What is a third degree tear during childbirth?
A third degree tear during childbirth is a tear that extends from the vaginal opening to the perineum and the anal sphincter muscle. It is more severe than first and second degree tears and may require stitches or surgical repair. Prompt medical attention is necessary to prevent complications.
Welcome to another blog, a little different this time, not money related, more personal related. About a Third degree tear.
I know many of my readers who are yummy mummy’s always go through a lot of drama when it comes to childbirth and for those who are new to be mums, here’s a little story of my childbirth and how you can prevent something traumatic from happening – the Third Degree tear. It is suggested that women who have had a third- or fourth-degree tear in their first vaginal birth have a 7-10 in 100 chance of having a similar tear in their next vaginal birth. Risk factors for having a repeat third- or fourth-degree tear include having a forceps delivery, your baby being born heavier than 4 kg, being of Asian ethnicity, and the expertise of the obstetrician involved in the delivery. If you have a third or fourth-degree tear, you’ll be taken through to the operating theatre to make sure you’re completely comfortable and the obstetrician has good light and equipment to repair it properly. Around 5 in 100 women having a vaginal delivery will have a third or fourth-degree tear.
My Experience with a Third degree Tear
I decided to share my experience with those whom my topic would relate to.
So have you suffered a third degree tear? or worried you may suffer one? Here I write what a third degree is and how it can be prevented.
The midwifes rushed me and below I will tell you why they shouldn’t have…
Becoming a first time mum was so overwhelming. It was a new chapter in my life, from the 9 months up till labour I felt like I managed very well, but there had to be some downfall right? yup!
I was one of those unlucky ones who suffered a Third degree tear during my vaginal delivery.
Well not suffered, the pain killers did a great job at keeping me normal.
At that time I didn’t know what this meant, I thought it was normal and that every women goes through this type of tear. (God Forbid!)
THIRD degree meant to me I needed stiches, mostly likely 3 stiches, that cant be that bad can it. After all in my head it was only 3 tiny winy stitches.
My family came to visit me and my new born baby and asked how I was doing, I responded with a “yes great” I just need a couple of stiches down there and were all good to go.
I guess I was wrong !
Third degree tear and how many stitches did you say?
Third degree is NOT that common, infact it’s more than 3 stiches, WAY MORE… lets say I needed around 38 STICHES, that’s only an extra 35 compared to what I had thought…”sighs”
What is a Third degree tear and how to prevent a third degree tear?
“A Third–degree tear is a tear in the vaginal tissue, perineal skin, and perineal muscles that extends into the anal sphincter (the muscle that surrounds your anus).”
So as you can see from the description, it goes pretty back and above.
It most commonly occurs in first time mums which I would say it goes down to being unpractised and unaware of what is going to happen next during labour.
Midwifes say a Third degree tear can not be prevented, but I felt with my experience and how my labour went, it could have.
The tears are classified in number order. There is first, second, third and fourth, fourth being the worst and ofcourse one that takes longer to heel.
- First-degree tears – small, skin-deep tears which usually heal naturally
- Second-degree tears – deeper tears affecting the muscle of the perineum as well as the skin; these usually require stitches
For some women with a tear, the tear may be more extensive. This may be:
- Third-degree tear extending downwards from the vaginal wall and perineum to the anal sphincter, the muscle that controls the anus
- Fourth-degree tear extending to the anus or rectum
I wasn’t in much pain after my vaginal delivery, I wasn’t in any pain actually. Probably that’s the reason the ward staff wasn’t too bothered to get me stitched back up again so soon.
I had my baby boy at 7pm, but they took me into theatre to be re-stitched at 12am.
That’s a whole 5 hour wait ladies, luckily I wasn’t losing much blood and wasn’t in scrutinising pain, however a third and forth degree tear can be somewhat very painful for some ladies and may require urgent treatment.
If you feel it hurts raise your voice and demand they get you sorted otherwise like me they would assume your fine and wait till there ready to treat you.
Once they took me into theatre that’s when I started feeling scared, I started thinking, “oh great, is this going to be like giving birth again?, will the pain be worse? what if I faint? what if I die? <ok, the last thought was extreme I know, but leaving your baby in the ward whilst you go into theatre was awful.
I was lucky once again that I had my partner staying over so he kept the baby whilst I got my tear stitched up. I know in some hospitals they don’t allow any extra people due to crowding.
Third degree tear repair
Depending on how deep your tear is, the doctors either offer you a spinal or an epidural as pain relief.
The choice is yours, I opted for a spinal as an epidural is birth related and since I wasn’t about to give birth to another baby any second I went for something lighter – the Spinal.
The procedure is similar for both, a long injection into the spine of your backbone to numb you from waist downwards. I was shaking, I kept asking the doctor “are you qualified? are you sure it goes in my spine, what if it goes bent? to which the doctors replied “please stay quiet so we can get this right. That obviously made me more nervous.
They make you sit upright with your legs dangling off the bed, both arms on the bed and head down, that helps them get your spine in place I suppose. A nurse will come and hold you from the front for comfort and then the doctor at the back will begin by positioning the large injection into your spine.
It stung that’s for sure, but it wasn’t as bad as labour so you ladies will also be fine.
How long does the Spinal take to kick in?
It takes around 10-15 minutes to kick in and before the doctor can go in and start stitching you up as they have to make sure your fully numb.
They used a deep cold ice freezer spray on my body and once I didn’t feel it they knew I was good to get stitched up. I remember dosing off a couple of times into sleep because I was so tired however don’t worry you wont go unconscious.
I asked the doctor what if I just go unconscious and you think I’m sleeping? FORGETTING this is the 21st century. To ensure the patient is alive and safe the doctors attach some heart monitors to your chest area to which they can continuously monitor your heartbeat and make sure its going at the right pace.
Third degree tear stitch up time?
My surgery took around 2 hours. Once I was stitched up I didn’t feel a thing and nor could I feel my legs. The doctors returned me to my ward after an hour of recovery to which I started feeling my legs again. Around 2.30am I was back in the ward with my baby. Happy days!
Third degree tear recovery time
So how long does a third degree tear repair take?
The recovery process before I felt I could fully move and return to my normal daily life took me around 4 weeks. This is about normal for this type of tear. It could take more or less, depends on your lifestyle.
Third degree tears don’t always have long term affects if you take care of yourself straight after.
I was lucky I had my mum staying over to help with my baby which allowed me to get full rest. It was only when the pain killers started varing off after every 4 hours I would start feeling a little bit of pain otherwise once I was dosed up on those I couldn’t feel a thing.
So ladies my recommendation is keep yourself dosed up! I know it’s not the best thing to stick to medication but for those few weeks you rather be pain free than in pain when picking up your baby.
Third degree tear and future births?
If you have recovered well, it shouldn’t affect your second baby. Second baby’s are usually faster when born “says the midwifes”. Some will beg to differ.
Third degree tear and pregnant again?
I’m currently 5 months pregnant with my second baby and I’m very nervous for my labour with this one as I’m not sure whats going to happen, I really don’t want another third degree nor a forth degree, fingers crossed!
With my second baby – midwifes were more proactive and my labour breathing skills really helped – I will right another post on how to PERFECT your labour so it’s smooth as possible for you. I DIDN’T suffer another Third degree tear:) Thank the lord.
Back to the topic – You do get a 6 month post check up followed up with a scan of the anal rectal area to see if you have fully healed. As long as no tears are seen in the scan it should all be ok.
What are the risks of me tearing again?
To be honest there are no risks. You could have the smoothest delivery and still tear down below, it all depends on the baby’s position and how your pushes go.
I honestly feel my third degree tear could have been prevented.
With it being my first child and first labour I wasn’t aware when to push, I just followed instructions, but when you hear the experienced family members/friends say “only push when you want to” then you know you should listen.
Trust me I now know what that urge feels like when you get it, YOU WILL TOO.
It’s like your body tells you to push and infact pushes for you. There’s nothing you can do to stop it, that’s mother nature right there my ladies!
Always trust your gut instinct!
My midwife kept telling me to push as I was fully dilated, but I didn’t want to, I was fake pushing and straining my down below which I felt led to my Third degree, in reality when I did get the urge to push it only took 2 pushes and my baby was out.
It made me think why I wasted 2 hours pre hand pushing when I didn’t even know what to push.
Also another way to know if you are pushing correctly is when your contractions come. If the push is a real one, you won’t feel the contraction pain while pushing. This is important for protecting the perineum and preventing tearing. By choosing an upright position during labor, gravity will work with you and enhance the contractions. It will also help strengthen the pelvic floor muscles and reduce stress on the perineal tissue. Performing a perineal massage in a comfortable position and applying a warm compress can be beneficial in preventing a third-degree tear. Talk to your healthcare professional about what is available. The state of mind at the time of birth is very important. Begin doing your pelvic floor exercises as soon as you can – this will strengthen the muscles around the vagina and anus, increase the blood supply and help with healing.
Don’t feel pressured by the midwives…
I just wish the midwifes wouldn’t rush what’s natural and listen to the patient more. I guess it was their lunch time and they just wanted my baby out so they could eat. YES that’s the honest truth – I overheard her!
Overall I would say just keep calm. We as women are designed to go through this labour system and give birth. A Third degree tear can be haunting but can be easily cared for and treated.
Just take in mind the wonderful blessing you have just bought into this world. A pat on the back for all you strong women 🙂
Much love. xx