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Episiotomy


Forum: January 2013 Playroom

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  #1  
September 25th, 2012, 11:42 AM
Lil_Mama2B's Avatar Veteran
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I'm so full of questions today

So whos getting one? Who isnt? Why or why not?
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  #2  
September 25th, 2012, 11:44 AM
MammaWannaBe's Avatar Mega Super Mommy
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I was under the impression that, that was something you only got if needed. All I know is I am SO not getting an episiotomy if I don't have to! No thank you sir! But if I need it and if it looks like I will tear then heck yes, cut before ripping!

Is it really a choice you have in the matter though? I'm not sure to be honest
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  #3  
September 25th, 2012, 11:47 AM
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I was never asked if I wanted one. From what I was told, its better to let your body naturally tear on its own, if needed.
When DD was born, I had a 3rd degree tear. Basically, I ripped from hole A to hole B. I had at least 20 stitches. It was a long, painful recovery and something I was unprepared for. Then again, I dont know how you would prepare for something like that?
This time around, I'll take the same approach. I'll keep my fingers crossed that I dont tear again. Hopefully I'm more stretched out down there after already giving birth once?
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  #4  
September 25th, 2012, 11:57 AM
Lil_Mama2B's Avatar Veteran
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I assumed it was a choice they give you. I have been looking up birth plans and every one says" I do or do not want an episiotomy." I guess its differs with every caregiver maybe?



Quote:
Originally Posted by LadieBug View Post
I was never asked if I wanted one. From what I was told, its better to let your body naturally tear on its own, if needed.
When DD was born, I had a 3rd degree tear. Basically, I ripped from hole A to hole B. I had at least 20 stitches. It was a long, painful recovery and something I was unprepared for. Then again, I dont know how you would prepare for something like that?
This time around, I'll take the same approach. I'll keep my fingers crossed that I dont tear again. Hopefully I'm more stretched out down there after already giving birth once?
and OMG I cannot imagine what that must have felt like!!!! I hurt just reading that! I'll definately keep my fingers crossed for you that you dont have to go through that again!
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  #5  
September 25th, 2012, 12:01 PM
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Eek, no no no! No way will I get an episiotomy. According to everything I have ever read/heard, it is much better for your body to tear on its own rather than being cut, and you will heal better and easier. I have torn with both of mine so far, it's just part of it and I am sure it will happen again this time. I'm not very worried about it. That's what the numbing spray and peri bottle are for, lol.
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  #6  
September 25th, 2012, 12:03 PM
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Not something I need to think about since I will have a c-section, but if it were I would chose to tear on my own.
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  #7  
September 25th, 2012, 12:05 PM
MammaWannaBe's Avatar Mega Super Mommy
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This is really interesting because I've heard it's better to cut than to tear. Gah can't we have a universal rule book on some of these things?
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  #8  
September 25th, 2012, 12:08 PM
Lil_Mama2B's Avatar Veteran
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At one of the birthing classes I took the nurse said it is better to get cut than to tear because with the cut it shows you where to tear. That if you don't get cut and allow yourself to tear naturally the tear does not always go back throught the perinium that it can actually go through your urethra and clitoris
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  #9  
September 25th, 2012, 12:12 PM
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I really didn't know if I had a choice and I guess, since I was afraid to think about it, I just never asked. I did wind up getting one and I really don't like how it turned out. Now I knew that, cosmetically, after having babies that it will never look the same down there- that I could care less about. But what made me mad is that once DH & I started having sex again, one of my fave positions (my feet up on his shoulders-sorry if TMI!) hurt like hell right where I was stitched up! We gave it plenty of time to heal and it still hurt. Gave it more time and still, 6 years later, it hurts every time. I would be willing to bet that if I'd just torn naturally, I wouldn't have this problem but I really don't know.
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  #10  
September 25th, 2012, 12:26 PM
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I'm a little freaked out by the fact that someone is going to cut something down there, I'd rather tear on my own. I'm going to try the massage approach to the whole trying not to tear. I read that 15 minute perineal massage with some lube can help soften and stretch the skin down there decreasing the risk of bad tearing. I'll find out if it works.
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  #11  
September 25th, 2012, 12:39 PM
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Quote:
Originally Posted by swaddlestar View Post
I really didn't know if I had a choice and I guess, since I was afraid to think about it, I just never asked. I did wind up getting one and I really don't like how it turned out. Now I knew that, cosmetically, after having babies that it will never look the same down there- that I could care less about. But what made me mad is that once DH & I started having sex again, one of my fave positions (my feet up on his shoulders-sorry if TMI!) hurt like hell right where I was stitched up! We gave it plenty of time to heal and it still hurt. Gave it more time and still, 6 years later, it hurts every time. I would be willing to bet that if I'd just torn naturally, I wouldn't have this problem but I really don't know.


Thats EXACTLY what I dont want, with the epi it can cause scar tissue that can hurt years later. I'm sorry that sucks big time. Gives you a chance to be creative and try out other positions as your new favorite!
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  #12  
September 25th, 2012, 01:33 PM
Lucky Mama's Avatar Platinum Supermommy
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No way would I get cut unless absolutely necessary (you must have an episiotomy if you have a vacuum or forceps delivery). It usually varies from doctor to doctor, but the more widely accepted standard now is that is should not be done routinely.

I tore with both my babies (8 lbs 15 oz and 8 lbs 2 oz), but I didn't need any stitches. My first tore up toward my clitoris (sorry if TMI). It was not pleasant, but it was so small it wouldn't have even fit one stitch. My second, my daughter was a thumb sucker and had her hand by her face during delivery. I tore on the inside of the birth canal with her, but I didn't feel it at all. My midwife said she could stitch it up, but at it would likely heal on it's own fine. I opted out of stitches and never had a problem. My worse tear was from my smaller baby, so it's not always a size thing, either.

I think of it as why make a deep cut through ALL the layers of tissue to prevent a tear that may or may not happen (and may or may not go through all the tissue layers - some tears are superficial and heal up well all on there own)? Seems silly, IMHO.

Not to mention that you may still tear even if cut. Sometimes the cut actually makes it worse. It's like trying to rip a piece stretchy fabric from the middle with your bare hands. You can pull and pull all you like, but it won't rip until you make a tiny snip. Then all the integrity of that one, unified material is gone and it will tear very easily at that weak point. The birth canal is one, unified collections of tissues. It's meant to stretch and is actually very strong. Tears happen, but it seems you are more likely to have problems (with this birth and subsequent births) if a cut is made preemptively.

Plus, once you have one, you will likely tear along that scar every time and the scar tissue can make sex, going to bathroom and even sitting very painful (sometimes that goes away with time, sometimes not).

I would check and see if your doc does them routinely. Whether you want one or not, it should be your choice (barring an assisted delivery), so if your doc insists on doing them on everyone regardless, that would be a red flag to me. On something that has not been proven to have a lot of medical benefits, the choice should rest with the patient, IMO.

Wow. That was long!
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Last edited by Lucky Mama; September 25th, 2012 at 01:40 PM.
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  #13  
September 25th, 2012, 01:49 PM
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I use a birth center and midwives, and they don't do an episiotomy unless absolutely necessary. Their rate is in the single digits. I'm in agreement with their philosophy.

(I had a borderline 2nd/3rd degree tear with my daughter).
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  #14  
September 25th, 2012, 01:51 PM
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I will 100% opt to tear rather than be cut.

With DS I tore in 4 places, and did have some stiches, but after a few months it healed just fine and down there feels normal now. And honestly, if I hadnt' pushed him out so darn fast, and he wasn't posterior, I doubt I would have torn at all.
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  #15  
September 25th, 2012, 02:15 PM
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This is all really interesting! Thanks for posing the question Lil Mama!
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  #16  
September 25th, 2012, 02:34 PM
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i wasnt given a choice but last birth i tore (a horrible tear) and it took months to recover. I imagine a clean cut might have recovered better.
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  #17  
September 25th, 2012, 02:37 PM
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I guess I'm the odd person because Ive always heard its worse to tear because it is uncontrolled and jagged. An episiotomy is straight and small and stitched right away. I had to have one because my son was born face up and I wasn't able to get him out. I healed fine and have no issues at all. I would MUCH rather have this done than to tear.

I find that "online" people almost ALWAYS have a completely different opinion than "real life" friends. I'm not sure if it's that "all natural" people are more likely to join online forums or what...lol....but if I ask my real life friends a question, it's always the complete opposite consensus of what I will get from online friends. So just keep that in mind!
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  #18  
September 25th, 2012, 02:55 PM
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I had one with my first and it was a 2nd degree. I elected to not have one with my second if needed and didn't end up tearing at all. I sometimes think the doc does it just to make it easier on himself when it's not really medically necessary.
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  #19  
September 25th, 2012, 04:05 PM
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Of my mother, grandmother, two sisters and an aunt I have spoken to about this, four were cut, one sister and myself tore naturally. we obviously all have very similar genetics, obviously. the ones who were cut all have had issues with incontinence and painful sex, one has had a uterine prolapse. the two of us who were not cut have had none of these issues.The research agrees that being cut is a bad, bad thing in most situations. Henci Goer has a couple of books that go into it I. detail. a cut may have cleaner edges, but that doesn't actually make it easier to stitch. rather, it means that it is more likely to be stitched crooked because you can't see where it's supposed to fit together (I've had some suturing experience). and a cut will *always* go through muscle, whereas the vast majority of natural tears are superficial and through skin only.
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  #20  
September 25th, 2012, 04:08 PM
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I get squirmy thinking about someone cutting my down south at all. With my first DD I tore up towards my clitoris (they had me flat on my back and wouldn't let me change positions), and it didn't heal all the way because my ex wouldn't listen to the recovery time rules at all.

With my second DD I didn't tear at all, but I worried I might. With this baby I would rather avoid tearing or being cut. I know that massage with lube or oil in the final weeks before hand can help stretch things. It seems like it would be a fun thing to try during DTD sessions, since it could become foreplay easily enough. I am on pelvic rest until further notice this time around, but I am hoping later on regular lovins sessions with my DH will keep things nicely stretched out.
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