? for homebirth moms

[mags]

You will have to excuse my ignorance, however my DH asked me a question yesterday about homebirth, and I did not know the answer and it has been bugging me all day! So, I thought I would ask you.

When you have a homebirth, I know midwives do a lot of perineal massage. However, what happens if that is not enough??? Are they allowed to perform an episiotomy or do they let the mom tear on her own? After the tearing, does the MW stitch up mom, or does she have to go to the doctor for that? I know, this is probably an odd question, esp since we will be having our baby at the hospital again (it is, '"ree" since my DH is a hospital employee) but I thought I'd go ahead and ask. I had honestly not thought about this before, and my DH asked the question, b/c last time I gave birth, I did end up with an episiotomy, and I was curious what homebirth moms do in that situation.

[isismama]

Midwives do stitch women who tear. About episiotomys, in most cases it is much better for a woman to tear than for an episiotomy to be performed so I imagine it would be rare for a homebirth midwife to perform one.

[candiland]

My midwife has only performed a couple episiotomies in her entire career. She's had a few moms tear to the extent that an episiotomy would be (third degree), and she knows how to repair. The vast majority of midwives do. They have all that equipment with them.

[Axis]

I don't know if I'm going to answer your question very well, but I will give you my experience. I had my daughter in a hospital and begged the OB not to do an episiotomy...she did, I was very upset and healing took soooo long.

When I had my son at home I didn't want perineal massage, it never felt comfortable IMO. My ds came VERY fast and I just completely relaxed and asked my dh for a hot compress (washcloth). We called our midwife a little too late and she missed the actual birth (kind of what I consciously wanted, but dh didn't). Anyhow, I only had a tiny little tear and she came and stiched it up no problem. My healing was so easy. I think the episiotomy took weeks to heal and the little tear I had took no time at all.

HTH

[WriterMama]

Like the pps said, mws can repair tears and do not do episiotomies unless there is some medical necessity (like fetal distress and they need to get the baby out quickly). Tears are preferable to cuts (and medical opinion is beginning to lean this way, too, I understand) because they are typically less severe and heal more quickly.

HTH

[mags]

Thanks for explaining mamas.

[~Megan~]

not all do a lot of perineal massage, ask yours if she does.

MWs can do episiotomies, at least in my state. And they can suture.

[Amy in NH]

I didn't have any perineal massage during my homebirth. It was a waterbirth, so I don't know if that contributed to my not tearing either.

[iamama]

My midwife said she was a great seamstress and I said "Your hired!"

[ramlita]

My mw didn't do any massage, either. She just made sure to apply olive oil to help DD slip out, and provided gentle support as she emerged. 15" head, no tearing at all.

My feeling is that midwives get better training about how to help keep us intact- actually, come to think of it, they seem far more interested in this as a goal in the first place than most hospital staff :