Why are episiotomies so bad? - Page 3

[sapphire_chan]

Maybe the way to make sure that episiotomies are only given when absolutely necessary would be to make the person giving the episiotomy have surgery on their genitals for every woman they cut. Not even making it as bad as the resulting tear, just a little 1st degree snip with the scissors and a few stitches.

[Mearaina]

Originally Posted by sapphire_chan

Just curious here, did he put in a monitor that let you change positions and did he encourage you to try changing positions to see if the heartrate would come back up?

The monitor would have let me but I wasn't up to it. I don't think he mentioned it; honestly all I remember is that he looked as scared as I've ever seen him (and I watched him deliver my preemie neice). Her heart rate just went down , and for a while he'd tickle her head and it would come back up, but when that stopped working he decided she had to come out, and considering how poorly she breathed once she came out I was glad. However, I was more mainstream (and totally naive) then and there are many things I will do differently with our babe due in June, although by now there is so much scar tissue (my 3rd degree from dd2 didn't heal right - I had a reaction to the stiches and had a weird growth called a granulosis that had to be burnt off). I am finding this thread very helpful - I will be much more confident with this birth.

[tinyshoes]

Originally Posted by huggerwocky

It is barbaric to cut women's vaginas, that's what I think. How many men will let someone cut their balls?

Originally Posted by sapphire_chan

Maybe the way to make sure that episiotomies are only given when absolutely necessary would be to make the person giving the episiotomy have surgery on their genitals for every woman they cut. Not even making it as bad as the resulting tear, just a little 1st degree snip with the scissors and a few stitches.

The irony of this is that probably every dude OB has had his genitals cut: routine male infant circumcision.

I hear what you're saying--episiotomy is one of the most bogus procedures around. Even Consumer Reports says it's a surgery you can do without...and that's not exactly a magazine like Mothering. Eventually, episiotomy will go the way of bloodletting....meanwhile, we all must live through this pathetic Dark Ages of Childbirth.

[pamamidwife]

I think the easiest way to avoid an episiotomy is to not seek care for your normal birth and pregnancy with a surgeon. Point blank. I think it's VERY VERY rare to meet an OB that doesn't do episiotomies - or at least that doesn't believe that they're beneficial. Sad. Many OBs will tell women that they "only do them when they're necessary"....but to those, "only necessary" is when a baby is emerging from the vagina.

[bobandjess99]

Also..one thing to consider is that, like stretch marks, some women are just more prone to tearing because they have more or less elastic skin.....

I personally tore from butt to clit and sideways too....and did EVERYTHING "right" to try an not tear, took fish oil/flax oil during preg to increase flexibility of tissues, labored in water, no directed pushing, used hot compresses, etc, etc........but it was just not in the cards for me.......you could feel as she was crowning there was just no way.....my vagina was TINY before i had dd.....i had to stretch it open to get a tampon in there...with me putting 2 fingers in and stretching, the widest it would open was about 3 CMs. When dd crowned (15 inch head with NO MOLDING), i reached down and felt the skin just being stretched tauter than you can imagine anything stretching...and it was only about a 4cm wide opening...clearly only a small fraction of her head......it stayed that way for about 3 contrax (all my body pushing on it's own, a true "fetal ejection reflex!), i was not "trying" to push at all, i was in a full upright squat (standing on my feet, not lying in bed)) and on the 3rd or 4th contrax, with no ring of fire or anything, she just BURST out all at once and tore me to high hell. I felt the skin under my hand (i was providing my own perineal support) split in two....literally up through my clit all the way back to my rectum (but not INTO, thank god!!), and DEEP....at least an inch. It did not heal together, it healed "open", and now it's like a third set of labia, plus my clit is torn in half and there's like a cm of skin between my vaginal opening and rectum opening at the back. BUT, after having felt dd crowning, and the just extreme tautness but still such a ridiculously small opening, i **know** that tearing was the only way she was coming out. My skin was stretched to it's absolute limit, and still just not even close to big enough. So, i feel okay about it. I have no doubt or regret that i could have dome anything differently or better to have made me not tear. So i am at peace with it.

It took 10 months for sex to be not-excruciating, and now at 18 months, i just realized last night(TMI, lol!), it is actually pleasant again.

But, regardless of the fact i did tear horribly, i am still glad i didn't get an epis. For some reason, it is *okay* with me that i tore, but having been cut open just wouldn't have felt right. I can't really explain why, its just how i feel.

[LeosMama]

It is barbaric to cut women's vaginas, that's what I think. How many men will let someone cut their balls?

It's barbaric to cut anyone's genitals. But OB/GYN's get paid to do it. They get paid to give episiotomies, they get paid to circumcise newborn children.

Our genitals don't recover from being cut, whether in childbirth or ritual circumcision, it's mutilation and leaves permanent damage.

[huggerwocky]

Originally Posted by LeosMama

It's barbaric to cut anyone's genitals. But OB/GYN's get paid to do it. They get paid to give episiotomies, they get paid to circumcise newborn children.

Our genitals don't recover from being cut, whether in childbirth or ritual circumcision, it's mutilation and leaves permanent damage.

I couldn't agree more.

[courtenay_e]

First birth...
At about minute 37 of 38 minutes of pushing...
CNM: Do you want an episiotomy? If you don't have one, you'll tear up, and that can be awful!

ME: Sure, whatever, just let me push now, okay?

That cut took almost nine weeks to heal and four or five months before I was comfortable enough to have pleasureable sex.


Second birth:
After having been in the tub for an hour, I moved to the birthing ball, where baby quickly moved down on his own, without any conscious pushing. Feeling him pass my rectum, I stood up, thinking I was in transition and was going to start having diarrhea and throwing up...

ME: OH! The baby just crowned! Ooops, I just tore, too!

And, out he came!

This was a labial tear, which they repaired with stitches. The stitches were torn out during an emergency D&C to stop hemorraging ten days later. Even having the stitches torn out, I was totally healed within four weeks. Never had any discomfort while healing, outside of the first four or five days, tops, when it was a little tender...and sex has been great from the first time we did it afterward (maybe a month and a half?)

Had it to do again? I would certainly take the tear over the epi. It just plain hurt less for a shorter amount of time.

[mezzaluna]

i was pretty adamant with my OB that i preferred to tear rather than get an episiotomy. i did tear, thanks in part to her management of my pushing - it wasn't coached pushing, but because he was coming "so fast" she "had to stretch me out" so i was getting tense with her hands all up my vagina... and she'd guided me into the semi-reclining position, which wasn't what i had imagined, but i was too far gone into labor to do anything other than follow her directions... and things were happening so fast that my DH and doula didn't intervene.

it was only 2nd degree tearing, but it was so bad internally that i had significant bleeding that they thought was uterine bleeding, leading to lots of intervention in the hours after birth to figure that out and correct it. after a drug-free birth i got pitocin and then was put under general tons of stitches later... it hurt for months and months to have sex, and i still have to take it gentle...

the OB made some snarky comment about how i'd torn just where she would have given me an episiotomy. despite my unhappy amount of tearing, i'm still glad it stopped with that and wasn't an episiotomy that tore further!

[Brisen]

pamamidwife, I think I love you. Can you come be my midwife, too? I'm another UC-minded-but-going-with-a-midwife gal. Are there threads here where you've talked about mw's not touching the perinium? Do you have links? I would like to bring info with me. Do you have links for not stitching, as well? I had a second degree tear with dk#1 (6lbs4oz, delivered semi-reclining, OB/hosp birth), a small tear that my mw wasn't sure if she needed to stitch or not but did in the end with dk#2 (7lbs3oz, delivered on my side), and didn't tear with dk#3 (5lbs8oz, delivered hands and knees). I would like to catch the baby myself, but whenever I've begun to bring it up with midwives, they don't even seem to understand what I'm saying.

Originally Posted by sapphire_chan

3rd and 4th degree tears (the ones to and through the anal sphincter) only happen with episiotomies and those are the ones that get the worst infections.

I have a friend who had a 3rd degree tear without an epis.

[tinyshoes]

Originally Posted by Brisen

I have a friend who had a 3rd degree tear without an epis.

We might have the same friend--'cause naturally-occuring 3rd degrees are rare as a non-episiotomy-cutting-OB!

[pamamidwife]

Here's an article I wrote for Midwifery Today on this very subject:

http://midwifemama.com/honoring.html


Really, it's very basic - you just tell your midwives that you'd appreciate your own hands helping your baby emerge, not theirs. I think being in the water also helps so much with creating a boundary for people not to touch you.

[sapphire_chan]

I meant to type the word "usually" in front of only.

[afishwithabike]

Originally Posted by LeosMama

you're more likely, not less, to tear if you've had an episiotomy.

and your tear is far more likely to be less serious if you haven't had an episiotomy.

That's it right there.

[Brisen]

Originally Posted by pamamidwife

Here's an article I wrote for Midwifery Today on this very subject:

http://midwifemama.com/honoring.html

Awesome.

I'm printing it up & bringing it to my first prenatal.

[orangefoot]

I think the cut with scissors also causes a kind of crush injury compared to a cut with a knife and this also has some bearing on stitching/healing.

I had an epis with ds1 in Mexico but have torn twice in subsequent births - but not along the epis scar.

I have a feeling that I have tearable skin and I don't feel bad about tearing. I don't think anyone *caused* my tearing; the first was in water and ds came fast with a hand up then with dd I was on a pit drip and not really in control of my body but thalternative was a cs for transverse lie so it was the lesser of two evils.

I would like not to tear of course but its not the aim of my next labour.