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Episiotomy

  1. #17
    chrissy2 is offline Registered User
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    Thank you all ladies for all your advice, I found it all to be very helpful! Wish me luck!

  2. #18
    thanka2 is offline Registered User
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    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.

  3. #19
    geomum is offline Registered User
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    "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.

  4. #20
    Cici is offline Registered User
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    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

  5. #21
    chrissy2 is offline Registered User
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    Thanks thanka2 I will start using the olive oil!

  6. #22
    Koan is offline Registered User
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    Quote Originally Posted by thanka2 View Post
    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.
    Like geomum's situation, getting an episiotomy was necessary for my baby. He was stuck and I couldn't get him out. I had an episiotomy so they could get the vacuum in.

    I don't know where some of these shocking stories of being cut without permission are occuring, but I'd be seriously peeved if I were cut without even being told beforehand. That's disturbing.

    I was given the consent form to sign when I arrived in delivery. I already knew all about it because I'd discussed it at appointments. It's a 'just in case' form. The nurse probably won't know until the baby is almost crowning if an epi will be useful. That's NOT the time to explain the epi and ask you to sign a consent form.

    The drs told me it was not standard practice to do epis. I asked for perineal massage and the nurses did that throughout my labour. Just say you don't want an epi unless medically necessary. I found the drs and nurses to be very amenable and willing to follow your wishes. BTW, I gave birth at POW.

  7. #23
    thanka2 is offline Registered User
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    Info. about episiotomies:

    Episiotomy: Is it really necessary?

    To those women who had them because of medical reasons or because of the health of the baby, I'm not going to argue whether they were actually needed or not--you were there, I wasn't so I don't know--and even if I had been there (which would have been awkward and weird for everyone! ) I may have not known whether it was needed or not.

    What I meant to bring up is that they are over-used and if those attending the birth do other things (perineal massage etc) they can be avoided most of the time. I think that sometimes doctors say "the baby is in distress" as well when they aren't really. It can be a catchall "excuse" for doing what they want to do. For example, the baby's heart-rate decreasing isn't always a sign of "distress"--it is normal for the baby's heart rate to decrease during contractions. Yes, there are truly dangerous situations and if at the time, the doctor cut you because it helped the baby come out faster, then that's how it happened.

    I think it's more of a time thing--not that the baby was caught up on some skin but because time was of the essence, the cutting was necessary to get the baby out--eventually with the right procedures you would have stretched or tore the baby would have come out--however, waiting wasn't an option. That's what I meant by my previous comment.

  8. #24
    FutureHKmom is offline Registered User
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    I had an episiotomy. I had discussed it previously with my obgyn and was perfectly comfortable with her doing it if it was necessary. I think the important thing is to have a good understanding and discussion with your obgyn about it. Also, though the wound hurt pretty badly for the first 4 days or so - by the end of the first week, it didn't hurt anymore. So all in all, it wasn't so bad for me.

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