thinking about birth - I know it's early!

[Beppie]

So those of you who've had babies before, for my last birth I had an episiotomy. The birth happened fast, and was unmedicated, and I pushed for just 20 minutes, and at the very last minute the midwife said she'd have to cut because otherwise I'd tear really badly. My skin just wasn't stretching.

My question is, is there anything I can do to not have to have an episiotomy the second time around? The midwife made it sound like my skin is just not stretchy, and that there's nothing I can do to change that. My mom also had unmedicated births for 5 out of her 6 kids, but had to have episiotomies for all of us. Is it something I just inherited from her and have to live with? Anyone else have experience/knowledge about this? Can I lessen my chances of having to be cut, or am I doomed?

[weliveintheforest]

Well I am not a midwife, but I find it hard to believe you will never be able to stretch... maybe you just needed more time?
You might want to post in the birth professionals forum, the midwives here know lots.
Does your mw do many episiotomy? that may have something to do with it as well.

[donutmolly]

If no episiotomy is important to you (and no tearing also!) tell your midwife! There are ways to avoid both, but it's important the midwife know ahead of time that this is a priority for you. (And so you can know whether your midwife is supportive or not!) I know there are ways to support the perineum so that you have plently of time to stretch, also perineal massage might help, especially with old scar tissue. From everything I've read, episiotomy is almost always unnecessary (but they still cut them...) and tearing is preferrable in terms of healing. I think that some visualizations might help too -- I'm not really one for that type of stuff, but for my first birth, I tried it out (a la "Birthing From Within") and I really thought it helped in terms of thinking of opening up the birth canal.

Will you be using the same midwife as before? A new one with strategies to preserve the perineum might be in order!

[mothragirl]

i would get a new midwife.

[zjande]

Was she massaging your perineum the whole time you were pushing?? I just can't fathom a perineum that doesn't stretch. My mw used olive oil & nonstop massage. I only pushed for 10mins or less (my last labor was super short) & I did not tear.

I think that with a different mw & better approach from her, you will do just fine!