pressure episiotomy

[valeria_vi]

this is just a theoretical questoin. the subject of "it's better to tear then have an episiotomy" is clear to me and i agree with it. so this is a "just wondering" kind of question:
i've seen it in many different places where women mention it in their birth plans:
"if an epis. is necesary - i'd like to have a pressure epis. and then have local for stitches"
why is that? how is that any better then having a local for the epis. itself?

[hawleyclan]

Hi! There are two reasons pressure episiotomy is safer...

first, pressure episiotomies are done once the baby is on the perineum and crowning, this causes pressure on the nerve which would need deadened if the episiotomy is done earlier (as they usually are if a local is used), since there is no deadener the mother can fully feel the baby moving down and is in full control of how hard and when to push- once you are numb all you do is push, you can't feel the ring of fire signals that tell you "SLOWER!" or "STEADY" and the result is usually a huge tear to go with your wonderful episiotomy because you were pushing too hard, too fast...

Second, the medication for the local goes quite quickly to the baby, and results in more slower-start babies, more apnea incidents, and poorer initial contact and bonding in nursing due to a drugged baby effect.

I can attest to these phenomenon... my first, with episiotomy ended with an amazing 4th degree tear and a baby who had no interest in nursing or even quality eye-to-eye contact. I also never felt the ring of fire sensation- which came as quite a shock with baby number 2!!

Out of 4 births, I only ever tore during the episiotomy birth. There is something to be said for the analogy that snipped fabric tears more easily...

The Lord bless you,
Zoie
http://groups.yahoo.com/group/Godsbabycatchers

[laralou]

I know you just wanted advice on pressure episotomies so if you aren't interested in what I have to say, please disregard, K? I don't want to butt in.

I just wanted to offer my experience. I had my first 8 years ago. I was on medicaid at the time and had to have my baby at the medicaid clinic. I was also very well-read. I insisted that they not do the episiotomy rather that they do perineal massage. They did it and I did not tear. I only had tiny itty bitty lacerations of the skin but no tearing of muscle tissue. Much easier to recover!!!

I would recommend that you read up on that and discuss it with your doc, unless you are set on having one. I just think that if the medicaid clinic would do it for me, your doc would do it for you!

[valeria_vi]

Lara,
it is really great to hear that even a mediacid clinic docs and nurses try to work on prventing tears rather then just cutting every woman. and I absolutely agree that it is the way to go. if you read y post carefully you'll see me saying:

the subject of "it's better to tear then have an episiotomy" is clear to me and i agree with it.

it was just a theoretical type of question to me. i do not consider an epi as an option unless the circumstances are life threatening for me or my baby.
anyway, it still is GREAT to hear that hospital staff worked with you so wonderfully on this issue. thanks for sharing.

[laralou]

Ok. I just didn't want to offend you. Some people get really mad if you offer advice that is counter to their question. I had read on other people's threads that some people don't want perineal massage so I wasn't sure how you would take it (if you were pro or con on that). (Can you tell I have been flamed for offering advice on other forums?)

I want to be prepared too in the event that things don't go the way I plan, so I'll be keeping up with this thread.

Good luck!!