Life After a Fourth Degree Tear

August 16, 2019

I don’t want to scare anyone off from reading this post, but I’m planning to be very candid about medical stuff. You’ve been warned!

I always knew there would be risks when having a baby. Anything from as simple as high blood pressure to other not-so-simple issues could happen, but it’s something I never put too much time into thinking about because I’m not the kind of person that likes to linger on negative emotions (yes, I’m an Enneagram 7…) Thankfully, last year when we delivered a healthy, happy 8 lb. baby girl, mostly everything went just great, other than the fact that I was induced. (More about our birth story here.) Honestly, I’m so relieved that things went as smoothly as they did with her. However, I really didn’t know what to expect when I was told that I had suffered a fourth degree.

As I sit here, just a few days away from her turning 10 months old, it’s hard to believe that I am just now starting to feel “back to normal.”

Last October, as my doctor stitched me up post-delivery and the epidural was wearing off, he made the decision to take me into the OR to complete the stitching. At the time, I didn’t realize just how unique of a situation I was in, and I’m not sure anyone did to be honest. Even leaving the hospital, hobbling along, I didn’t know that the amount of pain I was in wasn’t common. It wasn’t until about 9 days postpartum that I found myself writhing on the floor of our bathroom, sobbing in pain, that I thought “is this was recovery is like for everyone?” Something didn’t feel right, but maybe this was normal. I’d never had a baby before, so I didn’t have anything to compare it to.

A few weeks later, I visited my doctor because I had been experiencing what I thought was bowel leakage and was concerned. After an exam, he mentioned that surgery may be needed, and as you can imagine, I cried. Lots. I felt like I had finally started to make some progress healing and couldn’t believe I was going to go back to square one. But later that afternoon, after consulting with other doctors in the practice, he believed that surgery wasn’t necessary – at least not yet.

Unfortunately, things didn’t get better. January arrived and this is where things started to get embarrassing. Y’all, I had no control over gas. It sounds funny, and I suppose it was to some extent, but I felt like I just had a cloud around me 24/7. I vividly remember sitting on the bed, looking in a mirror and thinking… I know things change after having a baby but… this just doesn’t look right. My inner monologue kept repeating: this isn’t normal. This can’t be. Friends around me said things like, “well, this is just part of motherhood” and “nothing goes back to the way it was before.” But I just didn’t buy that.

Once my symptoms got worse when I went back to work, I made another appointment with my doctor to get a referral to the surgeon, a urogynocologist. Before I left, I asked him how often he saw injuries like these from labor. He hesitated.

“Do you really want to know? I don’t know if it will make you feel better or worse,” he warned.

I told him that I wanted to know.

“Well, I see a fourth degree tear probably once every two years. But to the extent that you had, once every five years.” (Even writing that now makes me a little nauseous to think about.)

A few weeks passed and the surgeon reviewed my case before calling me in for an appointment. When I finally met with him, he confirmed what we had suspected: my perineum was completely gone. Yes, you read that right. G-O-N-E. The muscles that were supposed to heal back together never did. He suggested that a perineoplasty and spinchteroplasty were the way to go. As I talked to the doctor, I told him that I felt silly coming in because I knew that changes like this were normal after giving birth. But he told me something that has stuck with me every since: “just because something in common doesn’t make it normal.” He explained that some women elect to hold off on the surgery so they can have a vaginal birth again, but because of our delivery and the complications, we had already decided that a c-section would be the case anyway, so we set up the surgery for two months later.

Of course there were risks involved. He mentioned that sometimes the surgery just doesn’t work. I thought to myself, could I live with these symptoms? Would I really need surgery? But again, I tried to focus on the positive and told myself that the surgery could really only improve the situation from here.

In the months leading up to my surgery, my symptoms got worse. I suffered the worst stomach bug I’d had in fifteen years. Let me tell you… not being able to control your bowels when you have a stomach bug is… well… not fun. I even had an episode at work and sat in a stall for twenty minutes while Nick drove to bring me clean clothes to change into. (Honestly I can’t believe that I’m admitting this on the internet.) But from that point on, I knew that the surgery was no longer something that it would be nice to have. It was necessary.

Now, I’m almost three months post-surgery and many of my issues have cleared up. I’ve seen my surgeon three or four times to make sure things are healing well. (As opposed to seeing my OB/GYN ONCE within six weeks after giving birth. That’s insane, right??)

I searched and searched online before I had the surgery because I had never heard of anyone else having this experience. I wanted to record this and put it out there for everyone to read because I felt so, so alone for the first half of the year, struggling with these issues.

Now as we approach my daughter’s first birthday, I’m amazed at how strong I’ve been over the past year, handling things I never thought possible, including childbirth. To me, that’s been the best lesson I could have learned: I can do anything.

Our Birth Story

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