- Pregnancy
- Baby & Toddler
- Parents
- Getting Pregnant
- Baby Names
- Product Reviews
-
Registry
- Community
-
More
Want a personalized experience?
Download the free app
3rd Trimester
Why would I want or not want an episiotomy? Need help w/ my birth plan.
I'm a FTM, so I think I have a general idea of how I want the birth to go, but some of the specifics are hard since I've never done this before. I've read some other nestie's birth plans to get some ideas.
I'm stuck on episiotomy vs. tearing. Why would I want one over the other? How about C. None of the above! 
That would be nice!
Warning
No formatter is installed for the format bbhtml
This discussion has been closed.
Re: Why would I want or not want an episiotomy? Need help w/ my birth plan.
Generally a natural tear heals easier. Also, the episiotomy creates a weak point that can actually make tearing worse this coming from experience; I had 2 episiotomies and still tore past them, resulting in a 4th degree tear.
Think of your perenium like fabric; you can pull and pull and it'll be ok, but if you put one little cut in the selvage suddenly you can rip the fabric apart easily.
Agreed.
I technically had a tear, but the doc said that it was so minor that it was barely a tear and he was just using stitches as a precaution. Stitches suck.
And, like the first PP said, I've heard tears are better because jagged skin is going to heal together better than a straight line.
Just because you have a birth plan doesn't mean you won't be/can't be flexible with it. It is always a good idea to go into the situation informed and aware of your options and your ideal scenario.
I had a cut, and then tore additionally. I wound up with 25 stitches both internal and external. nurses said it was the most traumatic birth they'd seen in years.
i tell you this to follow up with I felt neither the cut nor the tear. I heals evenly across both in the same amount of time.
my advice? Donto do a birth plan in this area. let your birth experience be what it will be and trust your doctors to make the best decisions for you and your abyss health. they do deliver more babies than we do.
Even though I wrote my birth plan and the doctor has it, and knows what I want that doesn?t mean that?s how it?s going to go, basically I left it as this, ?if you believe an episiotomy is necessary then I trust your judgment.? My Doctor will be able to see down there when I can?t, she will also know what?s best for me and my child, and I honestly believe that she will make the correct decision for me when it comes down to it.
Episiotomies used to be standard practice and in my area at least, no longer are. Generally speaking, an episiotomy is a 2" cut through skin & muscle that if done as standard procedure, is meant to prevent a tear. If done because baby is stuck or in distress and needs to get out now, it's meant to get baby out asap. Natural tears, on average, are a centimeter or two and are on the surface, meaning not a muscle tear. It is, of course, possible to have a more serioues tear but that is less common. A tear is not guaranteed to occur with a vaginal birth; an episiotomy is guaranteed to give you something to recover from.
Most women I know would rather risk a small natural tear rather than opt for an episiotomy. In my birth plan, it states that I would prefer not to have one and would like to try XYZ to help get the baby out first. If that fails & baby is stuck or in immediate distress, then I consent to having one but want only counter pressure applied for the cut and then something to numb the area when being stitched up.
FYI - my practice has a 2% episiotomy rate. Most women do not need one.
I think it really depends on your doctor with this one. My doctors won't even do an episiptomy unless absoluetly neccessary (like the baby gets stuck) because they think tearing heals better. Have you talked to them about it?
My opinion is don't cause yourself more pain down there with them making a cut and just let your body take care of itself. Although you will be very sore either way...
There are so many variables that go into which is going to result in less trauma (tearing vs epis) that it is a decision best left to the time of delivery. I agree with the other posters, though, that an epis is not always needed and shouldn't be done prophylactically for every patient.
The nitty gritty specifics, when it comes right down to it, really aren't up to you. They are mostly dictated by your baby and how your labor and delivery progress. Trying to micromanage it to that degree is pointless and pretty much only sets you up for disappointment.
The ACOG advises AGAINST the routine use of episiotomies and very few OBs will still do one just for kicks anymore. IF you are tearing in a bad direction and they want to reroute it, they will do it. If they need to make some extra room, they will do it. These are decisions that are made in the moment based upon your needs and the needs of your baby in the moment. If you don't trust your physician to make these sorts of judgement calls as you are delivering, you need to find a new doctor.
I found it's always best to discuss your concerns directly with your healthcare provider, rather than handing them a list of your "plans."
ditto, this is exactly what i meant in my post. they are paid to deliver our babies for a reason. they will do what they think is needed, and you should trust your drs judgement. of course nobody WANTS an episiotomy.. who really wants their vag cut open? but if your dr thinks you need one, what are you going to say "THATS NOT IN MY BIRTH PLAN!"... no.
Brayden (5 1/2) born 12.28.06
Hailey (4 1/2) born 2.25.08
Taylor (8 Months) born 12.26.11
My birth plan with DD said no episiotomy. However, after close to 3 hours of pushing my OB said that we'd either need to cut or consider a c-section (he wouldn't let me push longer than 3 hours). He said I had a ring of tissue that some women have that would not stretch or tear (they'd be trying to stretch it from before I'd even started pushing. I let them cut and in 2 pushes she was out. I had stitches but healed quickly, and it was surely better than a c-section.
Sooo, my suggestion is to talk to your OB, express your wishes, but keep your options open!
This exactly. Also, if you have an episiotomy, it may never have been necessary. There is no guarantee that you will tear during delivery, so you're better off just letting it happen naturally if it's going to happen unless there is some reason that the baby needs to come out immediately and letting you tear naturally would take too long, though this isn't too common.