Episiotomy or let er rip?

[ConservativeChristian97]

I'm just curious, did you choose to have an episiotomy or to rip naturally? I haven't decided yet, both seem painful and icky. Hubby suggested the episiotomy, in case it rips in a way that doesn't heal easily. I would prefer neither , but doubt I'll get that option. So, what was your experience like? Would you take that route again?
God bless,
Dawn

 

[Naomi4Christ]

I've had five children and no tearing or cutting. It is possible to give birth and remain intact. I didn't do anything special to strengthen my perineum.

I have found that midwives take it as an assault on their professional provide to have a mother tear. My first midwife was very clear about birthing positions and pushing and panting at the right times.

The most perineum friendly birthing positions are left lateral and all fours, which I have found are the positions to come naturally to me. The all fours also helps the midwife do her bit to provide extra support. The other vitally important thing is to let nature take its course and not to try to accelerate labour unless the baby is at risk.

 

[Linnis]

I was cut and it took 28 (yes, I said twenty eight) stitches to close me up again. I did not have a choice my son was stuck in my pelvis and the doctor needed to reach up with his hands and pull and twist my baby as I pushed to get him free.

I believe he got stuck because I had to stay on my right side and not move to keep his heart rate up. I believe if I'd been able to move and change positions to allow my pelvis to open the way it should he would not have gotten stuck and I'd have not had to have a episiotomy.

So for next time I hope the baby will not have a droppiing heart rate s I can labor better and help prevent this.

Discuss with your OB or midwife about putting counter pressure should it be needed to help you and about positioning so you can try and prevent or minimize any damage done to that area.

Either way, I'd get a container of witch hazel pads to have at home...those really help with the pain and swelling.

 

[purpleunicorn_Andi]

I didn't have a choise, Robert saw daylight, and went for it, they wanted to make sure HE arrived with as little trams as possible, so they cut (he was born at 31 weeks) I would think that cutting would be better if you don't have a choise because there would be no jagged edges to try to sew together as might happen if you rip... I hope to be able to avoid either this time arround, I didn't even have time for the local to kick in before he cut... that was how fast they had to do it... plus I think he sewed me up a bit tighter than he should of, cause the first time we were able to.... well you know... after Robert was born hurt more than anything I had experienced... except the episi... which hurt me more than the labor pains... I wish my dr had not been on vacations, I think she would have warned me that it was going to hurt before she cut, but the dr on call was male... and didn't say one word...

 

[Linnis]

According to most medical advice, tears heal better and quicker than cuts. That and cuts make it easier to tear.

 

[Athene]

I'm just curious, did you choose to have an episiotomy or to rip naturally? I haven't decided yet, both seem painful and icky. Hubby suggested the episiotomy, in case it rips in a way that doesn't heal easily. I would prefer neither , but doubt I'll get that option. So, what was your experience like? Would you take that route again?
God bless,
Dawn

An episiotomy is also more likely to result in a third or fourth degree tear, something else to consider.

I got a second degree tear with my second and I needed stitches, the reason I tore was because i was induced with the drip and the contractions were so strong that when Patricks head had crowned and i should have panted him out, i couldn't stop myself from pushing hard. I was healed by my 6 week check.

I would never go for an episiotomy unless it was absolutely necessary, like if the baby got stuck.

 

[Athene]

According to most medical advice, tears heal better and quicker than cuts. That and cuts make it easier to tear.

Like a piece of cloth, if you have a piece of cloth and you pull it from either side then you'll have to pull extremely hard to get it to rip in two, but if you put a small cut in the cloth it rips much more easily. Same principle with the perinium.

 

[karen freeinchristman]

I had to have episiotomies both times, but they waited until they thought it was very necessary. I had to have stiches both times; the first time things healed up really well, and the second time, I had to have a greater number of stiches. It wasn't too bad, they healed up OK. I would do it again that way, because I was having such a hard time delivering, and after the cut, they both came out so easily. Everyone is different, so just trust what they say, but make clear to them your own desires.

Like a piece of cloth, if you have a piece of cloth and you pull it from either side then you'll have to pull extremely hard to get it to rip in two, but if you put a small cut in the cloth it rips much more easily. Same principle with the perinium.

Good way of explaining it!

 

[jessesgirl]

Doesn't a natural tear heal faster and easier than an episiotomy? I figure if I am given the option, I will let it tear...hopefully I don't have to make that decision and he just won't mess anything up down there at all!!!

 

[RoseofLima]

The two births for which I had episiotomies- I had far more perineal trauma than for those which I did not have an episiotomy. In the cases where I needed to get the baby out pronto- I changed position--in one case I rolled over (the baby was dystocic and had her shoulder stuck), and in the other case, I stood up and squatted.

Where the baby was dystosic- she was also persitently posterior...and I had a 2nd degree tear, which still only needed a few stitches to repair.

The key to not tearing is to NOT be flat on your back to push, but rather in some upright position-- and to NOT push through crowning. Proper perineal support through crowning and birth of the shoulders helps immensely to protect the perineum.

 

[Green Orchid]

I don't want to have an episiotomy, for the reasons given beforehand.

Has anyone ever heard of the little exercise you can do to prevent tears? I'm sharing because I will definitely do it.
(This might be TMI!) At around 30 weeks, you (or your dh) can start doing a "perineal massage". (I'm quoting from a website.) This massage consists of introducing 1 or 2 fingers 3 to 4 cm deep into the vagina and applying and maintaining pressure, first downward for 2 minutes and then for 2 minutes to each side of the vaginal entrance.
I've spoken to a few women who have done this and didn't tear, including a very petite women who delivered two 9lbs boys!

 

[RedTulipMom]

My doctor didnt give me a choice. He did an episiotomy. In my circumstance i think it was the best choice anyway. i had toxemia so i got induced at 35 weeks. i was hooked up to an IV and a bunch of other stuff. i had to labor on my back in bed the entire 28 hours of labor. i was on my back with the bed tilted up only slightly while pushing. It wasn't fun. I did have an episiotomy and stiches and it was uncomfortable for a few weeks afterwards, very uncomfortable down there. The doctor gave me some tucks pads and also this spray can of something to ease the pain..it helped tremendously, i used it daily for awhile.

 

[ConservativeChristian97]

Thank you, ladies, for all of the info. I will be putting all of this into my pg journal so I'll remember it. Believe me, I'll be doing everything I can (praying especially) that I don't need an episiotomy and that it won't tear. :shudder: It hurts just thinking about it!

 

[jgonz]

I also vote for tearing over an episiotomy. A tear heals much faster than a cut (think about a paper cut~ those smooth clean edges take much longer to heal than a scratch).

I also agree with the other moms who said that you don't Have to tear or have the episiotomy. Positioning is key, having the caregiver agree to work With you by using warm cloths on your perineum as you're pushing, also listening to your caregiver when they tell you to Stop pushing is important. The baby's head should be Eased out, not pushed out. Make sure you talk to your caregiver about this ahead of time so he/she knows what your wishes are.

 

[ConservativeChristian97]

My aunt was lubed up with baby shampoo so she didn't tear. Has anyone heard of this?

 

[karen freeinchristman]

My aunt was lubed up with baby shampoo so she didn't tear. Has anyone heard of this?

:o So the babe gets washed as he/she comes out!

 

[RoseofLima]

I don't want to have an episiotomy, for the reasons given beforehand.

Has anyone ever heard of the little exercise you can do to prevent tears? I'm sharing because I will definitely do it.
(This might be TMI!) At around 30 weeks, you (or your dh) can start doing a "perineal massage". (I'm quoting from a website.) This massage consists of introducing 1 or 2 fingers 3 to 4 cm deep into the vagina and applying and maintaining pressure, first downward for 2 minutes and then for 2 minutes to each side of the vaginal entrance.
I've spoken to a few women who have done this and didn't tear, including a very petite women who delivered two 9lbs boys!

I am not a big fan of perineal massage- and research shows that while it decreases the incidence of 1st and second degree tears, it increases the incidence of 3rd degree tears. For whatever statistics are worth.

I have had babes big and small- I have had them come out with a hand by their face, and facing the wrong way....the key- is maternal positioning (being upright and not on your back), baby's positioning (which there is often very little one can do at the moment of birth), not pushing through crowning, and proper perineal support by your caregiver.

I really, truly do not think perineal massage is helpful- and it introduces bacteria into the vagina.

 

[RoseofLima]

My aunt was lubed up with baby shampoo so she didn't tear. Has anyone heard of this?

Ugh- that sounds AWFUL....

 

[ConservativeChristian97]

Yeah, I thought it sounded a bit rough, too, but it worked.

 

[~Mrs. A2J~]

I would choose tearing over an episiotomy for the reasons already mentioned above. I had an episiotomy with my daughter which was unnecessary and I still have tenderness there almost 5 years later. She was only 8lbs 4oz and 20in long so was not a big baby. Three months ago I gave birth to my son who was much, much bigger at 9lbs 12oz and 21.75in long without any tearing or needing and episiotomy. With my son I labored at my own pace without intervention and the midwife supported my perenium. With my daughter I was flat on my back in a hospital.