Episiotomy

[Matty]

Don't do it unless medically necessary.
I've had 2 births, no tearing.
Babies 4kg and 3.2kg.

You can also google advice on perineal massage. Does the same thing as the epi-no for free.

 

[freddiebiscuit]

It seemed like a fact of giving birth here that an episiotomy needed to be done. When I told a doctor at one of my checkups at a public hospital that I did not want to have an episiotomy unless it was absolutely necessary, she was taken aback. She seemed to say that the episiotomy was routinely done to prevent severe tears from happening. She even drew a picture for me! In many other countries, episiotomies are avoided if possible. I asked that it be done only if medically necessary and had her add those exact words to my file.

For me, it didn't matter in the end, as I had an elective c-section due to a breech baby.

So, stick with what you want with your birth plan - it's your birth, but, as others have said, be open and flexible as things can change (sometimes very quickly).

 

[babymommy2]

That is riduculous that your doctor thinks all first time moms need an episiotomy, completley untrue. I had one due to baby in distress, and I also had a 3rd degree tear as baby bacially flew out of me, really short pushing stage. (tear are graded 1 through4, with 4 being the worst. 1st and 2nd degree tear are the most common types, and heal pretty quickly). I'd say the tear was a bit worse than the episiotomy, but again, it was a 3rd degree tear. Both with the tear and the episiotomy my stitches popped and I ended up with infecitons, so it took longer to heal, about 3 weeks. With the episiotomy sex was very very painful for months, until the scar tissue finally stretched. I think I took advil for pain? The easiest ice pack to use, it to put some water on a maxi pad ( don't soak though) and freeze it. It works well, and not so hard like a regular ice pack, and you need a pad anyway. I also used a herbal solution to cleanse the perineum afterwards that my doula gave me, can't remember the name of it though. ALso if you do perineal massage at the end of your pregnancy you can help tp prevent tears.

 

[Matty]

It really is old fashioned advice, and the majority of private dr's here don't do it routinely.
Be insistent if you don't want one, put it in your birth plan that this is your wish.
It can't be performed without your consent.
If there is a medical need for one, it can be performed very quickly.
Why cut yourself and go through healing when you may not tear at all?
Why have a 3-4 cm cut when you may only have a 1cm tear?

I wasn't even offererd one when I gave birth the first time at QMH, but at PWH the second time, they wanted me to sign a consent form the second I arrived in the delivery room.
I kept saying no, saying I would give my verbal consent if there was a need, and they kept insisting.
In the end I threw the form and pen at the midwife, who then finally gave up.
Of course, my 4 kg baby was born, and I had no tearing.

 

[Janey]

I had an episiotomy performed on me, I don't think she even asked for my consent. She just told me she was going to do it. By then, the baby was about to crown. I didn't even feel it.

But afterwards, boy oh boy did it hurt! As geomum said, it took about one month to recover. And everytime I peed, it burnt like hell. It was so painful going to the bathroom that I held back on drinking water.

Some tips: frozen peas wrapped in a tea towel helped. I also found the donut shaped cushion worked, as well as using a squeezie bottle when peeing. And most of all, take it slow.

My cut healed nicely.

 

[lylee]

i had an episiotomy as well... trusted my obgyn & so let him do whatever he feels is necessary. he did an excellent job & even the nurses commented that they could barely see the cut at all. yes, the first pee was painful, but then it got better day by day... i didn't feel any pain after about a week. i stayed pretty active before/throughout my pregnancy, exercising at least 3x a week so maybe that helped with the recovery?

 

[chrissy2]

Thank you all ladies for all your advice, I found it all to be very helpful! Wish me luck!

 

[thanka2]

I've heard both--

I've heard it explained that getting an episiotomy can lead to a worse tear. I've read this analogy: When they cut you, it is like taking a piece of A4 paper and cutting it with a pair of scissors--making a knick on one side--that cut area is an easier starting point to tear the paper than if you just tried to tear an uncut edge of the paper. So, if you're bound to tear, doing an episiotomy can cause the tear to be even more severe. I've had friends whom this happened too--and they're tear was really severe.

However, if they do cut you and you don't tear further, then that "line" will be easier to sew back together and may heal more smoothly without as much scarring.

For me, I wrote in my birth plan that I did not want to have an episiotomy. I tore. But, I tore internally more than I tore externally (yes, a lot of the tearing of the birth canal actually happens internally). Episiotomies usually only deal with the outter part of the birth canal, not the inner so there was nothing that could have prevented the tearing. I had a lot of internal stitches and a few external.

I've really never heard of a case where an episiotomy was helpful when a baby is in distress--episiotomies are done more for the mother than the baby--usually if the baby is in distress it's from some other reason (lodged in the birth canal and not coming down)--a mere bit of skin isn't going to really hold the baby back, I don't think.

Do you remember seeing some of these old-time movies where a woman goes into labor at home and the doctor or midwife comes and says to the husband, "Go boil some water and get me some clean sheets/towels" ? It is always assumed that the husband is told to boil water to "keep him busy" and "out of the way." This isn't true. The actual function of the hot water and towels is that the midwife would use them as hot compresses during labor to help the skin to stretch and prevent tearing. Most home-birth midwives rarely see tearing at all. They use hot compresses and olive oil to massage the perineum to soften it so you don't tear. (or they did in the past) Warm skin expands better. It's doubtful that anyone at the hospital, including your doctor will do that--and it's probably not a good idea to use the warm compresses too much as they can decrease elasticity in that area anyway (meaning you don't go back to your original shape later as well as you should) but....use olive oil. Start using it now. That area of your body should be just as moisturized as every other part of your skin--olive oil is a good choice.

 

[joyofliving]

"I've really never heard of a case where an episiotomy was helpful when a baby is in distress--episiotomies are done more for the mother than the baby--usually if the baby is in distress it's from some other reason (lodged in the birth canal and not coming down)--a mere bit of skin isn't going to really hold the baby back, I don't think. "

My episotomy was done because my baby was stuck in the birth canal and in distress beacause of it. It was critical to get her out ASAP as she wasn't breathing. Its not just "mere bit of skin" that was cut but deeper tissue and muscle as well. I have stiches deep inside my birth canal just as you do besides the 4 stiches outside.

 

[Cici]

I did perineal massage and used the epi-no for my first child- no need for episotomy or any stitches at all, plus I had a very understanding doc as well