January 2012 Moms

Episiotomy...your experience

Today at work I'm spending my time researching labor and delivery. Now, I don't know how reliable babycenter.com is, but they had a section on Episiotomies that of course did nothing to help my nervousness in regards to tearing down there.

The paragraph I copy/pasted is what worries me the most, so I'm wondering if this is true, for those of you who had one with your first baby.

Is it better to just tear naturally?

http://www.babycenter.com/0_episiotomy_165.bc

Research has shown that women with a spontaneous tear generally recover in the same or less time and often with fewer complications than those who had an episiotomy.

Women who have an episiotomy tend to lose more blood at the time of delivery, have more pain during recovery, and have to wait longer before they have sex without discomfort. Episiotomy also increases the risk of infection, and a recent study showed that getting an episiotomy for a first vaginal birth is linked to an increased risk of tearing in the next birth.

What's more, women who get an episiotomy are more likely to end up with a serious tear through the anal sphincter or even all the way through the rectum (known as a third- or fourth-degree laceration, respectively) than those who deliver without being cut.

These serious tears result in more perineal pain after the birth, require a significantly longer recovery period, and are more likely to affect the strength of the pelvic floor muscles. Tears that disrupt the anal sphincter make it more likely that the mom will have anal incontinence -- trouble controlling bowel movements or gas.

Re: Episiotomy...your experience

  • From what I have heard from women who are already mommas it's way better to tear naturally, though I hope to god I don't have to tear at all.  Eh..

  • Is it bad that I have no idea if I had an Episiotomy or if I just tore with my first 2? I know I had stitches, but I have no idea why. The docs certainly didn't tell me anything. I know I didn't have either with my third and fourth because there were no stitches needed. I would still opt for a natural tear over being cut, I have heard the recovery is easier.
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  • I tore - very badly.  Not gonna lie and say it's super fun, but it really wasn't that bad to recover.  I never took anything stronger than motrin.
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  • Never agree to an episiotomy.  If you are going to tear then so be it but why would you make it worse by cutting.  Think of it like a piece of paper it you put a small cut in it then pull both sides how much further and easier is it to tear by pulling from opposite sides.  I personally think OB's who do them should be stoned!
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  • I'm small and I pushed for an hour and a half. At that point I was exhausted and totally ready for the baby to come out so when my OB said he was doing an episiotomy I did not care at all, I wanted it over. Even with the episiotomy, I tore more and ended up with a tear almost all the way through. So, I had both. My experience is that it probably doesn't make any difference how it happens, it's going to hurt and you're going to have a worse recovery than someone who did not need an epi or did not tear. Even someone who only had a small cut or tear would have an easier recovery  time. So, IMO the recovery depends on the person and the situation and how severe the tear or epi is. 

    I was scared of having sex for a long time, and it was not comfortable when I did. It didn't hurt but it felt weird. It was a while before that was back to normal. I have no issues with incontinence of any kind as the article warns.  

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  • image selena61307:
    Never agree to an episiotomy.  If you are going to tear then so be it but why would you make it worse by cutting.  Think of it like a piece of paper it you put a small cut in it then pull both sides how much further and easier is it to tear by pulling from opposite sides.  I personally think OB's who do them should be stoned!

    Really? Because they're doing something to try and help you? You may not agree with it, but they're not doing it to harm anyone. I agreed to one and would again.  

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  • I had a friend who had one.  She had been pushing for 2.5 hours and the doctors were starting to talk about doing a c-section because her baby needed to get out.  She asked if there was anyway to avoid the c-section, and the episiotomy was the answer.  Before giving birth, she was totally against it, but in the moment she felt that an episiotomy was better than a c-section.  She just wanted her baby out.

    I know she had a lot of pain at first, and was on quite a few painkillers (they even gave her cocaine cream to put directly on the area - that's right, straight up cocaine).  But, she's healed now (about 3 months later) and has no regrets.  

    I know it's easy to get really nervous when doing all the research (hello, who wants to think about pooping and bleeding in front of everyone), but I think when it gets to be the time, you just do what you need to do.  

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  • image anhg80:

    (they even gave her cocaine cream to put directly on the area - that's right, straight up cocaine).  

    Huh??   

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  • I don't think most Dr's even do them anymore. I tore naturally and ended up with like a million tears going all the way around. Think throwing a baseball at a window and seeing all the cracks. Yeah tearing sucks, but it's really not the worst thing ever.
  • image Kflie83:
    I don't think most Dr's even do them anymore. I tore naturally and ended up with like a million tears going all the way around. Think throwing a baseball at a window and seeing all the cracks. Yeah tearing sucks, but it's really not the worst thing ever.

     This gave me the oddest visual. haha, good description though!

  • Sometimes it's medically necessary.

    I had a very fast unmedicated labour. From start of contractions to pushing was 4 hours. I pushed for 20 min and the baby just wasn't coming out. His HR started dropping and was in the 50s for a couple minutes. At that point my midwife said she needed to do an episiotomy to get him out stat. With the next push he was delivered with a 1st APGAR of 9. Perfectly healthy.

    Midwives do not just choose to do episiotomies out of convenience. OBs dont either, but sometimes they are medically indicated.

    I ended up having a 3rd degree tear and the recovery wasnt pleasant. It took 1.5hrs for the OB to stitch me up. My anatomy is slightly different down there now and yes I am having pelvic floor issues with this second pregnancy due to the decreased muscle tone. I will likely having tearing this second time, but who knows.

    Was the tearing worse because of the episiotomy? Yes likely. But did the episiotomy enable my son to be born in a critical moment? Yes! And that is what is important.

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  • I just found out my doc does them all the time. If she thinks you are going to tear, she'll just cut, not even ask you. So we have to make sure to tell her, that I would prefer to not have one, or, at least let me know when she's gonna do it.
  • I had an episiotomy w/ DS, and have not had any issues whatsoever as a result.  I had been pushing for just shy for 2 hours, and my DH and mom both verified that his head was NOT coming out w/o either some tearing or the episiotomy - granted, I did birth a baby w/ a 15" head, though!  At the point that my OB went for it, I was running very low on energy, so my pushing was suffering as a result, and I could have cared less WHAT was necessary to get him out.  As soon as she made the cut, he was out.  She said later that it was basically equivalent to a 2nd degree tear, but that was the only damage done - one tiny, straight cut that she was able to stitch up cleanly, neatly, and quickly.

    My recovery was very quick and easy - I've never experienced recovering from a tear, but I was up and around w/in 2 hours of birth and never needed any painkillers beyond regular Tylenol, and even those I only took for a day or 2.  I had no complications whatsoever, no infections, everything healed up perfectly, and everything was fine in the bedroom, as well - nothing more than the average postpartum discomfort that I'd been expecting, and certainly no real pain to speak of.  I've had no residual issues w/ incontinence, either.

    If it was necessary for this baby, would I allow it?  Absolutely.  There was NOTHING in my recovery from DS that would make me stop and rethink the decision to allow such a procedure to be done to deliver my baby safely.

  • Both my kids came out in one push, so it wasn't really an option. I tore both times. I had an epi, so I didn't really know other than the dr. putting the stiches in. It hurt the next week or two, but I don't know any different. I imagine it would have still hurt down there had I not torn. It wasn't fun, but not as bad as I was expecting either.
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  • I tore naturally.  A friend of mine delivered at the same hospital as me and her doctor gave her an episiotomy.  Basically they cut her from one hole to the other.  She said she would have preferred a c-section over the botch job they gave her.  So my vote is to tear naturally and let your body decide how much it needs to tear vs the doctor taking a wild guess.
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  • image sheetzsa:
    I tore - very badly.  Not gonna lie and say it's super fun, but it really wasn't that bad to recover.  I never took anything stronger than motrin.

    This.  Think of it this way - if you cut a piece of paper with scissors, it continues to tear much more easily and it is much more difficult to connect the two pieces back together.  If you tear a piece of paper, it is much easier to put back together and doesn't continue to tear as easily as if it had been cut.  I think it's very similar to the way our bodies work when it comes to episiotomies.  I would never opt for one. 

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  • I had an episiotomy. I pushed for 3.5 hours and at that point I wanted him out! My recovery wasn't bad at all... and no lasting effects. I've heard of people tearing completely and that scares the crap out of me. I hope for my same experience again.


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  • I had one because I remember my doctor telling me "I'm going to make a small cut so we can control the tear."  I didn't feel a thing thanks to the Epidural, and since I honestly don't have anything to compare it to I don't know if it was the best way to go or not. I can tell you that it was nothing I couldn't handle with Motrin.  I'm not sure how much I did end up tearing, but I know I was stitched up pretty good on the inside and the outside. There was so much going on at that point that I just had to trust my doctor to do what was medically best. Everything healed perfectly and I have never had any issues.

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  • My OB doesn't do episiotomys - he feels that when you tear your body only tears as much as it needs to. I've only gone thru labor once (so far) and the healing was totally fine no issues...my sister in law's doc does episiotomys but she didn't have a probably at all...I feel like if given the choice I would want to tear on my own....
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  • I didn't have an episiotomy either time. I had a very minor internal tear that required a stitch or two with my first, but it honestly wasn't any more painful than healing from birth already is. I didn't tear at all with my second.
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  • I'll be honest after reading a lot of these stories it makes me not want to have a VBAC....all the internal and external tearing makes my c-section sound easy....not that any way of giving birth is easy, but these scare me.
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  • I had an episiotomy.  I never felt the cut -- but I felt when he was sewing me up.  Infection was not a major concern for me - I just used the water bottle the gave me to rinse myself each time I used the bathroom (I added a drop of betedine solution to the water, also).  My friend who did not tear at all bleed for more than 6 weeks. I only bleed for about 2 weeks and only the first couple of days were heavy.  the first being the heaviest, of course but nothing that grossed me out or anything like that. 

    I was cleared for sex at 6 weeks (as a matter of fact my male doc. felt the need to remind me that I had a duty to not forget my husband's needs -- it was funny).  We waited a couple of more weeks just so I could feel comfortable again.  I was worried... but the first time back was great.  No abnormal pains or anything like that.  I hope I don't tear this time around.  Obviously I would not like an episiotomy either -- but I had great healing with mine so I might choose that over tearing all the way to my crack.

    I don't remember needing motrin or anything.  I was most soar the first couple of days but not in major pain or anything. I used the witch hazel pads and they were like heaven each time I put on a new one.

    I hope this helps.

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  • Episiotomy's are kind of out dated. They used to be more common because they were thought to be better but it is better to tear naturally for you and the baby.

    EDIT:
    FWIW I tore with DD but only had 1 or 2 stitches. I don't remember. I don't remember it being totally unbearable recovering from though
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  • lp0lp0
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    I don't have any experience with this personally since I am a first time mom but a few of my friends had to have them (all within the last year so they are still very much in practice). I would think that a cut would be easier to stitch and heal than a tear but that's just my thought.
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  • I had an episiotomy and still tore. In all fairness to my doctor, he did let me push a long time and try on my own before he recommende that I get it. She had a big head and I couldn't get it out. She kept crowning then going back up and I was completely worn out and couldn't do it anymore. Recovery was rough for me. Sitting was very uncomfortable for probably about 4 weeks and still not great when i went for my pp check. Turns out that the dissolvable stiches did not desolve and he had to remove them because they were causing me discomfort. That spray bottle they give you at the hospital is your best friend!
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