Episiotomy FGM in disguise- a thought I had yesterday

[Mama Poot]

Many believe that FGM "never caught on" in the West, for various reasons. I disagree. I had these thoughts yesterday:

Could it be that all the centuries of needless male circumcisions damaged their sub-conscious mind, and when some of these men decided to become doctors they finally had an outlet for the anger and pain they were forced to undergo as infants? No one ever believed that their bodies were healthy and capable at birth, so in turn they started disbelieving in everyone else's bodies- especially womens.

Under normal circumstances, a woman can give birth without the assistance of anyone, and if allowed to move freely she will likely not sustain any perineal trauma. Even if a woman does tear, its not the big deal some make it out to be.

Fast-forward to the 19th/early 20th centuries. Birth is being medicalized, women are being chloroformed during delivery, and all women are forced to give birth on their backs. The attending male doctors suddenly feel this "need" to "help" the woman give birth by cutting an incision into her perineum several inches long. They claim it makes birth easier, and do not take into account the dangers and lasting bad effects such mutilation causes.

All this is done with no solid reasons, and women are never given a "choice". Of course things have changed a lot since those old days, but episiotomy rates are still WAY too high, IMO. During the birth of my first child, right as he was being born the doctor saw a **tiny** bit of blood, and "didn't want to risk anything else happening", so he sliced me open. I probably wouldn't have torn at all, but instead I was left to deal with an incision instead of a scratch. Why did my doctor feel this tremendous need to inflict more pain on me??? It doesnt make much sense.....unless some buried part of him is angry about being circumcised.

I apologize for this being sketchy. So what do you all think about my theory??

[moonmama7]

I need to think about it some more but it's a very interesting point. I do know that my episiotomy has left a very large area very numb and I often wonder it it's the sexual equiavalent of a male circumcision. I also know I never would have needed the episiotomy if they hadn't insisted on dumping so much pitocin in my system even while I was begging them not to. That's another story though.

Violet

[frenchie]

I have mixed feelings about the subject, and I really see both sides, though I believe routine episiotomies are unfair...women should have a choice...let them deal with the consequences of THEIR CHOICE. I know many OBs doon't give women a choice in the matter.
I have more than one friend who chose to forego the episiotomy, and wished they would've been cut instead...and vice versa. I have a friend that tore both up and down....I know a couple women who have torn from vaginal hole to anal hole. I asked for a pressure episiotomy, but ended up with a c-section.....so I have no personal experience with episiotomies or tears.....however, I think the observation you have made is a very interesting one....something to ponder!!

[Revamp]

A very interesting notion indeed.

I think there are many reasons for it occuring more often than it needs to, medical orthodoxy and perhaps some deep-seated notion that this is beyond a woman's body?

But that could certainly be a reason, quite possibly a substantial reason.

[trmpetplaya]

Originally Posted by Revamp

A very interesting notion indeed.

I think there are many reasons for it occuring more often than it needs to, medical orthodoxy and perhaps some deep-seated notion that this is beyond a woman's body?

But that could certainly be a reason, quite possibly a substantial reason.

:

Heaven forbid anyone in his care have intact genitalia if the doctor doesn't

love and peace.

[Revamp]

Originally Posted by trmpetplaya

:

Heaven forbid anyone in his care have intact genitalia if the doctor doesn't

Besides from resentment and envy there is also perhaps some causation of the blithe disregard resultant from having suffered the operation that you would not be concerned to inflict other forms of genital cutting as you yourself have endured them.

I like to think that doctors would rise above such things but in such stressful situations when they feel under obligation...

[trmpetplaya]

Originally Posted by Revamp

Besides from resentment and envy there is also perhaps some causation of the blithe disregard resultant from having suffered the operation that you would not be concerned to inflict other forms of genital cutting as you yourself have endured them.

I like to think that doctors would rise above such things but in such stressful situations when they feel under obligation...

doctors are human too....

love and peace.

[Revamp]

Originally Posted by trmpetplaya

doctors are human too....

love and peace.

Too true.

I would like to imagine that there was not malice in this, that it was just ignorance made orthodoxy. But that stems from me wishing to see the best in humanity, something I find most problematic at times.

[A&A]

Originally Posted by Mama Poot

Many believe that FGM "never caught on" in the West, for various reasons.

FGM was widely practiced in America.....especially around the 1900s, and was even covered by Blue Shield (insurance) until 1976. (Read Secret Wounds by Hanny Lightfoot-Klein.)

This same book calls episiotomy another type of FGM.....and states that 15% of women who went through episiotomy have significant pain for up to 3 years postpartum.

My genital wounds/scar tissue (from my epi) serve to fuel my energy against RIC.

[baybee]

Midwife Anne Frye calls episiotomy a "clitorectomy" because the nerves of the clitoris radiate down the sides of the vaginal opening (introitus) and around the perineum (which, by the way in Greek translates to "around the temple").

Medical school training involves humiliation and demotion for those who "question authority". Young drs learn very early on to do as they are told and not re-invent the wheel. A questioning attitude is soon knocked out of them. My ex husband was a physician. He said there was an ob/gyn that all the med students called "The Butcher" behind his back. He was fond of cutting two episiotomies, one on either side of the perineum towards the woman's thigh. The result, he said, was that the woman's whole ass would fall on the bed and the baby just fell out. None of those med students would ever have sent their relatives or friends to "The Butcher" but they also never criticized or complained about him because they knew they'd never pass med school if they did.

Don't get me started on the cutting of women's bellies as sexual assault, too.
Drs do everything they freekin can to stomp the hell out of the midwifery movement when, it's clear, they have no freeking idea themselves how to get a baby out of a vagina in a dignified manner. A 30% nationwide c-section rate is a travesty right up there with the 50% circ rate.
Baybee
Baybee

[Revamp]

I suppose that since no one else is prepared to do it and I am a beneficiary I should, at least half-heartedly, stand up for this procedure.

I was born prematurely and the analysis of my water showed that I was showing signs of great distress. It was feared that birthing me naturally would result in cerebal palsly or some other form of brain damage and accordingly my mother, who had had two children before me in hospital who did not require this procedure, was given an episiotomy.

I am not going to pretend that she found it pleasant because that would be a lie, she still says she has a scar and that it was never the same but the fact remains that if she had not of had it I might have been incapable of typing this message to you.

[orangebird]

Originally Posted by Revamp

I suppose that since no one else is prepared to do it and I am a beneficiary I should, at least half-heartedly, stand up for this procedure.

I was born prematurely and the analysis of my water showed that I was showing signs of great distress. It was feared that birthing me naturally would result in cerebal palsly or some other form of brain damage and accordingly my mother, who had had two children before me in hospital who did not require this procedure, was given an episiotomy.

I am not going to pretend that she found it pleasant because that would be a lie, she still says she has a scar and that it was never the same but the fact remains that if she had not of had it I might have been incapable of typing this message to you.

Fairly unlikely that is truely the case (I am a RN and I work in the NICU and sometimes L&D) but I am certain your mother believed it.

[pdx.mothernurture]

Slightly OT, but thought I'd share these resources...

The ChildbirthConnection.com website (Formerly, Maternity Center Association) has some of the best info on episiotomy I've come across:

JAMA Study on Routine Episiotomy

Advice for Women About Avoiding Routine Episiotomy

Preventing Pelvic Floor Disfunction

Tips & Tools: Pelvic Floor

GentleBirth.Org also has fabulous info:
Perineal Protection / Avoiding Tears and Episiotomy

I love this analogy:

There are many reasons why a natural tear heals faster, with less pain, and better than an episiotomy. First, a tear is generally smaller, often occurring only in the skin, rather than going through skin and muscle, as an episiotomy does. Secondly, because the tear isn't a perfectly straight line, the repair will have to be more precise. It's difficult to suture swollen tissue in any case, and it's not always obvious how to line up the two sides.

Especially with an episiotomy where the two sides are relatively straight, it's not always clear what lines up with what. (Kind of like doing a jigsaw puzzle where all the pieces are perfect squares. Who knows what you'll end up with?) So an episiotomy repair doesn't always connect the right muscles on both sides. However, a tear tends to have more landmarks to help match up the two sides. Also, since there's more "surface area" to a tear, it's easier for the two sides to reconnect themselves more quickly.

For a home demonstration of the difference, cut a piece of paper with a straight-edge scissors and a zigzag scissors (or pinking shears). Notice how much easier it is to line up the two pieces properly and how much more "surface" you would have to hold the tissue together on the zigzag tear.

While you've got your sewing materials out, try the following experiment. Get a piece of scrap material that has an intact selvage, or even a cut edge. Try tearing the cloth from the edge. Now make a little cut and apply the same force to the cut and see how much more it rips? This is also what happens with episiotomies.

All are great links to pass on to mommas-to-be on the more mainstream boards.

Jen

[A&A]

Originally Posted by Revamp

I suppose that since no one else is prepared to do it and I am a beneficiary I should, at least half-heartedly, stand up for this procedure.

I can't begin to tell you how extremely chauvinistic and sexist it is of you, a guy, to be "standing up" for female genital mutilation of any sort. Have you ever had a baby? Have you ever had an episiotomy? Then you don't know what the hell you're talking about.

Now, if your mother had only gotten off her back, onto more of a crouching position, she would have opened up her pelvic area by an additional 43%, and there wouldn't have been any need for the epi.

[AntoninBeGonin]

Chill out, people. Revamp explained that he was told if his mother didn't have the episiotomy at the time of his birth he might have been born severely handicapped. Yes, those of us who have studied birth know there were other options available to her, including squatting like a PP mentioned. You must remember, however, that RV is a teenaged guy. I'm not saying it's impossible for a teenaged guy to have an interest in studying birth, but it's pretty unlikely. So how about responding to his comment in a kind and decent manner instead of calling him names and potentially running a valuable member off the board?

Reneé

[USAmma]

It's an interesting thought . . .

but I doubt it's anger. It's probably more like ignorance. If you are raised believeing a certain thing you learn to accept it because you don't know any different. I know many women who have left the circ decision up to their husbands, and their husbands most often decide to have their sons circed. They have their reasons-- the main one being that it's cleaner. Second is so the son will look like the father. I doubt that the father is feeling angry about his own circ or else he would not subject his son to it. He probably just doesn't know any better.

I would imagine that doctors are trained in a certain way and they don't have much exposure to the alternatives, just like circed men don't have exposure to an alternative way of thinking unless they are educated somehow.

My own personal experience with my births did not indicate that the doctors thought it necessary and routine to cut me. The OB who delivered my first baby applied hot cloths and oil and pressure as I had requested. He said I didn't look like I was going to tear. Then my dd's heart fell way down and stayed down for several minutes. He apologized and cut me and got her out fast. BTW she was fine. She was a little sleepy when born but she cried as soon as they rubbed her and bothered her. Sigh.

My second birth, I again requested no cutting and it was respected. The scissors never came out. The OB had told me ahead of time that he did not routinely do the cuts, in fact he tried to avoid them unless it looked like someone was tearing in a bad direction or the baby was in distress. This was a different OB than the first birth. He did ask if he could break my water halfway through labor because uase he was nearing the end of his shift and I had made it clear I wanted him, and not some strange doctor, attending me. I said no, I did not want the water broken early. At least he asked. And he stayed until the baby was born a couple of hours after he was supposed to go home. My OB was not a saint but he was not evil, either.

[Revamp]

Originally Posted by A&A

I can't begin to tell you how extremely chauvinistic and sexist it is of you, a guy, to be "standing up" for female genital mutilation of any sort.

WTF.

That is probably the most offensive thing that anyone has ever said to me on the MDC. I hope that you feel proud of yourself.

You totally misunderstood me, I was saying that in some instances it might be beneficial, I am not saying that it doesen't matter that women are getting sliced open or that it is a good thing, that would make me a monster but the point is that if it was a choice between me being brain damaged and getting sliced open my mother prefered the latter.

And apparently America has a pretty mangled approach to the whole thing, it seems they do it far more often than neccessary but here in Britain that is not the case. They do it strictly when neccessary in most cases and personally I am pre-disposed to believing them. Accordingly that means that I benefited directly from the operation performed and that if it was not for it I could have suffered severe brain damage.

Now I have no idea about you but personally if there is one area of my body I consider to be of greater significance than my genitals it is my brain as that is what generates the mind. It is something which I cherish greatly and I have to say that I am very grateful it did not sustain any damage.

Am I happy that my mother was sliced open in that cause? Of course not! She is my own flesh and blood, half of my genetic make-up is hers. In fact if anything I feel slightly guilty that she was forced to suffer thus to have me safely. But all the same that operation spared me immense damage to the very organ which is controlling me typing this to you and for that I am thankful.

And there is certainly no need to be calling me sexist or chauvanistic, that is so incorrect it verges on surrealism. You should certainly think twice before saying such horrendous things about people.

Have you ever had a baby? Have you ever had an episiotomy? Then you don't know what the hell you're talking about.

Uh...Pardon? Have you ever had your penis circumcised?

Yet you are posting on this board.

I actually have a fairly good understanding of the procedure, obviously I have not had it performed upon me but you can hardly blame me for not having a womb.

Now, if your mother had only gotten off her back, onto more of a crouching position, she would have opened up her pelvic area by an additional 43%, and there wouldn't have been any need for the epi.

Well she was not informed of that now was she? Oh well, I suppose she was ignorant so she deserved what she got, right?

[phatchristy]

Revamp. I was trying to PM you and it said it was full. :


The only thing I would add is that there ARE cases where episiotomy is necessary. As I mentioned in a previous post the MW I work with, in nearly 30 years of practice had only done a few episiotomies. She said she only did them when they were clearly indicated. In the first 20 years she had only done one actually (accoding to the midwifery student she worked with who told me that they had a conversation about it). She attended a LOT of births as well, as she opened a birth center after it was legal.

Of course, she only attended moms who labored naturally (she's an LM...and worked as a lay midwife before it became legal 20 years ago in our state), and we all know here that when labor evolves naturally without medical interruption/alteration that true fetal distress is extremely rare.

We also know, that when a boy is left to grow up naturally, with his penis being left alone to grow and develop as nature intended it without medical interference that a circumcision is rarely necessary. I think I remember reading somewhere .006%. Circumcision is necessary only with cancer, frostbite and gangrene. All insanely low occurances.

In my book those are some analogies between the two, however I don't think RIC is anywhere really on the same level. Women have choices in their birth attendant is, little baby boys have no choice .

[jessjgh1]

Revamp,
I see where you were coming from in your post... and I agree that sometimes (rarely) episiotomies are necessary. I'm sorry that instead of gently clarifying that point people jumped and made assumptions about your mother's situation.

I don't see revamp's participation as sexist or chauvanistic-- that's pretty unfair. You don't have to be a teenaged boy to be ignorant about episiotomies-- I sure didn't know as much as I needed to know to prevent one from happening to me.

My best friend is a doctor and she knew she didn't want one or need one, yet her doctor bullied her into getting one. And many doctors, as we know, are ignorant about episiotomies and natural birth practices as well.

Even many women don't realize they have a choice about birth, birth attendants, or hospital policies. So I'm not really sure I even agree with the statement that women have choice who their birth attendant is.

I tried, for example, to choose a midwife practice that met me needs. I apparently got the one midwife out of all of them that didn't do things the way I had expected and been told. I was very surprised to hear, "and now I'm going to do an episiotomy". Shocked and upset, but I was not able to stand up to her and even though she had not gotten my trust I ddin't know how to counteract her assessment that it was necessary.

This same sense of 'medical professional' knows best and these people withholding information is a culprit in cicumcisions. Med. professionals may ask, "are you circumcising" which has many assumptions that go with the simple statement-- 1. its' okay to circ 2. yes is the right answer
Often they do not bother to bring up alternatives or information when a person says yes or asks about circumciosion-- never educating the person about the purpose of the foreskin, complications/risks, and alternative of leaving a boy intact.



Jessica

[Lara vanAEsir]