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I think you should ask your doctor about it. After a c-section, you get terrible gas pains...I can't even describe them, but they're bad. I don't know how that would affect you, but no one tells you about them before you have a c-section.

Jbear, thanks for your advice. My thought is where I already have damage to the anal area in the form of an anal tear or fissure that I cannot risk being further torn or possibly cut surgically by a doctor if he or she had to perform an episiotomy or even if I tore naturally. I assume the gas pains after a c-section would eventually go away but at least there would be no direct damage to the anal sphincter muscles in the form of a surgical instrument or by a natural third or fourth degree tear. As these types of cuts or tears can extend to the anus. It took almost a year to get my fissure until control and that was with me being careful and I am still not one hundred percent now. Once a person has had an anal fissure they are more susceptible to developing one again. So a surgical cut or a natural tear on top of the damage I already have would not be good for me. I mean sometimes when I have gas now I soil my panties but at least I still have control over my bowels.

It sounds like you might fair off better with a c-section where you seem to have anal damage already. Even if you have complications from the c-section, you will most likely not end up with fecal incontinence like you may if you have a difficult vaginal birth. You have to weigh the pros and cons. But as Jbear suggested ask your doctor about it as well.

I was looking for some more info for you and found this: http://boardsailor.com/jack/af/
I don't know if it will have any info that is new or helpful to you, but if you scroll down some, there are some stories about people with anal fissures before and during pregnancy, and what treatments they used. The gas pains after a c-section are along the incision line (above your pubic hair). They go away after a day or so. The overall recovery from a c-section is pretty painful, but I've never had a vaginal birth, so I don't know how much that hurts. I'm sure with your medical history your doctor would probably agree with you that a c-section is necessary (important if you want your insurance to pay for it).

Olivia, considering your medical history and your age, go for the c-section. If you are having problems now, your fissure issues may get worse or lead to total incontinence if you have a complicated vaginal delivery. I am not a doctor but I think most would agree that a c-section would be best under your circumstances.

i had a partial 4 th degree tear with my first and had a c section this time, and I'm so glad. the recovery was minimal and I'm shocked by that. I healed very well.

Olivia, My first pregnancy I delivered vaginally. The Dr. had to do a 4th degree episiotomy with my 5lb.5oz. baby. I did develop an anal/vaginal fissure from the birth. I had surgery 6 months after to correct this but still am not 100%. My OB recommended cesarean birth for later births to keep from damaging myself further. I also felt that it was too much of a risk to deliver my second child vaginally. I opt'd for the cesarean and it was very painful, but only for three days. My second ceasarean was a breeze. This outweighed the possibility of a lifetime of problems delivering vaginally. My advice would be to be well informed of all possible complications by discussing this thoroughly with your OB.

I think you should definitely have a c-section. I had third degree tears with the birth of my only child and developed anal fissures. The fissures are a great cause of depression for me and I have even had surgery, but they are still persistent. I don't know if I'll ever have another child, because my body is still traumatized. Do yourself a favour and have a c-section. Natural childbirth is seriously overrated and the pressure to have natural childbirth borders on misogyny. Good luck.x

girls, what kind of surgery did you have? I was told I shouldn't be operated on.

KH, my circumstances may have been different than yours, not sure. I had to have surgery because of the serious risk of infection I could have been facing. I will try not to be too graphic but during my vaginal birth and the 4th deg. episiotoomy and possibly an internal tear, a hole never healed between the anal canal and vaginal canal. Imagine what this caused! So if anyone is experiencing this, explain all your problems to your dr.(no matter how embarassing it may be). Angel

Oliva, considering your medical problem of anal fissures a vaginal delivery should not even be an option for you and any doctor who recommends that you try a vaginal delivery is only trying to cut down on the c-section rate and is not thinking of your best interests and future well being. If you have a difficult vaginal delivery you could end up incontinent and since there is no way to predict beforehand if the delivery will be difficult spare yourself and go for the section up front. In your case, a c-section IS medically necessary. Any doctor should realize this.

another thing to add to the pt- i had a small issure 10 years ago that wentaway with a bit of cream...now with the weight of my belly(i am petite) it has gotten muchmuch worse than ever and will just start spontaneously bleeding and seems to be ripping a bit more when i sit too long!!ouch!! i never expected this!!!!

Olivia, you may fair off better with a c-section. You sound like you would need one for medical reasons and considering your condition, I doubt that your doctor would deny you a section.

It sounds like you already have structural problems in the vaginal/anal area and must be cautious how you deliver. I think a c-section may be in order for you. I think you have to really discuss this at length with your doctor as c-sections can cause adhesions to form in the pelvic/anal area and heaven forbid you get those finger-like projections attaching around your fissure site! Then every time you moved or twist they could pull on the sides of your anal area and perhaps make things worse. Good luck and be careful, thoughtful and well-informed.

Oliva, I agree with mrs. cooper, have a c-section. It would probably be your best option.

I am not a fan of c-sections by choice, due to nearly dying from one, but in your particular case and from a nursing standpoint, I think you may be one of the ladies for which this operation is appropriate. You never know, you may have an entirely adequate pelvis and vaginal canal, an in depth discussion with your OB and an absolute identification of where your fissure is sounds in order. Good luck.