Can you say no to an episiotomy? - Page 3

[tankgirl73]

Baby #1: Delivered lying on my side, dr cut an episiotomy, I had 4th degree tears and hours of stitching up. Overheard between the *two* doctors working on me, one my OB and the other a plastic surgeon: "Do you think this bit goes here?"

Baby #2, 8 years later. I had those fears of the scar tissue not stretching. Had a midwife, but delivered in hospital, induced, under OB care due to hypertension and possible pre-eclampsia.

Delivered squatting. No cuts, no interventions other than the induction. Baby was out in 3 pushes. Needed 3 tiny stitches - 3 separate, tiny, 1-stitch tears.

Here's the fun part. When I was trying to get up into a squat, the nurse on duty kept yelling at me to lie down, "for the sake of the baby". Hubby, love 'im, yelled at the nurse to let me get up and squat. Nurse, resident, other nurses, all imploring me to lie down, I'm refusing. Finally OB comes in and says it's okay, I'm allowed to squat, as long as I consent and acknowledge that I'm putting myself at greater risk of tearing.

Yeah, whatever.

So a few weeks later my midwife showed me the birth report the OB had written up. "Patient delivered in a squat position. Patient was warned of the increased risk of tearing. Patient did tear and required several stitches."

ARGHHHHHH.... Talk about missing the point...

Anyway, that's my experience, despite my fears my first cut and tear and scar tissue did NOT create greater problems in the second birth. I was planning a waterbirth -- in part to help the scar tissue stay soft. If you can at all manage to labour at home in water and only go to the hospital at the last minute... or even just miss the chance entirely -- it would give a chance to stretch a bit before the actual delivery. But even if you can't, just yell and boss them around, be in charge of YOUR birth, squat and refuse interventions you don't want unless they are really necessary, and an episiotomy is NOT.

I like the "I DO NOT CONSENT" phrasing idea. Perfect. I'd also go so far as to research some of the more recent studies on episiotomies that do indeed show that they are not only unnecessary but make tears WORSE. Make sure you have the journal publication information. Print out what you can. If your ob or the resident nutjob on hand tries to push one on you, hand them the documentation and ask them why they aren't keeping up with current research and knowledge related to their supposed profession. ;p

[WifeofAnt]

"Patient delivered in a squat position. Patient was warned of the increased risk of tearing. Patient did tear and required several stitches."

I guess you "learned your lesson" then.

Sometimes I think the women who just let pregnancy 'happen' ruin it for the rest of us who actually want to be aware and part of the process. I can't imagine not having at least a basic knowledge of something that is going to take up years of my life!!

[caned & able]

Yes, that will learn you!

A woman can refuse any intervention to her body that she wants.

In the hospital, you are on the medical doctors' (surgeons') "turf", so to say, so they are in charge and may not listen to you.

An episiotomy, while not done as much as it used to be, is still considered the standard of care in obstetrics and a doctor can justify doing an episiotomy for any birth.

[kblackstone444]

Originally Posted by tankgirl73

If you can at all manage to labour at home in water and only go to the hospital at the last minute... or even just miss the chance entirely

The thought has crossed my mind, but around here, if, God forbid, I ended up going to the hospital AFTER the baby was born, I'd be on the 12 o'clock news. I'm also concerned because I'm at greater risk of a complicated delivery, and it would be a completely unassisted homebirth. Not sure I like those odds.

[Hannah32]

Originally Posted by jeminijad

I just wanted to mention that IME, these are becoming less and less common. Every OB I interviewed w/my last pregnancy stated that they "did not do routine epis." And I have never heard a peep of one, in either live birth I've had.

I think you are more likely to be fighting a section than an episiotomy!

Just wanted to add that this was my experience. My OB never brought it up at all. She just kept massaging the area, which felt sort of unpleasant. I did tear though, second degree.

[Wittyone]

Originally Posted by kblackstone444

There's gonna be so much to remember while I'm giving birth- I'm gonna be constantly telling them not to circumcise the baby and constantly telling them to keep the baby with me for all procedures and constantly telling them no bottles and pacifiers and constantly telling them to screen my visitors (the baby's father was abusive and threatened to take the baby) and now it occured to me that I will also be constantly telling them not to cut me (in any way!) unless it's a life or death situation. I'm worried that I will be unable to keep up with denying their demands, and I'm also aware of the fact that, even if they mean well, and even if they really do try to do everything my way, it's alot for the doctor and the nurses, etc. to remember.

Not exactly on topic here, but wanted to try to ease your mind about the bolded part above. Circumcision is an elective procedure that requires your consent prior to the surgery - there should be no fight to protect your baby from this!

[Lady Lilya]

Jessica, haven't you heard about baby Mario who was circed against his parents' wishes in a Miami hospital last month? The parents said again and again they didn't want him circumcised. He was in the NICU. They went home for one hour to get a change of clothes, and during that time he was circed.

[kblackstone444]

Originally Posted by Wittyone

Not exactly on topic here, but wanted to try to ease your mind about the bolded part above. Circumcision is an elective procedure that requires your consent prior to the surgery - there should be no fight to protect your baby from this!

Originally Posted by Lady Lilya

Jessica, haven't you heard about baby Mario who was circed against his parents' wishes in a Miami hospital last month? The parents said again and again they didn't want him circumcised. He was in the NICU. They went home for one hour to get a change of clothes, and during that time he was circed.

Yeah, that's part of my concern- it happens, and I do know people who have had close calls, as in baby taken and prepped, only to have the nurse notice there was no consent signed, literally seconds before the baby was to be cut. I don't want my main concern giving birth to be to keep everyone's genitals safe, I want to concentrating on bonding on my new baby!

[Lady Lilya]

My friend in Seattle had his son cut against his wishes too. If I were him I would have made a big noise about it.

[listipton]

Originally Posted by Galatea

One OB I saw said if he didn't do an episiotomy, my labia would rip off. !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

We dumped him that day.

WOW.

[MegBoz]

Originally Posted by Lady Lilya

Jessica, haven't you heard about baby Mario who was circed against his parents' wishes in a Miami hospital last month?

Sure, things like this happen, but I would agree with Jessica that it really isn't a big concern. Besides, AAP doesn't recommend routine circ (sure, they don't explicitly recommend against it, but they don't recommend it either.) It's not so unusual to decline.

Besides, if your baby is always in your sight, you don't have to worry about it. If you're really concerned & maybe baby is in NICU, you can always put a sign on the bassinet or talk to the nurses & make sure they all know.

I agree with others about episiotomy - if a doc wants to do one, he'll find an excuse to do one. Even if you decline, sometimes they do it anyway. It would be difficult to find a lawyer to take the case to court even though it IS medical battery and IT IS A CRIME.

But I think circ without consent is much, much more rare & not something I'd really worry about much.

[kcparker]

Originally Posted by kblackstone444

Yeah, that's part of my concern- it happens, and I do know people who have had close calls, as in baby taken and prepped, only to have the nurse notice there was no consent signed, literally seconds before the baby was to be cut. I don't want my main concern giving birth to be to keep everyone's genitals safe, I want to concentrating on bonding on my new baby!

If you are seriously, seriously concerned about this sort of unauthorized cutting being done to you or to the baby, I would really consider going elsewhere to give birth. You are right, this should not be an issue you have to deal with during birth or postpartum. "Don't cut me, don't cut my baby" is not that hard to understand. If you must give birth at this place, I would advise you to contact the patient representative before you give birth, talk to them about your desire and fears ahead of time, deliver this in writing, make sure it's in your charts, have signs posted in large print in your room and on the door spelling out your wishes. I was kidding before, but now I am serious - write "I do not consent to an episiotomy" in sharpie on your thigh for the birth, and have the baby outfitted in onesies that say something to the effect of, "Don't even think about circing me." Talk with your OB though about practice protocols - maybe you are worrying needlessly?

[Lady Lilya]

I have heard again and again about things being done to babies against parents' wishes. Whether it is circ, vaxes, giving formula or sugar water or pacifiers.

I've also heard again and again about doctors doing unwanted things to mothers during a birth. Sometimes without them even knowing (ie putting something in the IV). Sometimes too fast for them to say no. Sometimes even while they are saying no.

I don't think the fear of unwanted episiotomy is unfounded. That is why I am planning my second homebirth.

[MegBoz]

Originally Posted by Lady Lilya

I have heard again and again about things being done to babies against parents' wishes. Whether it is circ, vaxes, giving formula or sugar water or pacifiers.

I do personally think the fears of unwanted vaxes & pacifiers are warranted. First of all, both are so common & routine - MORE common & routine than circ.

Second of all, it's thought of as "dangerous" to NOT vax! but I do believe most medical professionals are aware there is no "danger" in not circing! (Again, AAP doesn't recommend it as routine.)

& HCPs do things to a birthing mama without (or even in spite of a lack of) her consent because of habit (remember, most mama's never question anything a doc says anyway!) or because they legitimately believe they know best and it's "necessary." Again, with circ, there's no issue of 'blanket consent' which gives an HCP more legal freedom to do things to a birthing mama- it's an optional thing, it's not viewed as dangerous to forgo & even it's not covered by all insurance some places.

I still say the fear of unwanted circ isn't that warranted - and no where near as much as the fear of unwanted epis or other procedures in labor (I agree - that fear is warranted.)

But, again, all this being said, I still think it's worth going on the hospital tour, chatting with the nurses, finding out what common rates are for things like epis, nursery-stays, etc. If only 50-60% of all boy babies are circed in the hospital anyway, I'd be a LOT less nervous about unwanted circ than at a place where 99% of the boys are. That's not to say I still wouldn't put it in the birth plan & remind the OB & the nurses, but I wouldn't let it stress me. Again - I wouldn't let it stress me - just like every time I get on the highway, I'm not stressed about an accident.

As I wrote before, it seems to me this OP is very stressed & anxious about this hospital birth - and all the responders only seem to be affirming that she has legitimate reason to be terrified & expect constant battles. In that regard, this thread is kinda making me sad.

Again, I believe I already wrote it - but while it's true that only the whole American maternity care is an "atrocity" - there are plenty of great hospitals & HCPs out there. It's absolutely ridiculous to paint them all with the same brush! Just as it's ridiculous to say, "You pick a hospital birth, you take the hospital ride." . Yeah, whatever. Just like every Homebirth midwife is caring, & consistently provides woman-centered, evidence-based, competent, & patient care. Right? There are no great hospital births & no horrible HB MWs?