Natural Birth

Why do doctors like to cut?

A lot of posts about episiotomies lately. From what I've read, of all the interventions, episiotomies seem to have far more risks than benefits. Surely, care providers are aware of the research: does not prevent tears, associated with more severe tearing, etc. So, why are so many of them so insistent on cutting, apparently even when a woman does not give consent.

Why is there such a rush to get the baby out now? As long as the baby's heartrate is strong, what is the point? Can some one explain this to me?

Re: Why do doctors like to cut?

  • None of the three different dr.'s I had liked to cut.   For them, it was an absolutely last resort.  For some cases, episiotomies are needed.    My case was one such case.
  • The one thing I've heard (from nurses at the hospital) is that it's the older doctors who are still stuck on cutting.  I guess 'cause it's just "what was done" many years ago.  A lot of the younger dr's are getting away from routine episiotomies.  Other than that, I have no idea!

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  • Because many of them don't read the updated research.  

    Because their mentors and Drs training them cut, so that is what they learned during their residencies.  

    Because it is EASIER for THEM to get the baby out while keeping the Mom in the standard position (on her back). 

    Because as OBs are surgeons and surgeons are trained look for problems and to treat them.  It is part of their training and for many of them in their nature.


    IMO OBs (in general) should have never become the standard for normal pregnancy care and should have been reserved for high risk situations.  They just don't have the proper training for healthy pregnancies and births...which is ironic considering how many years they have to attend school.  

    Lilypie - (ZESJ)Lilypie - (QAi1)

  • I was reading the episiotomy posts, and they really upset me.  I feel lucky that when we worked with an obgyn for my first that she massaged me with oil and did not cut me-- I told her I preferred not to be cut, but I trusted her if something was wrong, but please ask me again before doing it-- she never came close to cutting, and I did tear (albeit internally).  I am not sure why doctors cling to doing them, especially when recent studies really do support NOT doing it.
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  • In my case, I was never able to get any resolution by talking with the OB about it - she left the practice (and the state) after I filed my complaint with the state medical board and it was a different doc at my 6w PP check-up.

    At the time, she told me that I was going to tear anyway since I was too tight for the baby to come out. Which anyone who's done any reading knows is a ridiculous argument and impossible to prove.

    My baby's heart rate was fine, I was fine, there was really no medical indication for it.

    I truly believe that she was just cranky and wanted to go home. It was nearly midnight and she kept telling me the whole time I was pushing that I needed to hurry because she still had a c-section to do on someone else before she could go home. I also think that in some cruel, twisted way, she wanted to "punish" me for the med-free birth I wanted (and got) - which she had been telling me all along that I would never get because I would beg for the epi as soon as I got into labor.

    Why I did not switch practices, I will never know, and if I could go back in time, I would... I never liked that woman, but she was one of four OB's in the practice and I kept thinking that the chances are good I would get someone else... If anyone else reading this can learn from my mistakes, ladies, PLEASE trust your gut instincts!! I don't care how far along you are - it is NEVER too late to switch (or at least look into it).

  • It's faster and easier for a Dr. to cut rather than massage with oil.  It's also faster and easier for them to stitch up a straight cut than a jagged tear.  Easier stitching however does not mean better healing.
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  • My midwife went and got a Dr to get her thoughts on whether an episiotomy was necessary. She was worried baby was having trouble getting out.

    The OB took one look, and said, "no, two good pushes and she'll be fine." Then hung around to be my own personal cheer squad. 

    Elizabeth 3yrs old Jane 1yr old

  • For my son, they cut because his heartbeat kept dropping and he was sunny side up.  I'd do it again in a second.  His little face was all bruised from getting smashed inside.  Poor baby.....
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  • I wouldn't say that my doctor likes to cut. I needed an episiotomy during my delivery because my daughter's heartrate dropped dangerously low and wasn't coming back up...we needed her out ASAP. My OB flat out told me that she hates doing episiotomies, but that in the situation it had to happen. As a NICU RN, I completely agreed with her intervention. In addition, the entire time I was pushing, my OB was doing perineal massage, warm compresses, and encouraging slow pushing.

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  • Very, very, very, very, very, very, (etc) rarely is an episiotomy needed. Yes, women do tear sometimes, but it is far better to tear naturally than with a surgical cut.

    Some doctors (not all, but an alarming amount), feel the need to "do something" once they are there. So an episiotomy is what they "do" to "help". I could rant for hours on the subject.


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  • I wasn't cut with either girls. It was the only thing in my birth plan to avoid (and try to avoid an epidural)...
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  • At the hospital where I delivered, the trend is in the opposite direction.  They hardly ever do episiotomies anymore.

    It's a teaching hospital and while I was pushing out DD, DH heard the student/resident suggest an episiotomy.  The doctor (not my regular OB) replied, "I don't do episiotomies."  And that was that.  (I was very thankful that I did not hear that comment!  Thank goodness DH had paid attention in child birth class and knew enough to pay attention!)

    I had a second-degree tear which wasn't a big deal at all.


    TTC since 11/05...ectopic pg 4/08...early m/c 6/09...BFP 10/5/09!
    Nora B...June 15, 2010...8lbs, 8oz...Med-free birth!
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    Malcolm...September 21, 2012...8lbs, 6oz...Another med-free birth!
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  • image monkeyqueen:
    None of the three different dr.'s I had liked to cut.   For them, it was an absolutely last resort.  For some cases, episiotomies are needed.    My case was one such case.

    you are in canada, right? much better OBs there, i hear.

    my guess is that this is what they are trained to do. they are trained to use interventions, regardless of what that intervention is. they are trained and licensed to PRACTICE MEDICINE.

    if they just sit around and wait for mama to birth her baby all on her own, exactly what "medicine" did they get to practice?

    precisely why i think we need more MWs and fewer OBs in this country.

    [color=purple]Wife ? 9/18/04
    Mommy ? DS - 2006 (C/S) & DD - 2010 (HWBAC)
    Wellness Provider ? Birth Doula - Hypnotherapist - HypnoBirthing - Reiki Master/Teacher[/color]

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