episiotemy vs. none vs. tear - what's it like after the baby? - Page 2

[ramlita]

My DD was ten pounds, eight ounces, with a 15" head.
I birthed her in an upright position, and did not tear at all.
I was sore for a few days, but felt better really quickly!

It seems that the less a mom is messed-with during labor, the better chance
a) the hormones that help this brief stretch happen well will be able to do their job, and
b) mom will choose a position that works well not only for pushing, but for letting baby come out in the best way for her body

Drugs and stress during labor mess with labor hormones, and being pushed down on your back to deliver means that an undue amount of pressure will be applied to your perineum, greatly increasing your chances of tearing.

For everyone I've known, tearing is much better than getting cut, if those are the only options.

[LoveChild421]

I just had my baby a week ago and I didn't tear at all- the female body is really amazing- I was even pushing really quickly and didn't slow down to pant at all when he was crowning- I was upright in a squat on a birth stool though which I think helped a lot. I had some brusing but that's all.

I could easily have sex right now if my bleeding had stopped. And it's not loose by any means :LOL

I would say that Kegels really help-I did them religiously throughout pregnancy- and having sex helps too- Ina May Gaskin reports that women who stay sexually active during pregnancy tear less often- and that was true for me.

Basically I would never have an episiotomy because if you risk tearing at least you have a chance at an intact perineum which will produce the best possible sexual outcome- muscle gets back to normal faster and no chance of painful intercourse from scar tissue. If you have a slight tear it's still much better than an episiotomy- with an episiotomy you have an automatic 2nd degree laceration which involves the muscle- the muscle is what makes sex enjoyable and what makes your vagina go back to normal.

The best way to avoid tearing and make an episiotomy totally unnecessary is to not give birth on your back- there's just too much stress on the perineum when you're on your back.

[USAmma]

It took me a good 6 mos. to recover from my 2nd degree episiotomy. I had a very hard time with sex, passing bm's. It took me over a year to be able to comfortably use an in-vaginal menstrual product. (The epi was done b/c Abi's h/b remained at 40 for several minutes. She was born screaming and alive and well.)

When it was time for Nitara's birth I said no way do I want any scissors near my body, I'll just take my chances with tearing. I tore just a tiny bit to one side, and it did not need stitches. I was fully healed and not sore anymore after just 2 weeks.

I had epidurals/back delivery with both.

[Artisan]

I think we can all agree that no tearing, no episiotomy is what feels best after the birth. My second choice would be to tear, absolutely. I would only have an episiotomy if the baby's life depended on it.

I think the best way to avoid serious perineal trauma is to avoid an epidural and to avoid giving birth in a position that puts pressure on your tailbone. (Standing, squatting, on your side, in the water --- all better than reclining or semi-reclining. ) These positions can create 30% more room in the pelvis, which for some women, is all they need to avoid an epi or a C-section. Even with an epidural, a mom can still push on her side, with someone holding her top leg up.

[scrapadoozer]

I had a small epi with dd and must've gotten lucky or something because it has never caused me one bit of pain. I am pretty sure it was not necessary though (the OB said I had an unusually thick perineum) I birthed on my back with no pain drugs whatsoever. We resumed sex at 5 weeks PP with no issues. That said, if there is a next time I will not get an epi unless absolutely necessary.

[e&r]

I had a homebirth to hospital transfer and I told the very interventionist doc that he better not cut me, I'd rather tear. Of course I would rather not have torn, but he wouldn't let anyone support my perineum (sp?) and it was one issue I wasn't going to fight with him about (long story) so I did tear, and badly (they tell me) *but* I healed in about 4 days (really) and was feeling "normal" in just a few weeks. Not lingering problems and all is well with "relations" with dh

I have heard mostly horror stories about epis with long healing times from friends and relatives.

I would take my chance again, but this time I will make sure to have someone help me to reduce my chances of tearing.

Good luck,
Ellen

[*Erin*]

i had an episiotomy, and the sex would be much better if my vagina had been left intact and left alone to do it's job. i have a loss of sensitivity around the scar, and my anatomy just feels "wrong" now. like my perinium is up too high. i haven't read the replies, this may have already been said, but you know when you make a cut in a piece of fabric, how you can then tear it really easily? it's not so easy to tear a piece of fabric that has no cut in it. same thing with your perinium. the incision and the tearing that can result from it is usually worse than if you just tear. mine was.

i wouldve rather have torn than had the episiotomy, but it was never discussed b/n me and my ob (mistake.mistake. mistake)

he tells me, as i'm pushing out 8lbs15oz of baby, uphill in the lithotomy position, with the knowledge she passed meconium and could die running thru my head, and he tells me "you're either going to tear wide open or i can make a tiny cut, which do you want?".
oy
under diress, i chose the cut, and it was horrible. the stitching up afterwords was more painful and uncomfortable than anything else during labor had been. i took heavy pain meds for 2 weeks, and it took me 7 months before sex was even possible without extreme pain. it was another 5 months after that before i got any kind of pleasure out of sex.

what wouldve helped me was birthing upright, and birthing at my own pace, listening to my own urge to push, without people yelling at me to "PUSH PUSH PUSH".

[applejuice]

Tears usually happen because the woman is laying flat on her back, and the doctor does to bother to massage the perineum or allow it to stretch...doctors have no skill in this regard because they are not trained that way...they are first surgeons, and obstetricians are usually men, so what do they know or care?

If you go to a surgeon, you are going to be cut.

I had four children at home; two with a homebirth doctor and two with his midwife. I never tore, and the soreness from the delivery lasted only a day or so. Sex was never a problem. We usually resumed within a week...

[Aura_Kitten]

well... i've never had an episiotomy...

i tore very badly w/ my 1st, icluding a cervical tear + tons of stitches... we waited about 2.5 weeks before making love... and it was awesome. (can i say this at MDC?) it was absolutely some of the best sex ever... *because* i was so loose, and sensitive... it was awesome. my partner didn't think much of it... but the intimacy was nice i guess... and WOW it felt good. even with the pain.

then fast-forward 4 years and many kegels later... w/ my daughter i had an au naturelle home birth, no tearing at all... we made love the night after she was born. : which was also nice, but much more painful. i'm not nearly as... floppy... as i felt after my son's birth, and i feel... smaller. i loved my pregnant yoni ~ all full and ripe... my whole body was just brimming with fertility. i'm still getting used to my post-partum body & it's been 8 months. however, the sex is better than ever. & my partner & i are more connected than we ever have been.

Our bodies are designed to give birth. Our perineums are meant to strech to accomadate the head of a baby and then return to almost its same shape as before. Of course it wil never be virginal, but its pretty darn close.

[SaraC]

I had three episiotmies that tore to the 3rd degree with my first DD. We were a homebirth transport after about 10 hours of pushing. She was malpresented and I ended up with a vacum extraction. My recovery was terrible and it took me many months to heal emtionally and physically from it.

With DD #2 I gave birth to a bigger baby in a free standing birth center(no homebirth MWs around) and had a small skid mark. I gave birth on my back(my choice) and I recovered great. I could sit, stand, poop, pee, and even felt like sex within a few days.

[cottonwood]

If she opts to allow a doctor to do an episiotomy, she can assure herself of painful sex for a good long time. If she opts to not allow a doctor to have his hands anywhere near her vagina, and she doesn't do directed pushing on her back, her chance of tearing is very low and her chance of tearing into muscle (which an episiotomy always does) is almost nil. To me, this is a no-brainer.

As to whether the vagina will become permanently stretched with birth over an intact perineum -- that is a silly myth, and shame on her doctor for perpetuating it. But look, if she really believes it, why not at least wait until there is evidence of it before making surgical changes? There is no harm in waiting for that evidence, but there is certain harm in an episiotomy.

FWIW, I have given birth four times, and my vagina feels no different to me than it did before I ever gave birth.

[sohj]

I didn't want an episiotomy but was forceably given one that tore me right open into the anus -- cut open like a chicken with a cleaver.

The resulting rip (that the episiotomy was supposedly going to prevent) was stitched badly....it had torn through a lot of nerve endings and slightly into a muscle. When it was sewn up, my sciatic nerve from my right leg was trapped in the scar tissue and a ligament on the left side of my back was also somehow affected (I'm not an anatomist, so I can't remember the details).

I was in excrutiating pain for months until I finally found a doctor who (a) acknowledged that I was obviously in severe pain and (b) figured out what it was and how to solve it.

I had surgery to correct it.

I still go to physical therapy. This happened three years ago.

Because of this, I deeply regret the whole experience and my husband has had a vasectomy.

[A&A]

I had an episiotomy with a 7 lb. 5 oz. baby, and a slight tear with a 8 lb 6 oz. baby. The episiotomy was SO MUCH WORSE! OMG!! (And I tore additionally on top of the episiotomy.)

Also keep in mind, as others have said, that the WAY in which you give birth determines how much room the baby has to come out--giving birth on hands/knees, for example, allows for much more room.

[HelloKitty]

Guess I'm in the minority - I've had 4 episiotomies and had no issues w/ any of them. Recovery was quick, sex has been just fine, etc.

[mezzaluna]

i had 2nd degree tearing -internal and external - with an unmed hospital birth - 20 minutes of pushing, 8lb14oz baby, was sitting reclined, pulling my legs back (and having them pushed back by the ob and nurse). the ob had tried to do perineal stretching - i don't know what the heck she was doing but it hurt!! little did i know the stitching hurt even worse!!

the pain i was in for my recovery was manageable with lots of ibuprofen - i refused the offer of a percocet rx. but, it was painful to sit for about a month afterwards - and it especially interfered with getting bf'ing established since i couldn't sit and we took a while to master side-lying latching.

dh and i had sex once - at 7 weeks pp - it hurt some - not terribly. but my libido is shot still. i guess i'm also still a bit scared of pain...

oh yeah - fun fact - my OB said later - you tore just where i would have done an episiotomy! for all the bad things i could say about her, she did follow my birth plan!

[wasabi]

Originally Posted by blueviolet

If she opts to allow a doctor to do an episiotomy, she can assure herself of painful sex for a good long time.

I'm sorry this is just not true. I totally agree that not getting an epis means you at least give yourself the chance of not having an injury to your perinium and that a tear can be much less serious than even a basic epis but not every woman who has an epis has painful sex for a good long time. Several of us have posted to this thread alone and said that we had epis and did not have painful sex. On the other hand several of us had very drastic tears that did lead to long-term painful sex. It is one thing to say a tear is likely to heal better, more quickly etc but it is entirely different to guarantee that she will have a certain outcome when many women do not have that experience.

[wasabi]

I do want to add that I know just how the person who talked about pushing uphill felt. With #3 they had me flat on my back with my pelvis actually turned up to the ceiling. Here they are literally telling me to push my almost 10lb baby up towards the ceiling. Um yeah that's easy to do let's not use gravity at all.

[Yummymummy74]

[QUOTE=Full Heart]Our bodies are designed to give birth. Our perineums are meant to strech to accomadate the head of a baby and then return to almost its same shape as before. Of course it wil never be virginal, but its pretty darn close. Just don't look at it too soon after birth Michelle/QUOTE]


:LOL I have to comment on this! LOL I have never had an episiotomy and my first baby was 10 pounds I am convinced that perineal tissue stays much more toned by not being cut... I gave birth to my last baby in Dec /03 and I did look at my perineum an hour after she was born and it looked NORMAL! no swelling.. no bruising no grazing.. just normal in fact I was amazed dd had just popped out of there! :LOL I have had sex as soon as 8 days after my babies are born.. I feel good so why not right? I also have a theory that Kegals while great are not a substitute for actual sex.. I think sex and actual orgasm are likely the absolute best toners! and when you think about this it really makes sense, I do not notice a difference in my sex life before babies and after 8 babies :LOL of course your mileage may vary.

[*Erin*]

(((sohj)))

[cozymama]

((((((Sohj))))))

When I was pregnant I found out two of my friends had episiotomies against their will (not wishes- against their will, literally). They/I liken this to sexual absue and thus when I looked for a midwife I made this a clear part of my birth plan. I had a tear that required a few stitches from my midwife. Honestly I was fine with it-- I don't think there's anything I could have done to prevent the tear, my midwife, support person and doula all did a wonderful job helping me stretch, I just think it was meant to be.

I took no pain relivers and was fine-- really, I know this sounds weird with stitches and all, but honestly I didn't have pain beyond the slight burn when peeing for 24 or so hours.

The only issue I had was that I had to really fight off the nurses (I had a CNM birth in a hospital) to examine the stitches. I think I may have screamed at one woman, honestly : but it felt very private.

Personally I would never chose an episiotomy for the reasons other women mentioned- tears heal faster and quicker and "preventative" epis are usually only good for the doctor. Plus, being a survivor, it would feel like too much of a violation of my body.....

I saw two midwives, at a hospital, and between them they did 2 epi's in the year before I saw them- both were requested by the mothers.