Episiotomy

[smdenu]

What are your feelings about episiotomies?? Have a lot of you had them?? Anyone w/ a natural hospital birth that didn't???

[duckpondatdusk]

I didn't - I put it in my birth plan to avoid unless abslolutely, positively necessary. I had pretty bad tearing, but it healed very quickly.

[smdenu]

Did you do any massage or anything prior to birth?

[duckpondatdusk]

Not to prevent an episiotomy so much...did get a weekly massage , acupuncture, and chiro for the last 3 months which was really helpful in general.

[smdenu]

Well, supposedly you can massage w/ Olive Oil a few months before birth to stretch and that can help prevent. I am thinking about trying it.

[duckpondatdusk]

Yes, I did that a little, probably should have been a little more vigilant...maybe would have prevented some of the tearing.

[smdenu]

Thanks

[Dandelion]

As I'm currently pregnant with my first child, I've never had an Episiotomy. I am putting in my birth plan that I don't want one. We talked about this today in my pre-natal group. My Hospital rarely does them anyway, but I just want to have my bases covered. I am doing some massage with Vitamin E oil.

Personally I think Episiotomies are one of the most unnecessary surgical procedures done in the US.

[Bot Girl]

I had a vaginal hospital birth, no epi, and only one tiny tear that didn't even need a stitch. I did massage w/ olive oil.

[OneFabMama]

I'd say like MORE than 90% (that is a random number out of my head, FWIW) of episiotomies are "routine" and not necessary what so ever. I'd much rather tear naturally than be cut. Thankfully with my DD I had an OB with a episiotomy rate of like 2% and hadn't done one in years. I did tear naturally. And, my recovery was not hard at all.

Yes, perineal massage helps TONS.

I definitely am not having one with this kiddo because I have a MW and a home birth...so yeah...not a concern.

[kannondicarpo]

I had a natural, unmedicated birth. I did have a small tear but it healed quickly. I did not do any perineal massage but I think this time around I will. I was just too lazy last time.

[diane24]

I had DD in a hospital with an epidural, 2 hours of pushing and no episiotomy. I did tear but that is what I would have prefered anyway.With this pregnancy we are going natural in a hospital but the MW does not do routine episiotomy and knows I would rather tear anyway.

[smdenu]

Thanks for the thoughts. I have an appt. w/ my OB tomorrow and plan on discussing it then. Hopefully he will be ok w/ it!

[smdenu]

When you say tear how much are you talking? Inches?? How painful??

[mhaddon]

I've heard that it's not certain that doing anything ahead of time will prevent it. Kegals, speed and size of baby exiting, and position have to do w/ tearing. I would rather tear anyday than have an episotomy (no way) I have some statistics and reasons why if anyone wants me to share :) JLMK!

[spunkyhomeschoolmom]

I had a home birth and did tear but didn't feel it at all because the baby is putting so much pressure on the area that you don't have feeling there at the precise moment of tearing I think. Anyhow, it healed well and it really was because I didn't wait for the massage to let it stretch. If I had waited a contraction or two I doubt I would have tore but I popped that baby out because I didn't want to fight against the urge to push. Next time I'll try to have a little more self control! :)

[FinnegansMom]

I had a tough birth with my son, due to hospital interventions. (Live and learn). I pushed for 5 hours and he was extracted with the aid of a vaccum. I was 100% against the episiotomy, and didn't get one. I don't believe in cutting down there, to make it "easier" for the ObGyn or whomever. I tore, it hurt, I healed. From what I know, when you tear you tear more naturally and through fewer layers and it heals better. Can't say that's true, I'm no Dr, but having a midwife this time around, I find there are a lot of things ObGyns tend to do as part of "routine" that are not even in the Midwife's vocabulary.

[MyGlorylife]

What are your feelings about episiotomies?? Have a lot of you had them?? Anyone w/ a natural hospital birth that didn't???

my first baby was born in a hos. I did not have anything done to me- praise God:thumbsup: :thumbsup: But I had to be very specific and I had a great DR (who he and his wife have homebirths). Also positioning and the use of compresses can make a huge difference.
Stay off your bum- you can do a lot on a hospital bed. A great position is to raise up the back so that it makes a chair shape. Then get on your knees and you can lean on the back of the "chair" bed for added support and resting. anytime you have part of your body laying remember that that area can not open and stretch. Wether that be your side, bottom, whatever. You want your pelvic region to have complete fleaxabilty this will allow your body to move the baby more efficiently and allow yourself to stretch.
Also in good positions like the one I mentioned about your doula,midwife, hubby, girlsfriend, dr, whatever, can apply counter pressure and hot compresses which can do wonders- especially if you have had episiotmies or tears in the past.
Good luck:thumbsup:

[frogandtoad]

NO episiotomy here with #2 and #3 -- both 'unmedicated' - well, #2 was completely unmedicated, #3 was induced, but no other medications.

This was AFTER a 4th degree episiotomy and add'l tearing with #1, with epidural, vacuum and *finally* forcep delivery :\. My personal feeling is that in MOST cases, they are not necessary. JMO.

[OneFabMama]

When you say tear how much are you talking? Inches?? How painful??

:giggle: No clue. I did not ask. But, my tear required a few stitches. You mean, how painful WHEN you tear -- I had an epi but I don't think you really FEEL it happening. I did not even know it happened until he was stitched me up.

The recovery was not very painful. Obviously some discomfort, but...nothing a little Tylenol couldn't fix.

[happyvegan]

I had one with my first (plus additional tearing from the forceps), and I had a reaction to the dissolving stitches, which resulted in horrible inflammation and pain for a long time. It was...beyond horrible.

I had unassisted homebirths with my 2nd and 3rd baby with no problems. I was upright and kneeling with both (which is almost necessary to avoid episiotomy unless you're super stretchy). No rips/tears at all with either one (my mom told me how she ripped with her third baby after 2 episiotomies and it had me scared to death!). Within minutes of the births I only felt little sore and swollen, and I never took a single tylenol or anything, there was that little pain.

My trick with the first UC was to wait until the baby was crowning and then slowly push my skin over (under?) his head. I envisioned putting a turtleneck shirt on him. I tried just pushing him out first but I felt a burning and was afraid it was starting to tear, so I stopped and tried the turtleneck method and it worked like a charm!

My "trick" with the second was to not let my water break until she was crowning. :giggle2: The water kind of lubed her up, I guess, because she kind of wooshed out with the gush of water. :mrgreen: Seriously, I read that taking extra vitamin c in the last part of pregnancy makes for a stronger bag of waters (so much so that it's not easy to break even intentionally). I did the vitamin c thing, and it worked for me. The no tearing thing was a bonus, as I mainly did it to minimize risk of passing GBS (which I was negative for, but still).

The only person I know IRL that got a substantial tear was my cousin who got an episiotomy first, which then tore all the way into her rectum. It was terrible for her.

[sourpatch_babe]

I had a hossy birth with my first and told them no epi. I did tear but can't even tell you how big my tear was because as the doctor put it: it was so small that he couldn't even count the stitches he put in. It healed quickly IMO (at least, the whole area down there was sore anyways and I couldn't tell what was tear and what wasn't). I did no massage with that one. With second birth we went to a birth center and I did irregular massages (like maybe once/twice a week for the last month and not for the length of time that they say) and had no tearing at all. I used both olive oil and vitamin E oil.

[GrowingUpMad]

With my first I was given an episiotomy because I had begun to tear and it was going in a very wrong direction. I was young (16) and my hips hadn't spread to help get baby out. My 10# son had a 15" melon. In the end I ended up with just over 100 stitches downtown. It was bad!

With my second I tore and ended up with 1 stitch. With my 3rd no tearing. My hossy doesn't do episiotomies as routine, they prefer to let you tear naturally.

[Edensmomma]

Ugh, please don't get an episiotomy unless it's medically neccessary. Routine Epi's are terrible. You don't heal as good/fast as you do with a natural tear. Think of the skin as a balloon that is not blown up. Now make a small cut in the balloon. See how easy it is to tear the balloon in half now? That's what your peri skin is like. The only 4th degree (the worst) tears I have ever heard of have been from episiotomies!!!!!!
I had a small tear with a natural birthing center that was inside a hospital. I healed well.

[sourpatch_babe]

With my first I was given an episiotomy because I had begun to tear and it was going in a very wrong direction. I was young (16) and my hips hadn't spread to help get baby out. My 10# son had a 15" melon. In the end I ended up with just over 100 stitches downtown. It was bad!

With my second I tore and ended up with 1 stitch. With my 3rd no tearing. My hossy doesn't do episiotomies as routine, they prefer to let you tear naturally.

Oh mama I'm so sorry! I read your post and now I hurt down there. Ducky had a 14 inch head and I didn't tore, maybe cuz big bro paved the way?

[njbeachgirl]

I did not have one with DD, I did have a tear (I birthed with a midwife). The tear healed just fine. I never need pain meds or anything after.

Routine episiotomy is almost never necessary. Definitely talk to your provider about it!

The best thing you can do is don't push lying on your back, don't get an epidural, and push when you want to- no coached pushing.

[njbeachgirl]

Thanks for the thoughts. I have an appt. w/ my OB tomorrow and plan on discussing it then. Hopefully he will be ok w/ it!

If he is not OK with it I would seriously consider looking elsewhere. There is no reason you need to be cut as a matter of routine. :thumbsup:

[sweetpeasbowtique]

When you say tear how much are you talking? Inches?? How painful??

With my first child I had demerol and don't remember to much. I do remember all the nurses from the floor coming in and said I am so sorry, I heard you had a really rough time. I was still in and out and was like ??? she came out in like 5 minutes. They were talking about the pain I would indur after the drugs wore off. I had a 5+ tear they translated it to a c section in the wrong place. Her head was stuck and I tore and she even had to "cut" more to get her out. It was awful, the lamps, not being able to walk. I had to get a stool just to get into my bed. I still to this day don't know why it happened. With my other two they cut just a small amount and they repaired it and I was fine. I would prefer a cut instead of a tear, not near as painful and easier to heal from. that is just my opinion though.

[duckpondatdusk]

I just thought I'd add, my midwife started pouring cooking oil into the birth canal the closer we got to crowning and that definitely helped as my water had been broken and mostly gone for a couple of hours at that point. The oiling also helps to move things along. I agree with many pp's that I would clear this issue up with my care provider and make my intentions clear...the practice I used was a team of midwives and OBGyns and we had this conversation up front. They only very rarely will perform episiotomies and only when absolutely necessary (which on occasion probably can be necessary-but truly rarely).

[mhaddon]

Where in Indiana are you? Also be careful, many times they will say they'll only do it if necessary- that should be a big flash for, we do them all the time. They should say they will only do it if you request it type deal or as an absolute emergency and last resort. Most OB's feel it is necessary almost all the time :(

Ok all of these come from the book: "Born in the USA" Awsome book by an OB

On pg. 43 he discusses how an episiotomy is one of the causes of urinary incontence later down the road
pg 56-58 discusses the trouble. Summary an episiotomy is often made b/c it is easier for an ob to sew up b/c it is made w/ a scaple, they often have trouble putting back a natural tear. An episiotomy ignores muscles, blood vessles, nevers, and other tissue which can lead to excesive bleeding, loss of muscle tone, nerve damage, more pain, and eventual problems with sexual intercourse.

Just a few thoughts to throw out :)

[gracefaith]

I had an unmedicated hospital birth and my OB doesn't like to do epis. I tore, but not badly.

[smdenu]

I am from southern Indiana. I had my appt. today and my ob said he does not do routine episiotomies. That made me feel better and I told him my wishes so I am planning on starting the massaging and hopefully things will go well. Thanks for all the stories!!!

[sunnymw]

Didn't have one with Ds1, pushed on my back and ended up tearing a little w/ 2 stitches, recovery really wasn't bad at all, just hurt to pee for a few days.


No epis. this time... UCing ;)

[Bridget Riedell]

Hey sweetie!

The best advice I could give would be what worked for me, and that was to push upright. It opens up your pelvis so much more. I wish I had known with my first two what I knew with my third.

With my first girl, I labored on my back, my cervix swelled up, I had back labor, and I ended up having a nasty episiotomy. It hurt while it was healing. Thankfully, the pain didn't last forever!

With daughter #2, my bag of waters was broke prematurely, and she came so fast there wasn't time to do an e.p. if they wanted to. I tore, but it wasn't nearly as bad as the episiotomy was.

Daughter #3, fabulous birth. I used the birthing bar and pushed in a squat. The circle of fire hurt, but other than that; no pain really. I didn't tear at all and no episiotomy.

I'll be squatting again this time around if all goes well, and I'm going to try perineal massage. I'll be 34 weeks on Sunday.

Good luck to you!

[diane24]

A tear is not staged in inches. It is staged according to the amount of skin torn in the perineum. A first degree tear is a superfical tear commonly called a "skid mark." A second degree tear go through the skin, vaginal mucous, and muscle and is what they cut when you get an episiotomy. A thrid degree tearis a tear in the vaginal tissue, perineal skin, and perineal muscles that extends into the anal sphincter (the muscle that surrounds your anus). A fourth-degree tear goes through the anal sphincter and the tissue underneath it.

[missemily]

I remember it was more irritating than anything. I abused the spray numbing stuff. I forgot to put that i tore naturally. My OB was almost ready to deliver herself . . .

[keegans_mommy]

What are your feelings about episiotomies?? Have a lot of you had them?? Anyone w/ a natural hospital birth that didn't???

I did with my first baby. Doc got impatient and pulled out the scissors and gave me a 4th degree episiotomy (from hole to past the other hole.) and was extremely painful. The scar tissue from that still bothers me and my ODD will be 13 in less than 2 weeks.

Now, I have had 2 other vaginal births and I was allowed to tear naturally, needing only 2 small stitches.

To help avoid tearing or an episiotomy, your MW or doc should be supporting your perineum when the baby's head is crowing AND don't let them make you push! Push when YOU are ready to.

[wryknow]

I've had 2 hospitol births with No episiotomy and No tearing.
I didn;t do any masssaging prior to labor - but I did have a nurse massage me for 20 mins with olive oil prior to crownign with babe#1.

It was in my birth plan to forgo an epi in favor of natural tearing. Thankfully I never teared.

I did spend the majority of my labor in an upright position with my hips ian birth friendly position. And I didn;t push on demand or on count. I pushed as I felt I needed to for as long or as short as I needed to.

[vintagegyrl]

I definitely recommend P. Massage. I did it with #1 and even more dilligently with #2 and it helped a TON. My first was kind of a nightmare birth since I was in labor for nearly 2 days and he was turned, so they had to use forceps and I did have a little internal tearing but that could not be helped. Funny, how he is so stubborn to this day still. :giggle:

My 2nd was larger but much easier and quicker and the Dr. was suprised there was no tearing. :goodvibes:

I started PMassage at 32 wks - starting it again now. I use Burt's Bees Apricot Baby Oil. When u first start it is really uncomfortable but after about 4 or 5 days it starts stretching a little more and u can really massage while pressing down, etc. I do it after a bath or shower at night - when it is warmer and the kids are asleep, etc. I didnt like DH doing it for me, didnt work, bc really u feel what is working, how much pressure, etc.

It's not a guarantee, but at least u are doing everything u can!

[C-MaeMama]

I had w/my dd, was going to tear straight back. Rather episo over that!

[Bella Catalina]

I didn't read all the posts, but I like this analogy... Hold a square of paper diagonally and pull from two corners... it takes a huge amount to tear. Now take the smae piece of paper, put a snip in the top edge, and pull from both corners again and see what happens. An episiotmy puts you at risk for tearing further.

I didn't have an episiotomy - it was in my birth plan to avoid one unless absolutely medically necessary. I did have a second degree tear that healed just fine... tears heal better than cuts in general, and there is also less discomfort.

I had started perineal massage at 35 weeks, he was born at 36, so not enough time to really work and I wasn't doing it every night. The other issue was that I realized what my Bradley teacher meant when she said women in labor are highly suggestible - DS's birth was so quick and so intense that by the time we made it to the hospital, he was born 20 minutes later and would have been born almost straight away but for the fact they told me not to push until the doctor arrived. I planned to breathe through a contraction as he crowned to ease his head out, but it takes a lot to focus on that when everyone is yelling at you to push through the pain.

This time I am starting at 32 weeks, and plan to birth upright... either squatting, or on my hands and knees. Birthing on your back puts a lot of pressure on the perineum. I also plan to have my mw use hot compresses and oil if I do not birth in the tub.

[jessicanashville]

I had a natural hospital birth and chose a doctor who was willing to do extra massaging and longer delivery instead of cut and get the baby out...several doctors around here don't even wait, they cut as soon as you start pushing!!!! I did not tear I was super lucky.

I got evening primrose capsules to do at home massaging but they induced me early so I never got to use them. I read somewhere that sometimes there is a correlation in skin elasticity, if you got a lot a lot of stretch marks when you were preggers you might tear more easily because your skins is less elastic.. not sure if it bears weight but I had no stretch marks and didn't tear at all. :headscratch:
:2cents:

[rlharp5375]

#1 they did a "routine" episiotomy without even asking me first. It was horrible, took 10 stitches to close. I didn't heal quickly and it got infected even with my caring for it following their stupid directions. With #2 I said when I walked in the door, no way, no how. Didn't get one, didn't tear. With #3 I tore slightly, not even enough to get stitches. He was almost 9#s too. With #4 it is in my birth plan, not to cut.

[snelson924]

i had an epi with my dd. but it was necessary. she was 10 wks early and even at only 3 lbs was stuck in my vaginal canal. we had no idea how she would be doing once outside of me and so it was not safe for her to just "sit" in the canal. therefore i had an epi. the whole delivery was emergency though. but i'll tell you this: i NEVER want one again!!! it was horrible to recover from!!!