you a greater understanding of what actually happened during your birth and what factors contribued to your 3rd degree tear. I think you will find there is more to the story. Informed Choice is really important when being offered these interventions. Both induction and c/s carry significant risks also, you need to weigh these up when deciding the kind of birth you want. Good luck.

this was like my situation. my first was a 10lb 10oz baby who caused me a fiar bit of pain and a long recovery after.

my obs recommended an induction at due date to be 'safe'. we talked about elective c section but thought that this was a better option.

went through with the induction with no probs. 8lb 8oz bubs, easy delivery (with epidural). stiches but no ongoing probs like with ds and no pain.

i trused my obstetrician and valued her expertise. this is what i paid her for and this is why i took her advice and i am glad i did.

I am truely amazed at the amount of people that say there is NO WAY they would have a c/sec because of ALL the complications associated with it... What exactly IN YOUR experience would they be?

I am sorry, but unless you have had one, i dont think that any of you really understand what it is about. If we were to have a 3rd child i would opt for an elective c/sec. I recovered much quicker, with less pain, less bleeding, less hassel, less everything. I think that there are a lot of drama queens in the world that make it sound a lot worse than it actually is & a lot of people use scare tactics to encourage women to birth 'naturally' & of course there are always the horror stories to go along with the 'lucky' ones such as myself.

I for one, had an emergency c/sec, was up & moving around after 24 hours, was using no pain meds after 24 hours, went home on day 3, was walking DS to school within the week - sure it wasnt as quick as previously, but was without discomfort, had no trouble carrying/feeding the baby. Sure there were things that i couldnt do like hang out washing.. ohhh booo what a shame DH had to do it.. who cares.

It doesnt have to be a horrible experience.

As for the original question, i would, as others have recommended get a 2nd opinion too. I can see what your concerns are, but these people that tell you a c/sec is soo soo very bad would need to have one before i valued their opinion on it.

You need to be happy & comfortable with the decision that you make, so if you are unsure, then whatever you have decided is probably not the right one. good luck.

I didn't say it would be a 'horrible' experience I said c-sections had risks, and they are generally greater than a VB, so I personally wouldn't choose one unless myself or my baby were more likely to die if I didn't. A c-section is a MAJOR abdominal surgery and there are risks galore with it, I don't need to have had one to know what they are because I know how to read. Just because they are 'routine' doesn't mean they are without risk.......the same with inductions. She needs to look at all the risks and decide for HER what the best course of action is.

Based on the information the OP provided I don't think that the two options she has been given are the only ones available to her, thus why I suggested she get a second opinion, but only she knows her history and I am giving my opinion based on what she's said here.
[Edited on 10/02/2010]

[quote][b]Posted by:[/b] C_hippie_kiwi I didn't say it would be a 'horrible' experience I said c-sections had risks, and they are generally greater than a VB, so I [b]personally[/b] wouldn't choose one unless myself or my baby were more likely to die if I didn't. A c-section is a MAJOR abdominal surgery and there are risks galore with it, I don't need to have had one to know what they are because I know how to read. Just because they are 'routine' doesn't mean they are without risk.......the same with inductions. She needs to look at all the risks and decide for HER what the best course of action is.[quote] I totally agree with you. Everything carrys risks when it come to pregnancy and child birth and a c-section carrys the highest risks of all labours. Just because someone had a good experience doesn't mean it will always be that way as it is a very major abdominal surgery. Also everyone handle surgery particularly abdominal surgery better then other I would never want to have one if I could help as I know body doesn't cope well to abdonimal sergery when I had an a ppendictamy a thew years ago which was laproscopic surgery it took me 5 days to be able to to disscharged from hospital and 2 weeks after that of vomiting and pain to recover instead of the normal 24 hours. So to say people don't know unless there've had we learn from what read, other experiences and past experiences also that relate in some way. I have seen women come into hospital almost fainting in agony a thew days after a c-section because something hasn't gone to plan and also why do you think there is a special term (VBAC) for people who have had one and are about to try a vaginal birth after, its because they are high risk due to the c-section. Then on the other hand there are people like a friend of mine whos son was breech so she had to have a c-section and she had no probs and went onto have a perfectly fine VBAC but she did still say she preferred the VBAC to the c-section. [Edited on 10/02/2010]

unless you have had a c-section you truly dont know all about a c-section, a book only tells you so much.. ive had two and my first was a horrible experience as i had a long labour and had to have an emergancy c-section. i was put to sleep and when i woke i had this baby im my arms.. my second was fantastic i went in at 38 weeks and had a eppidural ( wrong spelling) and it was the best experience ever. it is a major operation but there are no high risks like people think. your baby wasnt that big am i right?? so eaither way you will be brough on early(just incase you go into labour) if i were you i would go for a c-section cos as they heve told you there is a high chance of tearing again as you already have the history of that and the scar tissue. they pain is not to bad for your first c-section as long as you have a pain managment plan youll be fine but at the end of the day it is up to you.
[Edited on 10/02/2010]