episotomy scars

[miguelsmom]

With my sons birth I had what I think is pretty significant episotomy. I have very sensitive skin and scars on other parts of my body are easily irritated, so you can imagine how fun its been down there. It's been an issue ever since even after I lost a bunch of weight. Lately it's been getting worse and I'm really uncomfortable. On top of that my roids are terrible. Is it possible that this is because my kiddos are close together (2 yrs)? Does this mean I'm going to tear through my whole scar?
I think I'm anxious about this because the episotomy I had was against my will, I told the OB not to do it and she did it anyway. I even yelled at her and she went ahead. I hold a lot of emotion in that scar, if that makes sense. My midwives do not practice episotomies unless it's an emergency. So hopefully it won't be an issue. Basically, I'm wondering if any of you have suggestions for what I can do to ease the discomfort, that and I'm hoping I'm not the only one with this going on.

[bleumoose]

I don't think it means that you will tear all the way through the episiotomy scar, although the fact that there is scar tissue there makes it more likely that it will tear.. just not all the way. Have you talked to your midwife about your fears of tearing? If not, do so.

Things you can do to reduce the risk of tearing include perineal massage, starting now until birth; a very careful and slow second stage -- don't rush pushing, especially as baby is crowning and being born; warm compresses during pushing; gentle massage with oil during pushing. You can ask for these things from your midwife, chances are she'll be more than happy to accomodate you - she likely already does them for her clients. Also remind her (or have your DP remind her) when it's time for pushing that you want these things and are really afraid of tearing more.

Something else you might consider doing is working through the emotion you hold in the scar. Let yourself feel whatever it is that scar represents to you - lack of control, being taken advantage of, not being listened to, etc. Feel it, and try to let it go. You could imagine yourself facing the doctor and having a conversation about it - ask her why she cut you despite your request not to, tell her how you felt and still feel about it, and listen to her response and apology. It could take several rounds of this until you work through it. Letting go of the emotion is important, because if you're holding onto it, you might be more prone to being tense during pushing and the tissues won't relax and stretch as effectively.

If it helps I had a 3rd+ degree tear with DS because of a poorly managed second stage - no one told me to slow my pushing as he crowned and was born and he just exploded out of me. Tearing is one of my big fears for this birth, but after talking to my midwives about it, I feel a lot better and fairly confident that even if I do tear, it will not be as bad as the first time.

[miguelsmom]

thanks bleumoose! I appreciate you taking the time to advise me. I've talked to my midwives about it and they are on board to do whatever it takes to to prevent any issues. I have come to terms with the fact that I may tear. It may be suprising but I am much better about this now than I was before. I had serious post-traumatic stress about it when my son was a few months old. I spent a lot of time talking about it with people but could never confront the OB. I think it started to freak me out when my perineum start to hurt even with out being in labor already. I just don't want it to be an issue that will hold me back from letting the labor process happen.

[bleumoose]

That's so good your midwives are on board already. You're already starting off in a lot better position for no/less severe tearing that you otherwise might be!

Originally Posted by miguelsmom

I spent a lot of time talking about it with people but could never confront the OB. I think it started to freak me out when my perineum start to hurt even with out being in labor already. I just don't want it to be an issue that will hold me back from letting the labor process happen.

I can completely understand where you're coming from! That sort of confrontation is really hard for me too. Would it help to write a letter to the OB? You might not even have to send it, it might help just to write it.

There's a book I've been using to prepare for this birth called An Easier Childbirth by Gayle Peterson. It has a lot of exercises, like the ones I wrote about before, in it to help you deal with issues from your past that might get in the way of future births. It's been really helpful to me. It might be a bit late for you to find the book, but maybe your mws know of someone who has a copy you could borrow.

[Ahappymel]

I hear you : )
I've got an episiotomy and have many memories of my son's violent birth associated with that scar (the doc forcefully pulled him out with a vacuum extractor).
I had pain with intercourse for YEARS afterward.
I fear tearing too.
I spoke with my midwife who suggested that I start thinking in the positive too....visualizing my vaginal tissues as healthy, pink and bubblegum stretchy.
She also told me that they can help with oils, compresses.
I'm starting massage this week just as soon as I kick this yeast infection.
I am thinking that being in warm water and going very slow with the pushing will keep me intact.