Episiotomy "necessary" for brow presentation?

[MittensKittens]

Has anyone heard of this before? Why would that be the case? Can anyone tell me more?

(They apparently did this to my mom. It was a hospital birth.)

[katelove]

Not as a blanket rule. It's impossible to judge individual circumstances without being there, obviously but I can't see why a brow presentation would automatically require an epis.

[beckyand3littlemonsters]

first i've heard of it is brow presentation when they are born face first (soz if i sound dumb) if so i'm pretty sure the only one of my lo's that wasn't born face first was my ds cameron and i could be wrong as i asked m and he said he thinks it was the back of his head that he saw first but couldn't remember, although i'm sure the mw said otherwise anyway i'm certain caitlin and caden both came face up as this was what i saw first.

[mwherbs]

did they use forceps? shoulder dystocia? or it could be routine in the 60's, 70's and 80's it was standard for women to get an epis
I also wanted to mention that brow is not face but very often converts to face, it is one of widest diameters of the head presenting- and so can slow or prolong birth and the doc may have thought that cutting an epis would speed up the last bit

[notjustmamie]

I know my mw has attended births with a brow presentation and not cut an epis, so it's certainly not a requirement across the board.

[Breathless Wonder]

One of my children (my first homebirth) was a brow presentation, who was also posterior and asynclitic. I pushed for 3 hours, which was completely abnormal for me (I had 2 prior, posterior births- one with 20 minutes of pushing, one with 9 minutes of pushing). I also had a cervical lip that would not go away. The only thing that worked was getting on my hands and knees. It corrected the brow presentation and asynclitic positioning. The baby was born just 3 pushes later, with his cord wrapped around him twice. No episiotomy, no tearing. He was pink and healthy from the get go.

[tankgirl73]

It's probably one of those things that was believed to be necessary at the time, is still believed to be so by many OB's, but research has since shown to be completely unnecessary -- like the VAST MAJORITY of episiotomies.

I was given an episiotomy for DS. He wasn't even that big, under 7lbs, normal presentation... he was just 'stuck' in the birth canal for a long time -- I blame the drugs they gave me (to help me rest before the actual birth and were supposed to be worn off) so I wasn't 'all there' or focused to push well, and the fact that they had me side-lying. Anyway, he cut me, and I *still* had 4th degree tears.

But anyway, yeah, my understanding is that episiotomy was quite routine for just about ANY kind of birth, it was believed it would reduce the incidence of tearing. (It didn't).

[NSmomtobe]

I believe I was a brow presentation. Luckily, my mother had a very patient mw who turned my head slightly with each contraction until I was able to crown normally. She still tore a little when I came out, but she did not have an episiotomy.

[MittensKittens]

Thanks for your replies. I was under the impression that a simple change of position would solve any issues, but of course you "can't" do that in a hospital. or you couldn't at least when my mom's generation gave birth.

[beckyand3littlemonsters]

Originally Posted by mwherbs

I also wanted to mention that brow is not face but very often converts to face, it is one of widest diameters of the head presenting- and so can slow or prolong birth and the doc may have thought that cutting an epis would speed up the last bit

yes realised after i asked, all my babies have been posterior position for labour and birth, probebly why i always felt as though pushing wasn't getting anywhere for the first 30+mins

[bobandjess99]

We're pretty sure ds was a brow presentation for a while, given the bruisey-ridge on his forehead and really slow dilation at the end....i was *forced*, by my body, to get into the hands and knees position (like, literally, it was like an invisible force pushing me into that position, it was surreal) and he was born a few contractions later, facing the right way, with no episiotomy, although i did tear.