S/O of Birth plan post

PC0909 · July 2014

Why are a lot of people trying to avoid episiotomies? I was devastated that I needed one with DS and it turned out to not be a big deal at all... and my OB made a comment after that really hit home. What's easier to tape together - 2 straight edge pieces of paper or 2 jagged torn pieces?

I know it's good to avoid if you aren't going to tear, but if you are going to tear anyway why not make it easier to repair?

Saragoeswest · July 2014

I don't think anyone would prefer to tear rather than having an episiotomy. But if both could be avoided, that would obviously be ideal.

hgielrebmik · July 2014

I had an episiotomy with my first and a small tear with my second....neither were that bad, but you are going to be sore down there no matter what. I would rather have an episiotomy than a 2nd or 3rd degree tear though. The only thing I notice occasionally is that my perineum is sore....I don't know if this is normal for pregnancy, or because of the prior tearing and episiotomy.

Emerald27 · July 2014

Whether or not it's easier to "tape together" an episiotomy isn't the issue. It's how easily and painfully it heals. A jagged, natural tear will typically heal more easily and naturally than an episiotomy incision.

Also, when you tear naturally, you only tear as much or as far as you need to. An episiotomy doesn't take that into account and you can either 1. be cut farther than was necessary, or 2. tear further anyway.

There's also some thought that episiotomies can make natural tears worse. They may not be in quite the natural place that you would tear, so when you tear naturally as well, this can connect to the episiotomy, making a much larger and cumbersome tear than you would have had if allowed to just tear naturally.

IMHO, keep that scalpel away from my lady bits!!

bumpuser10309732 · July 2014

Emerald27 said:

Whether or not it's easier to "tape together" an episiotomy isn't the issue. It's how easily and painfully it heals. A jagged, natural tear will typically heal more easily and naturally than an episiotomy incision.

Also, when you tear naturally, you only tear as much or as far as you need to. An episiotomy doesn't take that into account and you can either 1. be cut farther than was necessary, or 2. tear further anyway.

There's also some thought that episiotomies can make natural tears worse. They may not be in quite the natural place that you would tear, so when you tear naturally as well, this can connect to the episiotomy, making a much larger and cumbersome tear than you would have had if allowed to just tear naturally.

IMHO, keep that scalpel away from my lady bits!!

^this is what I've read. Seeing as how I have no experience! Bringing it up makes me think I have yet to discuss that with the doctor...

[Deleted User] · July 2014

All this talk makes me appreciate my mom even more.

pnwlover12 · July 2014

I had a second degree tear and the stitching up part was way worse than the crowning/delivery...but I still don't want an episiotomy. I guess it's because in my mind, my body did what it had to do to get the job done, and I'm ok with that.

vrj0522 · July 2014

PC0909 said:

Why are a lot of people trying to avoid episiotomies? I was devastated that I needed one with DS and it turned out to not be a big deal at all... and my OB made a comment after that really hit home. What's easier to tape together - 2 straight edge pieces of paper or 2 jagged torn pieces?

I know it's good to avoid if you aren't going to tear, but if you are going to tear anyway why not make it easier to repair?

I agree with everything Emerald said.

Also, last time I was trying to avoid an episiotomy. MW told me that she needed to cut and I asked if we could wait a little longer. Had it not been in my plan, she would've cut without asking. We did wait and eventually she ended up cutting me anyway because DS was not coming out. Sometimes it needs to happen but I prefer the decision being made after trying other things, if it can be avoided. I do trust that my provider knows best and if she were to say that I needed one again, I would go with it, but it's included in my plan because I don't want the decision made lightly.

jesslinnn · July 2014

Emerald27 said:

Whether or not it's easier to "tape together" an episiotomy isn't the issue. It's how easily and painfully it heals. A jagged, natural tear will typically heal more easily and naturally than an episiotomy incision.

Also, when you tear naturally, you only tear as much or as far as you need to. An episiotomy doesn't take that into account and you can either 1. be cut farther than was necessary, or 2. tear further anyway.

There's also some thought that episiotomies can make natural tears worse. They may not be in quite the natural place that you would tear, so when you tear naturally as well, this can connect to the episiotomy, making a much larger and cumbersome tear than you would have had if allowed to just tear naturally.

IMHO, keep that scalpel away from my lady bits!!

This! Episiotomies scar the shit out of me. Uggh! I was fortunate that I didn't need one and only had a very tiny tear with each birth. I really don't remember the stitches being that bad... maybe because I only needed 1 or 2 or because I was holding my new baby and wasn't paying attention to anything else. Fwiw, I had VERY easy recoveries after them.

Edit: add

mrstorrestobe · July 2014

My OB told me before the birth of my first born (she's now 3) that episiotomies were no longer a standard practice. He said studies have shown that that natural tears heal better and only go as far as they need to rather than the person delivering your baby overestimating cutting further than needed. Basically, ditto PP's comments. He said there was only 1 circumstance where he would do an episiotomy and it was something about the baby's head coming out at an angle towards the rectum our something like that that I don't really remember. My OB is amazing and is there with you from the very first push until the baby is out. He does perineal massage and stretching through the entire pushing process and generally his patients have very small tears (I'm an RN and almost all the girls I work with have delivered with him as well). With both of my babies, delivered by him, I had small 1rst degree tears requiring 2 stitches each time. The very few other girls I work with who went with another OB at our hospital (one who walks in to "catch the baby") and had no perineal massage or stretching during pushing, all suffered much bigger tears or even episiotomies with much longer recovery times.

lrobi13 · July 2014

mrstorrestobe said:

The very few other girls I work with who went with another OB at our hospital (one who walks in to "catch the baby") and had no perineal massage or stretching during pushing, all suffered much bigger tears or even episiotomies with much longer recovery times.

Who does the massaging? Sorry I have not taken any birth classes yet and just looking for some tips! I always think abut Baby Mama and the olive oil bit...

cozybluebear · July 2014

After mine, my vaginal was never the same. Every time we had sex, that area was very painful. Kinda hoping this delivery magically fixes it.

mrstorrestobe · July 2014

lrobi13 said:

mrstorrestobe said:

The very few other girls I work with who went with another OB at our hospital (one who walks in to "catch the baby") and had no perineal massage or stretching during pushing, all suffered much bigger tears or even episiotomies with much longer recovery times.

Who does the massaging? Sorry I have not taken any birth classes yet and just looking for some tips! I always think abut Baby Mama and the olive oil bit...

My OB does it! Once you hit 10cm and its time to push, he's there, massaging and stretching!

Glas43 · July 2014

Im 100% with @Emerald27‌ im a PHysical therapist and did a lot with woman's health issues and i would rather tear than have an episiotomy for the healing and less scar tissue issues. Personal preference based on the research in the field.

lrobi13 · July 2014

Thanks for the insight ladies! I knew what an episiotomy was but it is great to hear more information about that whole (pun almost intended) scenario.

KariAnnM 23 · July 2014

Thankfully I didn't tear at all with my first. After all this talk, I am now scared to death to tear this time. :-O

HappyCianci · July 2014

KariAnnM 23 said:

Thankfully I didn't tear at all with my first. After all this talk, I am now scared to death to tear this time. :-O

If you didn't tear the first time, there's a very good chance you won't tear this time. I believe the first birth has the highest chance of tearing.

I had a little tear in the usual spot, and a much bigger tear on my labia, because my son came out like superman, with one fist alongside his head. I would LOVE to not repeat that! My recovery would have been instantaneous, I swear, had it not been for that tear...

kindacrunchy · July 2014

TicketTuesday said:
Dude, I had an episiotomy annnnd now after reading this I'm pissed about it. Recovery wasn't a big deal but still... It could have healed that much more easily?!

Now I'm wondering if I tell my OB no episiotomy this time, will I be more likely to tear since I was cut there with my first? Are there any third time moms who have had an episiotomy with a first delivery and not with others?

That is another good reason against episiotomies, you are more likely to tear there in future deliveries. With that said I was a labor coach for my best friend with all three of her births. Her first she had an episiotomy because she has been pushing for three hours and the baby was starting to show distress and it became an emergent situation, she then tore beyond the episiotomy and ended up with a fourth degree tear and needing a plastic surgeon to come in and do the stitching. With her second child she had perennial massage and a very small tear. With her third she again had massage and didn't tear at all. So just because you had one doesn't guarantee a tear.

kindacrunchy · July 2014

This site has a good breakdown of the pros and cons to an episiotomy. I know some of you might find the site biased but it is still a good list and keep in mind both the ACOG and WHO recommend against routine episiotomies.

https://www.givingbirthnaturally.com/benefits-and-risks-of-episiotomy.html

keenkamsmom · July 2014

I agree. I tore with both my other boys and the worst part was the stitches. I wouldn't elect to be cut for no reason. My body will do what it needs to do and I will heal just fine from that.

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