she fully understands that the episiotemy is not natural and not necessary during the course of a normal birth but is very concerned about what sex will be like after giving birth in general. i had a c/s so can't help :-( i think she may be under the impression that not having an episiotemy means there is more stretching and that sex will be very loose or something.
can any mamas share their experiences with either tearing, no tearing or episiotemy...like what's sex like, what was healing like etc.
While delivering my first child - the Dr. indicated that I needed an episiotemy. I resisted as I had frequently heard on sites such as this that they are rarely necessary. The doula supported my decision not to have one. The Dr. indicated it was against his medical advice. I tore 4 degrees in each direction - all the way to my anus and tore my clitoris in half - I had nearly 20 stitches. The recovery was terrible and my child was well over a year old before I didn't need a drink to have sex.
During my second delivery, I was again told I needed an episiotemy and this time I had one. I needed two stitches and hardly remember any discomfort during recovery.
I am sorry to be so blunt but I think that some people do need to have an episiotemy. I am sure I am going to get blasted by people who had little tears or didn't tear at all but I think it is important to share that resisting medical intervention isn't ALWAYS in the best interest of the mom and baby. That being said, I would not work with a Dr. who gave one to EVERYONE nor would I deal with a midwife or Dr. who never thinks they are necessary.
Barney & Ben
Most doctors don't know how to help a woman stretch out and birth without an episiotomy, which is one reason doctors see tears far more frequently and of a much harsher degree than midwives do.
My midwife's clients don't get episiotomies. She's only had a couple of tears that equalled the severity of an episiotomy. Many women don't tear at all, because they push their babies out veeeery slowly in an upright or semi-upright position while she works their tissues over the babies' heads with olive oil. Most ob's don't have the time and patience for this.
So...... you have docs like your sister's that guarantee a deep cut through tissue and muscle for every person.... and other practitioners that rarely do episiotomies and whose clients don't tear as deeply as an episiotomy would cut them.
That's like cutting off every woman's breasts because a few might get breast cancer.
As a doula, the most extensive damage I've ever seen done to a woman's perenium was done by a "medwife" in a hospital. She had my natural birthin' momma in stirrups with directed pushing. As the baby crowned, it's heartrate dropped (totally normal, happens at every birth) so she told the mom the baby was in distress and she had to cut an episiotomy.
She cut an episiotomy, and as the babe crowned, it ripped down into her anus. Now, if the "medwife" would have let her body do its thing, the worst that could've happened was a regular old tear.
So, I do believe that for the vast majority of mothers, when birthing with a person EXPERIENCED in preventing tears to begin with, episiotomies do far more damage than a small tear would.
hope that bit of tmi helps!
Our bodies are similar.
My first birth I was cut, and then tore even more. I ended up with a 3rd degree tear/epis. It was aweful, and far worse than the birth itself. I had pain during sex 18 months later. I was also pushing in the position they told me too (flat on back, legs in stirups) and pushing when they told me to, not listening to my body.
Second (home) birth, I pushed in what ever position I felt most comfortable, pushed when my body told me to, and no tear or epis. and a bigger baby. I had sex 2 weeks after the birth with no pain.
I vote for push in whichever position you want, listen to your body to know when to push, and DON"T let the Dr cut you!!!
You might advise your sister to look into different birthing positions, and talk it over with her doctor.
The doctor was very in favor of natural births, so he let me stretch as much as possible, but when I started tearing, he did a small epi to try to stop the tearing, but I tore through that even. I ended up with 12 stitches (6 inside, 6 outside), but Sebastian's head, even as a newborn, was HUGE.
I remember it was very painful - I had a hard time defecating and needed stool softners before I could go. I waited 6 weeks post partum for sex and it was brutally painful that first time - even with my then husband being very gentle.
I don't mean to scare her, and everyone's experience is different, but I was relieved when I had a c-section with Trystan (despite pushing for 90 minutes, there was no tearing because he never came down low enough!) because there was no episiotomy!
I've heard that olive oil applied frequently pre-birth can help the skin soften and prevent tearing (it stretches easier).
I would also be adamant that the doctor is NOT to cut... I've heard from others that tearing is less painful then the cut when it comes to healing.
Hope this helps!
As far as the sex thing- If a baby is comming through your birth canal period, things are just naturally going to open up. There are always exercises you can do to "tighten up" but once you've been cut there's a definate wound.
Jennifer, LPN and nursing student, Doula, CPST, and VBAC mama x3 to
AJ (5/03), Evan (12/04), Ilana (11/06), Olivia (2/09), and Unity (8/2012)
I never went back to the midwife after that 6 week appointment. We came to see her filled with gratitude that I had managed to give birth vaginally, because I had my water break without going into labor. I must have the world's most pitocin-resistant uterus. I knew that without her expert help during that crazy labor, I would have had a c/s. We even brought her presents!
So I come in and I'm still bleeding from the episotomy, which I didn't even want, and she's like "oh yeah, that'll heal up soon, I guess sex will be a bit like losing your virginity, don't sweat it. Have you had sex yet?" Then she pressured me into being fit for a diaphragm--I put it in right there in the office and bled all over it because the @#$*& incision wasn't healed yet. I never filled the prescription for the diaphragm. (the OT part: she also gave me a hassle about my weight at the 6 week PP appt. Thanks lady.)
I am feeling guilty that I need to have a regular pap smear but I just don't even want to deal with trying to find a good OB practitioner.
Divorced mom of one awesome boy born 2-3-2003.
Sex for dh and myself is better now than ever before (after 5 kids thank-you very much). This is probably too much info but...dh being a man and not a virgin when we met said that some women are really loose to begin with. So I can see where someone would think that childbirth is gonna strech it out so much more that sex would be almost non exisitent. But if a woman does her kegels (remember its a muscle - you don't use it you loose it) than I think her vagina will be nearly the same as before birth.
Now you throw in a tear or an episiotomy and that changes things. From the women I know that had tears or episiotomies sex was much more painful, for longer than those that hadn't. And the scar will not strech easily. So if she gives birth again she has a good chance of tearing or needing cut since the scar won't strech. THe same hold true for sex. Sure it can be tight because it won't strech.
I would be worried about a dr who gives all first time mothers an episiotomy. I would have a hard time giving birth because I would be to afraid he was gonna cut me! I would probably be pushing with my legs crossed!
Oh....My mother said to me after my first was born, "Oh how nice you didn't tear, you will be able to sit afterwards right away!" She would know having had 6 kids and 4 of them she was cut.
My sister had an episiotomy with her 1st baby and none (no tearing either) with 2nd baby and she says her sex life is as good as before
Hope this makes your friend feel better!
Add to that the fact that a DEFINITE episiotomy from a doc who routinely cuts them (what the heck is his problem?) will certainly be worse than a POSSIBLE tear. I would rather take the risk of tearing...and possibly escape with little or no injury...than have the episiotomy.
I did end up with an episiotimy, which then ALSO tore. Childbirth without medication, no problem. The pain of a healing episiotomy, OH MY FREAKING GOODNESS.
Issues I had with my episiotomy:
- About 1 week of intense pain, all from the surgical wound. This had a profound effect on my ability to function post-birth and I am certain it affected me as a parent during that time.
- The sutures dissolved before my tissues healed back together. 1 1/2 weeks after birth, I took a look with a hand mirror and discovered that I had a gaping wound where I should have had a healing scar. It took over 6 weeks for the whole thing to close. This is not typical, but it can happen.
- I have definite scarring - kindof a trough-like scar on the outside, ropy scarring on the inside.
- Didn't dare to have sex for 3 mos. Hated it every time until after 1 year. Fortunately, sex is now fine. I have no residual pain or numbness. I consider myself lucky for that.
- Lots of emotional trauma from the birth, the post-birth pain, the healing troubles, and now worrying about what my 2nd birth will be like.
...so like I said, I would rather risk tearing than have a definite surgical wound. I would never choose to have an episiotomy, and I would be uncomfortable with a physician who cuts them on ALL of his first-birth patients. That habit of his makes me concerned about what his beliefs are about birth and how those beliefs are reflected in other practices, too.
I have lots of friends who did not have episiotomies. None of them had as horrific an experience as I did. Many of them didn't tear at all, most who did tear had a few "skid mark" type of tears that didn't require any stitches and healed quickly. The rest mostly had small natural tears and only one or two stitches.
For "tightness" issues regarding sex after birth, check out the "happy husband stitch" thread. Tightness has much more to do with vaginal tone than the perineum. Kegel kegel kegel kegel....
I did NOT do an episiotomy. They very thought of if completely creeps me out and I made sure my doc knew my feelings. And my OB says she rarely does them anyway. (Again, the fabric example. YUCK!)
I ended up with 2nd degree tears, and I did get stitches. The funny thing is that I didn't even notice anything with the stitches while they healed.They didn't itch and they didn't hurt. (Just general soreness in the area from pushing out a 7+ lb. baby.)
I wasn't even worried about post-partum sex by the time I got my OK at 8 weeks or whatever they say. (Can't remember now.)
I think it's best to just let the tear happen IF it needs to. I didn't even know I had torn until the doctor told me anyway.
BTW, I didn't do the vaginal stretching stuff with my partner. If you are worried about tearing, I would suggest doing that.
Baby's waking up from her nap. Hope this helps.
That said, my MIL told me she had an epi with DH and nothing has ever been the same. Sex was painful for years, the scar was painful for years, it was not a good situation at all and she calls the doc that delivered DH a "butcher"...my Mom on the other hand, had 2 epis with my brothers and said that they didn't seem to affect her in the sex or pain department and healed pretty quickly, so I don't know.
I am not a fan of them, (epis)...and prefer to stretch/tear on my own, but I have heard okay, and not so okay, to downright bad stories across the board from tearing to epis...
So maybe this post was no help at all...lol
I birthed her in an upright position, and did not tear at all.
I was sore for a few days, but felt better really quickly!
It seems that the less a mom is messed-with during labor, the better chance
a) the hormones that help this brief stretch happen well will be able to do their job, and
b) mom will choose a position that works well not only for pushing, but for letting baby come out in the best way for her body
Drugs and stress during labor mess with labor hormones, and being pushed down on your back to deliver means that an undue amount of pressure will be applied to your perineum, greatly increasing your chances of tearing.
For everyone I've known, tearing is much better than getting cut, if those are the only options.
...missing Mothering Magazine...
I could easily have sex right now if my bleeding had stopped. And it's not loose by any means :LOL
I would say that Kegels really help-I did them religiously throughout pregnancy- and having sex helps too- Ina May Gaskin reports that women who stay sexually active during pregnancy tear less often- and that was true for me.
Basically I would never have an episiotomy because if you risk tearing at least you have a chance at an intact perineum which will produce the best possible sexual outcome- muscle gets back to normal faster and no chance of painful intercourse from scar tissue. If you have a slight tear it's still much better than an episiotomy- with an episiotomy you have an automatic 2nd degree laceration which involves the muscle- the muscle is what makes sex enjoyable and what makes your vagina go back to normal.
The best way to avoid tearing and make an episiotomy totally unnecessary is to not give birth on your back- there's just too much stress on the perineum when you're on your back.
Jen Mama of 2 precious boys (9) (6) and still in with my Matt after 12 years together.
Domestic Violence Children's Advocate and Counselor
When it was time for Nitara's birth I said no way do I want any scissors near my body, I'll just take my chances with tearing. I tore just a tiny bit to one side, and it did not need stitches. I was fully healed and not sore anymore after just 2 weeks.
I had epidurals/back delivery with both.
I think the best way to avoid serious perineal trauma is to avoid an epidural and to avoid giving birth in a position that puts pressure on your tailbone. (Standing, squatting, on your side, in the water --- all better than reclining or semi-reclining. ) These positions can create 30% more room in the pelvis, which for some women, is all they need to avoid an epi or a C-section. Even with an epidural, a mom can still push on her side, with someone holding her top leg up.
I have heard mostly horror stories about epis with long healing times from friends and relatives.
I would take my chance again, but this time I will make sure to have someone help me to reduce my chances of tearing.
i wouldve rather have torn than had the episiotomy, but it was never discussed b/n me and my ob (mistake.mistake. mistake)
he tells me, as i'm pushing out 8lbs15oz of baby, uphill in the lithotomy position, with the knowledge she passed meconium and could die running thru my head, and he tells me "you're either going to tear wide open or i can make a tiny cut, which do you want?".
under diress, i chose the cut, and it was horrible. the stitching up afterwords was more painful and uncomfortable than anything else during labor had been. i took heavy pain meds for 2 weeks, and it took me 7 months before sex was even possible without extreme pain. it was another 5 months after that before i got any kind of pleasure out of sex.
what wouldve helped me was birthing upright, and birthing at my own pace, listening to my own urge to push, without people yelling at me to "PUSH PUSH PUSH".
If you go to a surgeon, you are going to be cut.
I had four children at home; two with a homebirth doctor and two with his midwife. I never tore, and the soreness from the delivery lasted only a day or so. Sex was never a problem. We usually resumed within a week...
i tore very badly w/ my 1st, icluding a cervical tear + tons of stitches... we waited about 2.5 weeks before making love... and it was awesome. (can i say this at MDC?) it was absolutely some of the best sex ever... *because* i was so loose, and sensitive... it was awesome. my partner didn't think much of it... but the intimacy was nice i guess... and WOW it felt good. even with the pain.
then fast-forward 4 years and many kegels later... w/ my daughter i had an au naturelle home birth, no tearing at all... we made love the night after she was born. : which was also nice, but much more painful. i'm not nearly as... floppy... as i felt after my son's birth, and i feel... smaller. i loved my pregnant yoni ~ all full and ripe... my whole body was just brimming with fertility. i'm still getting used to my post-partum body & it's been 8 months. however, the sex is better than ever. & my partner & i are more connected than we ever have been.
|Our bodies are designed to give birth. Our perineums are meant to strech to accomadate the head of a baby and then return to almost its same shape as before. Of course it wil never be virginal, but its pretty darn close.|
With DD #2 I gave birth to a bigger baby in a free standing birth center(no homebirth MWs around) and had a small skid mark. I gave birth on my back(my choice) and I recovered great. I could sit, stand, poop, pee, and even felt like sex within a few days.
I love my girlsMadaline(9), Mary-Grace(7), Georgia(3), & Evelyn(1)