episiotomy!!

mommy2bex3 · September 2010

okay,so this is my 3rd child.have had epidurals with my first 2 and want to go natural this time.the only thing that has me undecided is the episiotomy.im so worried how bad that will hurt without pain meds if i have to have one.any advice/encouragement?

Lexs4 · September 2010

Don't get one! There's generally no reason you need it. Do some research and you will come to this conclusion. If you tear, you tear, but there's a good chance you may not & if you have an episiotomy you have no choice but to suffer the recovery. If you absolutely have to have one, make sure you tell your doc to do a pressure episiotomy which does not require any meds when the incision is made.

AshasaurusRex · September 2010

Are you saying that you're under the impression that an episiotomy is inevitable? If you do some perennial massage, and push the head out nice and slow, you will not only not need an episiotomy, but you have a good change of not tearing at all. And if you do tear, most of the time it's not nearly as bad as an episiotomy, in fact episiotomies make you more susceptible to tearing. Imagine pulling on a piece of fabric really hard that already had a nick in it, it would tear easily and a lot more than a piece that was intact.

mommy2bex3 · September 2010

i havent really talked to my doc yet but im hoping he isint one who generally goes for it.i had them with both of my other 2 and still hurts sometimes

mommy2bex3 · September 2010

not really enevitable but it seems my opinion wasnt asked with my last two.then again i didnt know to speak up either.i go back for an anatomy scan on oct 18th and am planning to talk to my doc about it then.i really want to go natural.i wont be having any more kids after this so i want to experience as much as i can

papagena · September 2010

Ditto pp - I've always heard that healing and complications are actually fewer with tearing than with episiotomies. Definitely talk to your doctor.

cheerleader.08 · September 2010

Talk to your OB about it. I have really fast labors, so I made sure my OB's knew that. Then he was prepared to help slow the baby down. After I delivered he said my entire last push he was holding the baby in until the very end when my force was not as strong, and then he could guide him out. So if you feel you are likely to tear, make them aware of it, and then they can be extra diligent during those last two pushes.

~adamwife~ · September 2010

Don't get one. Focus on breathing through the pushing and have your OB/MW work on stretching you. I have had two vaginal births and haven't torn with either and I credit my amazing MW and her massages.

mommy2bex3 · September 2010

thanks for all the advice everyone.with my first it was pretty fast i only pushed 3 times but had a spinal instead of epidural and couldnt move my legs or feel them.not a good feeling.with my second i was put in the hospital 3 weeks early and induced due to problems.but i didnt push much with him either and in my opinion they gave me my epidural waaay to early.i wasnt even hurting at the time was dilated to 6 already.but the anesthesiologist had to hurry had a kid getting their tonsils out.needless to say i switched OB this time and he is heaven sent so far.im really looking forward to doing thids natural,as i have definetly not liked meds

erinkate23 · September 2010

I just wanted to hop in and say that it's not always an either-or!

I had neither.

Kegels and perineal massage, plus a midwife who will support you and tell you when not to push.... all of the above are very helpful. I'm not saying you won't tear for sure, but you should know that tearing isn't inevitable!

SoxChamps · September 2010

Make sure to ask your Dr about what % of their patients have one. It shouldn't be necessary unless there is an issue with the baby that requires a quick delivery (heartrate issues etc.), but if your Dr routinely does them 80% of the time, then don't count on being able to get around it. If one were to be necessary, they will usually give you a shot of lidocaine as the baby is crowning, when the pressure of the head should make it so that you don't feel the shot. Then you may get more afterwards for stitching.

SoxChamps · September 2010

And if you are giving birth without meds and pushing with your urges instead of with every one yelling at you, in a position that is comfortable (esp. not on your back), you aren't likely to have a bad tear anyway. You could also consider having a doula. She could be your extra set of eyes to watch for the DR grabbing the scissors.

AshasaurusRex · September 2010

mommy2bex3:

not really enevitable but it seems my opinion wasnt asked with my last two.then again i didnt know to speak up either.i go back for an anatomy scan on oct 18th and am planning to talk to my doc about it then.i really want to go natural.i wont be having any more kids after this so i want to experience as much as i can

In that case, I hope you switched OBs. You might want to write up a birth plan with all of your birth preferences listed and give it to you OB so you're on the same page.

bliss611 · September 2010

even without an epi - they generally inject a tiny bit of something for this. But I have to admit getting the stitches for the episiotomy was the worse than the entire labor without an epidural.

Temp110085250009077 · September 2010

I've also had 2 LOs, both with epidurals and episiotomies. One of the main reasons I began considering a natural birth was to avoid the episiotomy this time around. If I can feel what I'm doing, and have the help and encouragement from my midwife, I feel very confident it can/will be avoided, as well as tearing. GL

ErinMSB · September 2010

I agree with all the advice so far. But I'm gonna give you a little different take... I went med-free with DD but still ended up with an episiotomy. (Long story short, there was some concern about late decels with her heart rate and they started threatening a C-section if I didn't consent to an episiotomy to get her out.) I think the episiotomy greatly affected my recovery. But when it comes to actually feeling them cut my perineum... I didn't feel anything! I know that sounds crazy and I wouldn't have believed it if it didn't happen to me, but it's true. My understanding is that the baby's head creates so much pressure that it affects the nerves and you don't feel it like you think you would. Afterward, they used some lydocaine (I think) to numb the area before stitching it up. Hope this helps!

koosh ball · September 2010

I would be finding a new doctor if they said they did episiotomies unless it was a life or death situation. There is 0 reason to do them not a days.

macchiatto · September 2010

I switched doctors at 31w because my original practice was just way too intervention-happy. DH and I met with the new OB for a good hour (he was very willing to talk to us, gave me a u/s, etc.) and went over my birth plan. I said I wanted perineal massage and that I would prefer to tear naturally rather than have an episiotomy if at all possible and he was fine with that. I ended up with a second degree tear (not sure if that was from pushing out Baby A or the breech extraction of Baby

, but healing wasn't *too* bad. I definitely haven't had any lingering pain from it.

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