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Someone suggested I post my question here...<br><br>
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. She said that my skin just wasn't stretching.<br><br>
I'm newly pregnant again, and my question is, is there anything I can do to not have to have an episiotomy for my second birth? 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? Can I lessen my chances of having to be cut, or am I doomed? Hope someone can help!
 

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You never "have" to be cut. If the birth is spontaneous and you are pushing on your own not being "coached" then you will tear as much as you need to or not at all. Most likely you were on your back or in a reclined position, try different positions next time and be very clear with your care provider. I was told by the OB with my first that I was "small down there" with my 2nd a HB, I tore a little bit down the scar but it was no big deal and it felt better under a week.
 

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I had a fourth degree tear and an episiotomy with my first. Second time, despite my baby being a pound bigger than the first, with her hand coming out with her head and slightly transversed i only ended up with a very small tear.
 

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It is extremely rare for a woman to really <i>need</i> an episiotomy in order for the baby to be born.<br><br>
One instance where an episiotomy might be preferred would be if the tearing were going up toward the urethra or clitoris. An episiotomy may redirect the tear downward and avoid damaging that more sensitive area.<br><br>
Of course, positioning and perineal support do a great deal to prevent tearing all together! I did my own perineal support with my last birth and I think that's definitely the way to go. I knew exactly where I needed support and didn't have to bother with verbalizing it. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/winky.gif" style="border:0px solid;" title="Wink">
 

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With my second I was told I needed an episiotomy because otherwise I would tear. Darn hospital midwife cut me without my permission and it took me weeks to heal.<br><br>
With my third I went to a freestanding birth center where I knew I'd have a better experience. I only tore a little bit.<br><br>
I truly believe that I would have only torn a little bit with my second and that the midwife caused me to suffer needlessly.
 

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Don't go back to that midwife, that's step one. How is it logical to inflict the equivalent of at least a second degree tear to AVOID tearing? Makes no sense. And how on earth could she know you simply weren't going to stretch after pushing only 20 minutes?
 

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I certainly agree with all of the above..there was simply no reason to cut you! What about hot compresses and perineal support? Couldn't she have helped you to slow down a bit? I have seen paper thin, tight perineums just slip right out of the way ( and I have seen a tear or two for no good reason) so take heart. We once worked with a mom having her 8th baby and had had the first 7 in hospital with epis each time! No tear, even with a 10+ baby and a shoulder dystocia! It helps some ladies to do perineal massage the last 6 weeks or so of their pregnancy..lots of oil and gentle streach. Can't hurt, might help. And delivery position is very important (or water birth)
 

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I have a related question... I pushed for 2 hours and for the last half hour my dd's head was stuck half way out (almost to the ears). Then her heart rate started dropping and my midwife told me that she knew I didn't want an episiotomy, but since the baby's heart rate was dropping she'd give me a few more pushes to try and get her out without one and then she would like to cut me. I appreciated that she gave it as an offer instead of a "we're doing this now" but now I'm so confused. It was a tiny epis (7 stitches) and I didn't tear anywhere at all... did I actually need one? Obviously I'm glad my daughter was fine and the healing wasn't bad at all since it was such a small cut, but I'm wondering why since my daughter's head didn't move at ALL for about 30 minutes why I didn't stretch or tear or SOMETHING? Is it possible my skin was just a bit too tough down there? Are these genetic issues actually possible (as mentioned in the leading post) where our skin just isn't made for that or something?<br><br>
I'm pregnant again, now, and I'm assuming I won't be needing an episiotomy this time.... but I'm so curious about what happened last time.
 

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Did you try changing positions, Juvysen? It's unlikely that your perineum wouldn't stretch though I guess anything is possible.
 

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<div>Originally Posted by <strong>SublimeBirthGirl</strong> <a href="/community/forum/post/7953388"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Did you try changing positions, Juvysen? It's unlikely that your perineum wouldn't stretch though I guess anything is possible.</div>
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No. Next time it will be discussed AT LEAST, but to tell you the truth I'm not sure after all that moving was a choice... Opening my eyes didn't even feel like a valid choice... pushing was all my body was interested in. I do wish someone had harassed me into it though.
 
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