Future Births

This information was brought to you by Queensland Clinical Guidelines.

What is the chance of having a 3rd or 4th degree tear next baby?

The likelihood of experiencing a repeat 3rd or 4th degree tear during your subsequent childbirth is approximately 4% to 8%. It's important to note that the majority of women who previously had such tears will have a normal vaginal birth. However, certain factors increase the risk of another 3rd or 4th degree tear, including:

  • Previous occurrence of a 4th degree tear.
  • Requirement of instruments, such as vacuum or forceps, to assist with the birth.
  • The baby weighs more than 4kg or 8.8 lbs.
  • It's worth noting that having a planned episiotomy (a deliberate cut made in the perineum) during future births does not appear to reduce the chances of experiencing another tear.

After a 3rd or 4th degree tear, how should you birth your next baby?

Engage in a conversation with your healthcare provider to explore whether a cesarean section or a vaginal birth aligns better with your specific circumstances. It's important to understand that there is no definitive right or wrong choice. What may be suitable for one woman might not be the optimal decision for another. Take the time to discuss your personal situation, medical history, and preferences with your healthcare provider. In certain cases, an elective cesarean section might be the appropriate choice if:

  • Your previous tear has impacted your current sex life.
  • You experience distress concerning your previous birth and have concerns about undergoing another vaginal birth.
  • You have previously experienced a 4th degree tear.
  • You currently struggle with controlling flatulence or bowel movements.
  • An endoanal ultrasound reveals a gap in the muscle surrounding your anus.
  • A test measuring the squeeze pressure of your anal sphincters indicates low values.