Episiotomy

[agemish]

after reading what capital went through i dont think i would want any other babies! ouch!
i had an episotomy for both sons and the important part is the way the obs stiches it back which helps heals better and quicker. my second delivery was so much better than the first.
take painkillers and don't be afraid to take a stool softerner for the first week. you'll need to keep the stiches as clean and dry as possible. should take abt 5 days then sit in a salt water bath which really soothes the bottom and dissolves the stitches.
an episiotomy is definitely better than tearing.

 

[jools]

I think it depends on how much you are tearing. I have heard that small tears heal better than an episiotomy. When the tissue from an incision comes together it is a flat surface trying to attach to another flat surface and therefore the two sides have nothing to hold onto, if you like; with a tear the more 'jagged' edges mesh together better. Obviously if it's going to be a massive tear then it would be better to opt for the scapel.
With our third, delivered in Hong Kong, he came out so fast there was no time to perform an episiotomy so I did tear. I had an episiotomy with the first two, as they were both ventouse, and I have to say the recovery after the third was much faster than either of the first two. I had the same doctor stitch the tear, as did the second episiotomy, so for my money I would say a slight tear is better than an episiotomy. As always just an opinion.

 

[barbwong_130]

I had an episiotomy with my first child and was very uncomfortable afterwards. With the next child I tore. The tear was up the line of the old episiotomy and then more. But the healing was much easier than after my first child.

I discussed with my doctor what to do when pregnant with my next child. He told me that mothers usually find tearing heals more easily than a cut and asked me my experience. So we decided not to have an episiotomy unless medically required. But as it turned out I ended up with an emergency c-section. And both my episiotomy and my tear healed more quickly than that!

 

[mmec]

Thank you all for your quick response. With a better understanding, I know my choices and the consequences.

 

[JennyB]

Hong Kong doctors IMHO are really behind modern research in relation to their love of episiotomies. In Western countries they rarely do episiotomies nowadays unless you need ventouse/forceps, and even then not always, because the research is overwhelmingly that women heal better from natural tears. Here they are still treated as standard unless you make a fuss about wanting to avoid one.

I've delivered twice at QMH and both times they wanted me to sign a form authorising episiotomy. I refused. The first time I ended up having an episiotomy because at the time they recommended it I was too tired to argue! It was not terribly painful but the recovery was slow. Stitches kept rubbing on my sanitary towels when walking, and I needed the towels for 6 weeks...

So by the second time I was even more determined to avoid an episiotomy. I asked my private Ob/Gyn whether he could recommend any method to make them especially unnecessary and he said one gadget that been proven to help avoid episiotomy is the Epi-no (do a web search), which is available in HK, although expensive. It basically means that for the last few weeks of your pregnancy doing intense stretching of the perineum, which you could do manually if you don't want to pay for the gadget, but you need to do it intensively. It did the trick for me: baby just slipped out before any medical staff could sharpen their scalpels!

The main point I want to make is that if you don't want an episiotomy, make sure you and your partner make your wishes strongly felt. If you are going privately, choose an Ob/Gyn who believes most episotomies in HK are unnecessary such as Dawkins. If the staff do suggest an episiotomy is necessary, ask them what would happen if they waited a little longer.

Also, don't be too horrified by all the horror stories mothers have told you about their birth experiences! If you stay relaxed and not in fear of pain, you are likely to have an easier experience, and many women do have easier experiences than you have heard described here.

 

[mosmom]

It's comforting to know that not every woman has horrible experiences with having/not having episitiomy. I'm very much looking forward to giving birth i.e. to welcome baby for whatever pain it takes, but the episiotomy issue does worry me. I heard that most women don't even feel the scalpell during birth as they're too much concerned with other things. On the other hand, I heard one story in which a woman's stitches were so bad that the doc removed them and had to stitch again - ouch Really dunno what to expect (I'm gonna give birth in POW).

 

[Seb's Dad]

(written from my husband's account!)

had natural delivery with ds, no episiotomy.

like a previous poster, i did massage the weeks before, and i think that might have had something to do with the fact that although ds' head was in the 110 per centile (if you saw my husband's head you would not be surprised with this news) i had no tearing or stitches.

hope this helps.

 

[Matty]

Just reinforcing again, don't waste your money on an Epi-no, you can acheive the same results with your own hands (or your Husbands) with massage.
It only takes 5 mins a day in the last few weeks.

 

[JennyB]

I'm sure you're right Matty that Epi-no is not essential, but it certainly is useful if you can afford it! Apart from stretching the perineum and giving feedback on how much you are stretching it, it gave me an enormous amount of confidence to know that I had already stretched my perineum to 10cm diameter (approx the size of baby's head) with comfort at home. I knew that the last stage of giving birth was going to be easy, so I could laugh off episiotomy invitations.

Also, I tried manual massage in my first pregnancy, and I obviously had no idea how firmly I ought to be massaging/stretching the perineum. Only using the Epi-no has taught me that you need to stretch the perineum until it STINGS for the skin to stretch properly.

The first time I used it, I inflated the ball to 5cm diameter and ouch! No wonder people who have done no stretching at all often tear or their doctors think they need episiotomies.