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    Nov 23

    vaginal birth after 4th degree tear

    M R

    Dear Henci,

    I experienced a fourth degree tear with my first child because he was born very quickly (3 pushes/9 minutes) with both arms in front of his face like superman. I recently found out we're expecting TWINS! I know a decision can't really be made until we find out the position of baby A, but I'm curious what your thoughts are on delivering twins naturally after a 4th degree tear. He was born so quickly that I missed the window to get an epidural. If we try a natural birth this time around, should I get an epidural so things are slower and more controlled? I'm okay if I end up with a 1st or 2nd degree tear this time around but the thought of a 3rd or 4th degree tear terrifies me. I don't want to risk becoming incontinent. Twins are typically born earlier and smaller, so does that decrease my risk for a 3rd or 4th degree tear? I know an uncomplicated vaginal birth is the best option for everyone, but is that even possible after my history and considering we're expecting twins?

    I've been told that the scar tissue will probably tear, but "hopefully not as deep" at my initial appointment. In all honesty, it didn't feel very encouraging.

    Thank you so much for your help!
    M R

    Oh, and I was told to consider a c-section.

    Thanks again!

    All Times America/New_York

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