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By jhenscott On 02/25/04  

forgot to ask my midwife something last visit. thought maybe some of you might have personal experience to draw upon.
Is an episiotomy a better alternative to tearing or not. I am getting mixed messages.
thank you~jhen



By looloo On 02/25/04  

episiotomy to me seems more prepared than tearing. Are you having an epidural or au naturale? I would think maybe if you were having the baby natural then an episiotomy, if needed, would be best.



By hashbrown On 02/25/04  

my midwife tells me there are exercises you can do to strengthen that area.. in attempt to prevent tearing. (like kegels and squats). Also during the birth you can use olive oil or other oils. im due in august and am worried bout that too.
Congrats and good luck.



By melmelon On 02/25/04  

I would recommend against an episiotomy - tears heal faster. As well, when you tear, you tear the exact amount that you need to....why have something cut a little more than need be?



By blissed On 02/25/04  

Massage and compresses might help you avoid an episiotomy. My health care provider discourages episiotomies because a natural, jagged tear heals better than an artificial slice, and as noted, most women tear just as much as they need to. You may not be able to avoid one if you're risking a severe tear. If you're going to have a doctor attending your birth, definitely ask if and why an episiotomy is being reocmmended; I've heard fourth- or fifth-hand reports of male doctors liking episiotomies because it hurries the delivery along.



By stargirley On 02/25/04  

I had an episiotomy with my first and i'd say only get one if there is no way in hell that thing can come out vaginally with out one. I have scar tissue that is not as stretchy and uuummmm moisture producing as the rest of the tissue down there and it gets sore from sex, and even from constipation. It sucks. I told my current OB that i had one last time and he said we'd do some work during my pregnancy to prevent that this time. I love my new DR. I'm not sure what we're gonna do, but i'm sure stretching and conditioning in the area will be part of it.. Good luck.



By bratgirl On 02/25/04  

My doctor told me that tearing is better as you tear only as much as you need. As for an episiotomy, they tend to cut too deep and more than you need (as they only want to cut once) and cutting can lead several diffenet problems (note: not all epis. lead to problems). However, my doctor said sometimes they are just necessary - ex. when the baby's shoulders are too big and the opening too small.

I am hoping to avoid one.

m.



By sofrosyne On 02/26/04  

I didn't have an episiotomy, but I tore kind of alot (I still say it was my dr's fault, she rushed me at the end and didn't let things stretch naturally). Anyway, I suppose sometimes they are warranted, but I decided after researching it to just tear if I had to and not get an episiotomy unless he just wasn't coming out without one, because there is always a chance you won't tear, and anyway episiotomies are always at least 2nd degree (through the skin tissue and some muscle tissue), and can more easily rip from there (into rectal tissue), whereas if you tear naturally, there is very VERY little chance that you will tear beyond 2nd degree. Plus the whole tear healing faster thing.



By luci_mama On 02/26/04  

One thing I've read that was helpful to me in deciding:

Take a strong piece of fabric and stretch it tightly, trying to rip it.

Now take the same piece of fabric and put just a teeny tiny little nick in the edge of it with a scissors ... see how easily it tears now?

I've read that the metaphor is also true for a woman's perineum: once it's cut, it's MUCH easier to tear even further. Given enough patience, the right positioning during birth, and some planning ahead with exercise and/or massage, your perineum is designed to stretch open wide enough.
The concept that it hurries along labor has been proven false: at the most, it may hurry the matter by 15 minutes or so.

And just think: if you got through labor without an episiotomy and without a tear, you'd be healed SO much faster! (Take this from a woman who spent sigificant time sitting on eggcrate foam and sitzbaths!)
L



By jennymeg On 02/27/04  

I've heard, too, that a tear is better than a cut, but doctors prefer to cut, because it is easier for THEM to stitch a nice, straight line.

Mine was a cut last time b/c of induction and the way it causes things to progress very quickly. I want to do things differently this time.



By SmudgyCat On 02/27/04  

My cousin is a neonatal nurse, and when she did her labor/delivery rotation, she told me she'd never have an episiotomy done if she has kids. She saw lots of complications that made healing take longer, which I think is what swayed her strongly.

If I'm ever in the situation, I think I'd do stretches or massage. Scar tissue is a lot less flexible, and I would think with subsequent births, it would increase the need of having future episiotomies.



By msm On 02/27/04  

male dr.s also used to do epis routinely because with the stretching reduced, post-birth sex was supposedly more pleasureable to the dad. i have to admit that many women i know who opted for epis are thrilled about how tight they still are; they think it has been better sex since the baby. who knows- if they can't compare both ways.
i had "No Epidural" in my birth plan, but also prefaced my plan with a statement that i respected d the dr and would understand if changes in my plan were necessary for the baby's life, but nothing was to be changed for my personal comfort without my approval. It turned out that DS's cord was wrapped around his neck 3 times and they did a major epi to get him out fast- (sometimes that difference of only 15 minutes is important!). my doctor was great though and kept apologizing while she sewed me up.



By moondance1 On 03/07/04  

I did kegels, squats and massage. I don't know if it had anything to do with my lack of tearing but I would like to think it did.

I have a short horror story about the dreaded episiotomy. My best friend had her baby a year ago on the 15th. Her doctor told her that most women 'need' an episiotomy because it is so much better to have a nice controlled cut than a jagged tear that could rip down to her rectum and make her incontinent. My friend isn't the type that reads up on anything so she just let the doctor cut. Well, like most women that get episiotomies she was cut and then ripped some more. When she was stitched up the doctor didn't stitch her up totally straight. If you can imagine a perineum that is like a zipper and one side of the zipper is about an inch higher than the other. Basically she has this weird flap of skin that flaps out of her vagina. She can actually look down and see it when she goes to the bathroom. Also, sex has been pretty painful for her where she has the scar tissue.

make sure your doctor knows you would rather tear... then massage, kegel and squat your heart out. You may not tear at all (although it will feel like you are).

Good luck.
amy



By melmelon On 03/07/04  

geeez...and I thought I was a lousy seamstress..not impressive whatsoever. Just outta curiosity...was it a MALE dr.? I think he needs an episiotomy....that way he wont have to worry about constipation, just ignorance.

When I had my first daughter....I probably wouldnt have torn at all, but the little bugger came out with her hand on her head, giving the middle finger...I wouldnt have believed it if I hadnt seen it in the mirror myself.



By sofrosyne On 03/09/04  

LOL mel that's hilarious

what a way to enter the world :D



By faerie_eyez On 03/30/04  

Something else to take into consideration is that you can't predict how large a tear might end up...often times, if a midwife is forced to use an episiotemy, they make a teeny, teeny cut, not at like the gaping ones in hospitals. Just enough to make a bit of room.



By Eva666 On 03/31/04  

in my opinion, if you're going to go naturally, it's alot less painfull to tear then to be cut. i tore enough to need 28 stitches and didn't feel a thing due to the adrenaline rush and the natural high during actual birth (i did on the otherhand feel a LOT of labor pain). im also a firm believer in it being better for the healing process if its left to tear on it's own rather then forced. i just used a squirt bottle filed with a homemade "healing" tea that helped tremendously.
and as far as sex and tightness goes, im way tighter then ive ever been pre-baby. i dont know how in the world that happened though..



By jennymeg On 03/31/04  

I just remembered something a couple of my friends went through - tearing north instead of south - ouch!



By seventwelve On 04/03/04  

I have nothing to contribute except that I keep clicking this thread, knowing what's here! If I keep reading it, I'm NEVER going to want to have kids!



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