"Give me a cut over a tear any day!" - Mothering Forums

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Old 08-23-2008, 05:37 PM - Thread Starter
 
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I've seen this sentiment several times (not here, of course). Usually, the woman insists that she would definitely rather be cut than tear. I've even seen birth plans that ask for an episiotomy if there is a chance of tearing. One woman even demanded that her doctor give her one!

I don't get this at all. Is it a fear of the idea of your skin ripping? Is it a belief that episiotomies prevent worse tearing? Is it the idea of the "nice, clean cut"?

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Old 08-23-2008, 05:43 PM
 
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I would say it's the power of advertising.
We read al lthe time how episiotomies protect us from tearing.
If they protect us, obviously the thing they are protecting us from must be worse, right?


(please note the sarcasm )

nothing more to say I guess :
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Old 08-23-2008, 05:46 PM
 
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I have no idea, but it doesn't make any sense. Sometimes an episiotomy will tear further creating a much bigger trauma than would have happened in the first place. That happened to me with the birth of my first son and it ended up being a 3rd almost 4th degree trauma. Of course, the alternative they were offering me at the time was a c-section so I chose the episiotomy instead.
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Old 08-23-2008, 05:49 PM
 
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It's just a misconception that has been heavily promoted and widely accepted. I'm the total opposite - I'd wayyy rather tear than be cut. There are some bad-tear horror stories, sure, but it's just more consistent IMO that the longest-lasting problems come from epis.

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Old 08-23-2008, 06:52 PM
 
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I think this is a huge misconception based on advertising. I had the routine episiotomy in the hospital and ended up with an excrutiating 4th degree tear. I had tears with my homebirth but they were miniscule and healed just fine without intervention.
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Old 08-23-2008, 07:00 PM
 
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I have had both, and would much rather tear on my own. I healed much better with my tear than with my episiotomies.
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Old 08-23-2008, 07:11 PM
 
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I never got it either. I think the most common reason is thinking that a cut would heal easier than a tear (not true, generally), I think women are told that and it makes sense to them so they never question it.
I never understood the women who insist on an episiotomy, or the docs who do them on all FTMs. I didn't tear at all with my first, and she was 10 lbs! (and I am pretty petite) not all women tear giving birth, even ones with big, malpositioned babies!

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Old 08-23-2008, 07:29 PM
 
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I've had both and would MUCH rather tear. Women just don't know how excruciating an episiotomy is to recover from, unless they've had one. My tears had virtually no recovery time.
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Old 08-23-2008, 08:15 PM
 
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I dont know but I was scared to death of being cut and my dr. (a fill in) did it without even telling me. My husband watched and said he went from one hole all the way to the other (tmi I know). And mann could I feel it. It took him about 30 minutes to stitch me up and I could see just how far he cut me. There was NO way I needed that. I had been pushing for 10 minutes ON MY BACK when he decided to do this... no decline in heart rate or anything. The next push, her whole body came out cause I was so cut up. UGH makes me mad!

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Old 08-23-2008, 09:42 PM
 
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Definitely ignorance.

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Old 08-23-2008, 10:13 PM
 
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I've heard this about c-sections vs. vaginal birth. I had a third-degree tear (which, yeah, ouch) and my friend said, "I'm glad I had a c-section so I didn't end up with what my doctor calls the 'c-section down below' like that." The same doctor told her at. eight. weeks. that she was too small and the baby was too big for a normal birth.
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Old 08-23-2008, 10:55 PM
 
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My favorite cut-vs.-tear example, from Ina May Gaskin herself:

Take a piece of white paper. Tear it in half slowly -- you should get a somewhat irregular edge. Take another piece, and cut it in half, getting a perfect straight line.

Which one is easier to match up correctly, therefore restoring it most closesly to its previous state?
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Old 08-23-2008, 11:04 PM
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I don't know about what other women experience, but when I went to the "child birth preparedness class" with my mother during her last pregnancy, the woman told everyone that it was better to get an episiotomy because it was easier to stich up, and that if you just tore, you could tear all the way through to your rectum, and it would be jagged and difficult to sew up, and it would REALLY HURT. So, if you insist on no episiotomy, make sure to get the epidural! But even if you don't, get the epidural!

My mother was the ONLY woman in the group that was NOT a first time mom. What do you think those young ladies did? :

Fortunately (hear the sarcasm....), my mother was induced three weeks too early so my sister was so small, she slid out without an episiotomy. Which is a whole 'nother in and of itself.
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Old 08-23-2008, 11:50 PM
 
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Take a bedsheet. Hold it along one hemmed edge and try to tear it. Very difficult, unless you're reeeeeally strong. Now snip into it (episiotomy) and try again. Super easy to tear as far as you like.

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Old 08-24-2008, 12:02 AM
 
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I'll tell you one thing for sure, the women who say that aren't sewers.
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Old 08-24-2008, 12:06 AM
 
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Quote:
Originally Posted by Calidris View Post
I would say it's the power of advertising.
We read al lthe time how episiotomies protect us from tearing.
I don't remember where I read this, but some place described an episiotomy as "a guaranteed second degree tear done to avoid a possible first degree tear maybe extending into a third degree tear."

Mind you, considering coached pushing, I'd bet that doctors do see a lot more tearing.
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Old 08-24-2008, 12:09 AM
 
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With DS I had a small epi and oh my goodness, it was the worst thing ever. My OB just did it, she didn't ask me or tell me It took forever to heal, F.O.R.E.V.E.R. This time I am going to demand no epi if I end up at the hospital (hopefully I get a HB

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Old 08-24-2008, 04:57 AM
 
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Never had an epi but I do tear, last time from hole to hole, second degree, nearly third. It didn't hurt but I do remember the moment it happened, it kinda pinged and I felt the release and I thought 'dammit, I tore'.

I just have this weird feeling that a cut would hurt.

I would still rather tear than be cut any day, the repairs etc are a total PITA (I seem to always get 2nd degree tears fingers crossed for this upcoming birth that I don't get anything).
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Old 08-24-2008, 05:05 AM
 
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From the perspective of someone who is TTC and has not given birth yet, I must admit - both possibilities are not very appealing to me. It's actually the only thing I'm truly scared of ... that I'll be the rare statistic who has some 4th degree tear, and is never the same again. (Yes, I read too many birth horror stories in my research.)

However, I'd trust my body to tear "correctly" than a doctor with scissors (or whatever they use) any day.

Plus, I'm hoping for a UC ... so no one will be around with scissors near my genital region anyway.

I can't ever imagine asking for it, though. I don't know how it could sound even remotely better than natural tearing.

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Old 08-24-2008, 05:12 AM
 
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Their doctor told them that it was best. And they hear about it enough that they think it's normal.

My sister asked about episiotomies (FTM) a couple months before she gave birth (on email). My mom reassured her that they don't always happen, but sometimes the doctor needs too (! ) -- my RN mother who had seven babies, nursed us all, was the first to room-in ever at that hospital, and did NCB with all of us .... had several epis. Including, with her first, a lateral episiotomy.



So I responded and told sister to read the birth books she had, that episiotomies are no longer recommended and I didn't need one with either of mine, etc. etc. And my other sisters agreed (all having birthed more recently than mom ) ....

My sister ended up with an episiotomy. The doctor cranked the pit because she'd had ROM that morning and wasn't progressing fast enough - she went from 3 cm to 10 cm in 45 minutes and the doctor cut her during the delivery. She told her she needed to, or else she would tear, and that would be worse so she'd just give her a little snip.

My sister thought therefore that she needed it, and that it was perfectly normal. I think there is a lot of that out there. The doctor says it's necessary, therefore it must be.

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Old 08-24-2008, 05:28 AM
 
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I've read some of the horror stories about epi's that never heal back correctly. My homebirth ended up with me being transferred to the hospital after 15 hours. I ended up having 3 tears, one cervical, one vaginal and one peri. I think the peri was around a 2-3 degree. But I wasn't cut, and the doctor sewed me up afterwards. I've had no issues from them and I am grateful for it. I am guessing the DR was afraid to ask if he could cut me cuz I kept saying "No" to all his other interventions. He must have figured out by then that I'd just say no to an epi as well.
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Old 08-24-2008, 05:43 AM
 
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I have to say though, if you get a Doc like my first (although I don't birth in hospital anymore and didn't want to with my first), then maybe, a cut is better lol. He was really nic when he walked into the room, he asked if he could do an epi (at least he asked right?), I said no, from that point on, he turned into a right UAV.

If that wassn't bad enough, the othe Ob/Gyns closed ranks (except for my lovely one at a different clinic). My Gyn was horrifieed by how I had been stitched and said I NEEDED it to be redone, I was referred over to gynae (its complicated, tthe Gyn I was seeing was part of Genito Urinary Medicinee, for Ops etc, you need to be referred over to the Gynaee Dept which is different) the gynae oveer there stated that the pain I was suffering was from my vestibulitis (however it was in the wrong place to be that) and that because the guy who repaired me is so good at what he does, there is no way he could have made a mistake with mine.

I lived with it until I next gave birth, the female gyn who repaired me that time did a great job. Its difficult to describe.
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Old 08-24-2008, 09:42 AM
 
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My mum told me it was because it was neater. She had one because i had to be gotten out with the vacume (true need her back collapsed and was unable to push) I dont think she really thought about it to be honest, until i told her a few facts about it, now she agrees with me.
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Old 08-24-2008, 10:49 AM
 
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I have had both. I had a small snip with my first child that took 2 stitches to fix afterwards. Honestly, I recovered just fine from it, but the doc did that little snip just as DD's head was already coming out (to help her come out faster maybe? IDK.) I had a good amount of tearing with #2 and her arm was up so her elbow caught me along one side. I had an internal tear on that side that took about 20 stitches or so. I felt back to normal pretty soon, except in certain positions it felt funny for about 6 months. With #3 I tore a LOT! I felt the urge to push at 9 1/2 cm and my wonderful OB said go ahead then and massaged with olive oil. That baby came out so darn fast that I ended up with quite a bit of tearing. I think that one was around 30 stitches or so. I felt completely normal in 4 weeks.

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Old 08-24-2008, 02:37 PM
 
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My OB insisted on one due to the vacuum extraction... just one more thing I can add to the list of "if I only knew then what I know now".

Episiotomy took months and months to heal and almost a year before I felt normal down there again. I also had a nasty tear into my urethra so it didn't prevent me from tearing. The tear hurt worse initially because of the location but it did heal much much faster. I tore again with my second and it was nothing.
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Old 08-24-2008, 03:25 PM
 
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I got into it with a woman once. I am surprised we remained civil it was not a pretty discussion. And she finally just came out and said that it totally skeeved her that her skin could tear. The thought of the sound, the way it would feel. She would much rather be numbed and cut. I can imagine the fear that raced through her, the thoughts she had.

Of course women don't understand the risk factors, the chance of tearing once you are cut, the bruising from the scissors, the numbing meds might not work, etc etc etc. How exposed are most women to birth? Esp natural birth where tearing happens vs an epis? They just don't know.

I have never torn or had an epis. A couple of skid marks but nothing requiring stitches. And I STILL worry about it. 7 births and I still worry! I don't want to tear. So I take every precaution so I don't. Wouldn't be awful to say go ahead and cut me so you don't tear only to have never torn? Then how would you know? And I think that thought will keep scissors far away from my bottom. Just let me tear.

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Old 08-24-2008, 04:18 PM
 
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It's a dated idea. My mother was an L&D nurse in the late 60's/early 70's and although had 3 unmedicated births demanded an episiotomy because "damned if she was going to tear". It was the belief at the time that a clean cut healed better... but research since showed that fewer women tore less than routine episiotomy warrants (I know, preaching to the choir). But I guess not everybody is aware of or gives value to that research, just like so many other issues in womens' medicine.
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Old 08-25-2008, 02:47 AM
 
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Yep... it's just from what has been passed down. Before my first I had L&D nurses telling me horror stories of women they'd seen tear up into their cervix. They were trying to convince me an episiotomy wouldn't be too bad.

I've now had both. The tear healed much much much faster.
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Old 08-25-2008, 05:37 AM
 
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Like other parts of modern medicine, if an episiotomy is a pre-emptive strike against a random tear, I will take my chances with a natural tear. I have had four children, never an episiotomy, two small tears that I never noticed.

Quote:
It was the belief at the time that a clean cut healed better... but research since showed that fewer women tore less than routine episiotomy warrants (I know, preaching to the choir). But I guess not everybody is aware of or gives value to that research,...
There never, ever was a smidge of evidence anywhere that an episiotomy was better than a tear. NEVER! Again, a sign of doctors using a treasured procedure without a shred of evidence it works. There was always plenty of evidence that episiotomies did more harm than good. Someday doctors will back off of doing so many caesarean sections, but I am afraid of what they will replace it with.

It is not nice to fool Mother Nature.

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Old 08-25-2008, 08:35 PM
 
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I always wondered about this...I never new much about weather it was better to tear or have an episiotomy. I had a natural birth and tore and got some stitches. It did not heal well on its own at all. I went back for my 6 wk pp check up and the thought of anyone touching anything anywhere down there scared the crap out of me. The midwife took one look and said, "Oh, that's not what we were going for." and called in the OB. I ended up getting surgery to repair it (they recut me open and resewed me up) and then another in office procedure later and I still have issues with pain (ds is 8 months). So I often wondered if an episiotomy would have been better. Reading this thread has been interesting.
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