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Birth Stories

Positive Birth of Twins After 4th Degree Tear

birth of twins after 4th degree tear

Trigger Warning: This birth story involves positive birth of twins after 4th degree tear from a prior traumatic birth, and postnatal depression. If you are triggered by these topics you may wish to skip this blog or read it once you have support available. If you are seeking support for your birth trauma, you may wish to contact our Peer Support Service.

My name is Tracey and I am 43 years old at the time of writing this article. 

11 years ago I gave birth to my first son. I was fortunate enough to have some time off work and put a lot of time in preparing for the birth; meditation, yoga, relaxation and after a 16 hour labour I had a beautiful boy. No issues, no stitches, hard work but I survived. It felt amazing. 
About 18 months later I was due to have my second baby. The labour was about 4 hours. I had one midwife who was running between myself and another mother in the next suite. She seemed very rushed and run off her feet. 
I remember feeling a great deal of pain during the pushing phase and thinking this is not how I remember it. I was told to push push push! There was no pausing and it was just go go go, I put my faith in the midwife as she is the expert. I found it unusual that there was no pausing and it was just a big rush. 
My son Bronson was born and I suffered a fourth degree tear during a fairly natural birth with the exception of some happy gas. I’m an average size woman, so not tiny and he weighed just 8 pound, so not huge. Later the surgeon and doctors thought it unusual to tear with no real apparent reason.
I had no idea that I’d had a tear. After some time the midwife had a look at me and stated that she thought I may have a bit of a tear and she would call the doctor. I had two female doctors examine me. As the first doctor started to poke and prod at me I was feeling extremely uncomfortable and couldn’t sit still (exposed nerve endings and damage will do that). The first doctor said she couldn’t do this and left the room. The second doctor went on to tell me that I must sit still and stop moving and that some people aren’t very good at coping with pain. This made me very annoyed and I thought what is wrong with me? I felt bad that I wasn’t cooperating and I was making it hard for the doctor and I felt very angry that the doctor was being so rude to me, more importantly.
The seriousness of my injury wasn’t known to us at this stage and my husband returned home to help with our son at home as it was 11pm.
After he left I was informed that the tear might be worse than first thought and they were calling in a Colorectal surgeon and Doctor from a nearby hospital. 
I’m not sure how many came but I was surrounded, they said I would need surgery and they needed to have another look. I was very confused, I think in shock and overwhelmed. They agreed that I would be in too much pain to assess properly so they started to prep me for a spinal block so I wouldn’t feel anything while I was being poked at. I was petrified and found it bizarre that after giving birth I needed a spinal block. It was agreed that I had a fourth degree tear and would need surgery first thing in the morning when the Colorectal surgeon would be able to get there. I laid awake for the remaining hours with my baby, although I don’t remember spending anytime with him. I felt sad, confused and lost.
My beautiful bub was taken and I was told they would take good care of him while I was in surgery. I felt so much anxiety and I wondered if he would be OK without me? During surgery the doctors were chatting about a recent cooking show and holidays while I lay there freaking out. The anaesthetist was very caring and organised something extra to help me relax but I just couldn’t, I just remember thinking, is this a bad dream and why is this happening, I didn’t know this could happen. 
After surgery I spent some time in recovery till the feeling in my legs came back. I was eventually taken to my room, I think about 8.30am. It was empty. The nurse was about to leave me when I had to ask her if she knew where my baby was? She went and asked and they brought baby Bronson back to me. I just broke down and cried and cried while they looked at me and then left me alone. I found my phone and rang my husband and said come as soon as you can, at this stage he knew I was getting repaired but not how traumatic it all was.
One of the doctors who worked on my stitches came to see me. I asked him if I was going to be OK, will it heal and he said “Oh yeah you will be OK, it’s going to be a bit uncomfortable but in a couple of weeks you’ll feel much better. He said all the doctors did a great job and it was a nice straight split so easy to repair. He also said this sort of thing rarely happens – It’s like winning the lotto, it only happens here once or twice a year. Somehow I didn’t feel lucky. I asked how many stitches I had and he replied “oh you don’t want to know” he said I had a tear from front to back and about 6cm up my back passage.
The Colorectal Surgeon came to see me and said I was taking this all very well. (I guess at that point he knew more than me) He explained the grading of tears and basically this was the fourth degree, I would need a stool softener and perhaps a donut pillow. I remember being so sad and worried, I didn’t want visitors, which wasn’t like me. I remember my parents coming to visit and I broke down and cried. Nobody really knew what to say. I had a physio come see me to say we will need to do some appointments together in the future so we locked in a couple of dates.
Once I left the hospital I struggled. The stool softener made things messy and I didn’t realise this was going to happen. I had to sit on a donut pillow. I had to look after a toddler and a baby while my husband returned to work. I had physio appointments that I would struggle through and breakdown afterwards and eventually breakdown during. No one seemed to understand my struggle. My husband would work late on weekends and come home to find me crying my eyes out and a blubbering mess, especially the night I Googled 4th degree tears and saw what I must have looked like. That really hit home. I was at times faecally incontinent and could not control my wind and was embarrassed. I had people laugh at me when I would tell them, so … I stopped telling people, friends, and family. No one understood and it was just too painful, I felt ashamed of my body.
bith after birth injury
A couple of months later I went back for a check up as I wasn’t feeling great, the hospital gave me an appointment with their psychologist and she seemed to think I was suffering with PTSD and anxiety which was probably associated with the birth. The psychologist advised me to go and see my GP and get a referral to see a psychologist. This confused me and I felt pushed away. Why couldn’t they keep seeing me? They have all my details and information.
The psychologist was kind enough to direct me to a good GP in the area who could support me and write the referral. I had anxiety before this appointment because I knew I had to go through it all again with a stranger. The GP was curious about my physio as I was saying I was extremely anxious for my appointments. I explained the electric current therapy from the device that had to be inserted into my anus. He said Whoa! that sounds a bit like Guantanamo Bay! He prescribed me some valium and off I went feeling embarrassed, and ashamed. 
I did go back to the hospital as I wanted to see someone about some of the comments and treatment and just let them know that I don’t think there was enough emotional support offered but it didn’t really go anywhere. I was told, I don’t think the comments were meant to hurt you.
At around the three month mark I was sent for an internal scan up the back passage at a different hospital. Again, I was confused and I felt pushed away and had to go through and explain it all again. It was at this scan that I found out that things aren’t really going to improve. The lady told me “Oh yeah it’s pretty bad, I know a woman who had to quit her job teaching because she couldn’t control her wind and they used to laugh at her. OMG! I felt devastated. I went home and I broke down, big time. I felt a bit more of me slip away, I felt broken. I wasn’t fixed yet but here they were telling me this is it.
I started seeing a psychologist who specialises in this area, a young woman who hadn’t had children yet who said ” eventually you will get sick of telling your story and it won’t be so painful”. Again I felt confused. I felt like there was something wrong with me and not coping well. That I wasn’t’ good enough.
I needed a check up with the colorectal surgeon from the hospital but needed a GP to get a referral so off I went to tell my story again. I always found myself feeling angry when I had to do this, usually with two kids in tow! The Colorectal Surgeon asked how I was going and I just said good. I didn’t know how to say anything else because I felt everyone just wanted to hear that I was good. He examined me, embarrassing and uncomfortable and a bit messy. He said I would need to continue physio, be careful and probably not be a good idea to have anymore children as just carrying the baby alone would create more damage and weakness. He said I had lost that last line of defence in my bottom and that once those nerves are damaged it never comes back. I can strengthen the muscle within but anything past that can’t be stopped basically. I felt disappointed not being able to have more kids as I always wanted at least three, but after this I was happy to say never again. His assistant told me natural births are the worst and you should always have a C-section… um ok Thanks.
When Bronson was eight months old we moved from Sydney to Newcastle and I had to start up physio all over again. Every appointment and new person was traumatising for me. I hated it. By now I was pretty withdrawn socially, I felt like I couldn’t connect with people and I was embarrassed. I was like so many mothers that just don’t get time to heal and process anything because the little people are just keeping you so busy! I stopped doing physio and just did my own thing and the psychologist was right, I got sick of telling my story.
I started exercising again and noticing what foods would affect me more and avoid them. I couldn’t leave the house until I had been to the toilet and always had to know if there was a toilet nearby. Over time, things improved and I found a routine that works but I still have my worries and anxieties. I worked in a bar for a little while, did some admin for a friend but I always felt anxious and worried if I couldn’t control my wind or needed to go suddenly which never really happened. I was just scared of it. I always thought I can’t go back to work, I’m broken and I felt scared.
The year Bronson started school was very hard for me, we had moved to Melbourne for my husband’s work and it was time for me. I just felt sad, I felt like I had lost so much and was cheated and I didn’t know how to start again, I was tired. It was that year I received a call from the hospital. I was walking down the main street shopping when I answered the phone, I was asked if I was Tracey Duthie and did I have a 3rd or 4th degree tear giving birth at the hospital? I said yes and they went on to say they are looking into handling the support system in a better way for mothers who have this in the future. After a quick chat I broke down and cried on the footpath, everything came flooding back! We emailed a bit and they wanted to know if they could use my story and that they wouldn’t put my name to it. I said yes, but to be honest I felt dismissed, they sent me some info that they could get me more help but once they had my story I never heard from them again... for a long time I just felt anger towards them.
I struggled to stay with friends or go away as I was too self conscious of my imperfections so I pushed people away. 
2018 was a big year, I was getting fit, healthy and starting a new course and seeing I could maybe get somewhere and was accepting and loving my body. 
Then in February 2019 I found out I was pregnant at 42. I was thrilled but devastated, it wasn’t planned just one of those things. Then I found out I was pregnant with twins!
I needed extra help during my pregnancy and definitely checked out a lot but I was trying to remain present and positive because I wanted a better birth experience as well as the months and years that follow it. On the 3rd of October 2019 at 37 weeks ( I was still at the gym at 36 weeks) we had a planned C-section and welcomed our gorgeous baby girls. I wanted to be healthy, fit and strong. I wanted to add to my birthing experience. I wanted it to be a better experience than my last. 
Our girls Rosie and Lena are nearly 11 months old now and somehow, I did it! I got through it, I survived it. I’m still a bit broken but that is what has given me strength to get where I am today. 
I am currently studying Nursing, I work in Aged Care and get to honour and help so many beautiful women who have sacrificed their bodies for their children and had such full lives.
I realise there are a lot of mothers that have had it worse than me and harder times, but when you are in it, it’s just everything, it’s all consuming. I have been reminded of it every day since it happened. It has taught me to be grateful for the unbroken parts of me and that my health is everything and I need to honour and cherish that. 
I have now accepted my body and my situation, I have made improvements and I want to help others. 
I have only just come across your page and the story of April also in Newcastle.
Thank you for everything you are doing for all of these amazing mothers, we need this support and change..

If you would like to connect with a mum who has experienced birth trauma, please contact our Peer2Peer Support service to connect with one of our Peer Mentors.

One Response

  1. I am a Midwifery Educator in a hospital in Victoria. I was looking for birth trauma stories to share with our new graduate midwives and educate them on the physical and emotional effects perineal trauma can have on women and their families in the short and long term. I have found that birth trauma is not widely talked about in undergraduate courses and that awareness needs to improve dramatically.

    As a midwife myself, I am so sorry this has happened to you. I am sorry you were coached excessively during the birth of you second baby for no apparent reason. I am sorry the doctor made you feel like you were being “difficult”. I’m sorry you had to repeat your story so many times and felt that no one was really listening to you.

    Hopefully your story and many others on this page with empower health professional to change how they perceive and approach birth trauma in the future.

    I am glad you have found joy again with your twins. Thank you for sharing your story.

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