Any advice on whether or not to have an epidural and episiotomy?

Question

I have read a lot of article about the danger of epidurals and the complications with episiotomies.

Answer 1

The episiotomy is based on how the baby is born, if the doctor has to cut the canal to make it large enough for the birthing process... That is something you have no control over and it will be sewn back up and you will heal...

There are alternatives to an epidural so you should look into those options well before labor starts as you will have to make a decision at a certain time during birth for the epidural because after a certain time, the doctor will not allow an epidural as it would be ineffective and "too late"... As far as you choosing the epidural or not is up to you...

Answer 2

It really depends upon how you are tolerating the pain, you won't be able to make that decision until it happens of course. I wasn't sure whether I would have on epidural or not, but I had back labor, and my tail bone even got injured during labor, so as soon as I was presented with the option, I took the epidural. Everything was so good after that, I was happy, excited and pain-free when my daughter arrived. I'm not sure about episiotomies, that also depends on factors unique to you, like the size of your baby for one thing. My baby was born before the nurses called the Dr. so I didn't have one of those, but still had to get stitches.
P.S.- I have never heard that an epidural can cause you to gain weight, I didn't, and nobody else I've known whose had one has. I've had two epidurals, my first one was when I had knee surgery and they didn't want to give me general anesthesia. There is a small chance they can cause back problems, if the needle goes in too deep or the wrong way, but that is rare.

Answer 3

I've had three amazing, uncomplicated unmedicated births. I'd highly recommend attempting to go unmedicated. All it takes is education, preparation and support. Learn as much as you can about birth and about different coping techniques. Make sure your caregiver and partner are prepared to support you. Consider hiring a doula to help you. (Some hospitals will even provide one for free if you ask ahead of time.)

As a breastfeeding counselor, I have seen many babies who were sleepy or had an uncordinated suck in the early days due to the meds from the epidural.

You *DO* have control over if you have an episiotomy. It is YOUR body and they can't do anything without your consent. DEFINATELY do not consent to an episiotomy unless there is maternal/fetal distress. Talk to your caregiver now and find out what his episiotomy rate is. It should be LOW. If not, I'd consider finding a new caregiver...especially if he still prescribes to the old school notion that, "all first time moms need one" which is a load of bunk!

Think of it this way.....if you try to tear a piece of fabric, it's tough! You can't really do it or at least not very far. If you put a cut into the fabric with scissors and then try to tear it, it rips right in half easily. Your perineum is the same way. When it is intact, it is stronger and will stretch. Once the doc cuts you, you are more likely to extend into a tear making the injury bigger.

If you are not cut and do tear, it will be less severe. A cut is certain to involve BOTH skin and muscle. A tear may only involve skin.

A tear takes longer for the doc to repair, but it will be more likely to be similar to how you were before. Think of it this way, if you are putting together a puzzle, the straight-edged pieces are harder to match up perfectly. The pieces that are unique shapes are easy to match up. It's the same way with sewing you back together. Tears tend to heal better too.

Staying active in labor and being allowed to choose your own pushing positions will help you to avoid tearing or "needing" to be cut. DO NOT push flat on your back as that is the worst position to be in. Squatting is a great position to avoid perienal damage as you get the help of gravity AND it widens the pelvic outlet something like 25%.

ETA:
I tore with my first baby (2nd degree tear). I had no idea it had happened until afterwards. I was tender for a while, but I healed fine. Use the big thick maxi pads and soak them with witch hazel and freeze them. This will help keep you comfortable and help you heal if you have perineal damage of any kind.
With baby #2 and baby #3, I birthed over an intact perineum both times. Those babies were both waterbirths, which I think helped a lot.

Answer 4

Hi, I've been wondering too about epidurals, I'm 21 weeks along with my first...

I think though, the best thing is to go in ready to do what you need to get the baby out. If the pain is so bad that you aren't helping in the birth, than an epidural is needed. I plan to sign all the necessary paperwork, but only take the epidural if my doctor and I feel it would be unwise not to. (If you're in too much pain, and too exhausted to push, the birth is not going to be easy...) Cause giant needles scare me way more than pain does, so if I can avoid an epidural, I will.

As for episiotomy, I didn't evenknow that was up to us to choose, I thought they just did that when they need to. I do know, however, that a clean cut is way less painful, heals much faster, and requires fewer stitches than a rip...and you're going to be hurting down there anyways, so I say better to make it that much easier on yourself and have the episiotomy if you need it!

Either way you decide to go, good luck & congratulations!

Answer 5

I've had four children. Three of the deliveries involved epidurals and episiotomies. The fourth, my youngest was unassisted in those ways.

First off, episiotomies are sometimes necessary evils. If it could be explained to me that it was medically necessary, I would consent to an episiotomy. However, a doctor would be hard pressed to get my consent! The episiotomies made life painful for the first couple of weeks.

Now, epidurals... the epidurals I got were all spotty. They did not numb all of my pain. In fact, they only blocked about 15% of my pain during each delivery. I was so caught up in the pain that I had a hard time being an active participant in the deliveries. It was nearly impossible for me to listen to my body and know what needed to happen next.

After each delivery, I had what I call "migraines" in my back at the site of the epidural catheter (the method they use to put the meds in). The migraines sometimes became as painful as the contractions themselves. I got the migraines for about a year after each of those deliveries.

When I had my daughter this past January, I had no epidural and no episiotomy. I did tear a bit, and had a few stitches. I never had any pain from the tear. It was uncomfortable, but never painful and even the discomfort was gone with one or two days (by the time I left the hospital!).

Having no epidural meant I felt all the pain, yes, but it also meant that I got to be a full participant in the delivery. I knew when it was time to push and when it was time to rest. I didn't need to doctor telling me when it was time to do those things. I was able to guide the delivery in the way that was most comfortable for me. It was the easiest delivery by far!

A couple of important points...

One of the things that helped me the most during the epidural-less delivery was knowledge! I had taken the time to learn about the whole birthing process. I learned what was going to happen with me, with the baby and with the people around me. My husband and I went to childbirthing classes, asked tons of questions (most nights we stayed behind and chatted with the childbirth educator for up to an hour or so after class). We were as prepared as two people can be.

I also went into it with an open mind. If it had become necessary for me to have more medical intervention (epidural, episiotomy or even a c-section) for the health and well-being of the baby, I was prepared to consent to those things. I went into it aware of the possibilities and knowing that things could change in the blink of an eye.

I believe wholeheartedly that my husband was the biggest reason for my easy delivery. He stood by my side the entire time. He encouraged me to focus, to breathe. He took my mind away from the pain and back to the point... getting the baby here safe and sound. He was wonderful! A brave and supportive birth partner is of the utmost importance, I believe.

If I get nothing else across, let me say this... The pain from the contractions leveled off before I even left for the hospital! The pain got no worse than it had gotten before I left the house! By the time we got to the hospital, the pain had plateaued and never got any worse. The epidural would have only taken away my ability to be a full participant in the birth, since I'd already felt the pain at it's worst.

Pushing the baby out was painful, but more than a pain it was a tremendous relief! It felt absolutely wonderful!

There would have to be serious medical reasons for me to have a epidural or an episiotomy in the future. Then again, the doctors will be hard pressed to get my consent unless not having those interventions are going to affect the health and well-being of the baby.

Sorry about the book I just wrote!

Answer 6

My first child I did not have an epidural, the second two I did. There are dangers with everything, but I would not want to go through childbirth without one. They normally only do an episiotomy if it is medically necessary. I had one with my first child, it did take longer to heal. I had a healthy baby and that is all that is important. Good luck.

Answer 7

If you need pain relief get the epidural. There is no prize for women who labor with out pain medicine. (maybe the prize is putting others down for using pain medicine) The important thing is being a good mother, not weather or not you use pain medicine. As with any pain medicine, there is always a chance of complications. I look at it this way, I will not have a root canal without pain medicine so why go through birth without it. Both of my boys came out pink and screaming. Neither of them were drowsy.

As for the episiotomy, I have no experiences with that. Both my kids were c-section.

Answer 8

Well I had a c-section and thank god I did my daughter wieghed 11 lbs and 3 oz when she was born i had a epideral before my syrgery and it was wonderful. It all depends on the type of person you are if you can handle the pain opt for a natural birth. If you giving natural birth and the baby is to big the doctor will recomend a epistomy. You do know it is only a small cut down there to make more room for the baby. As with any medical procedures you and your doctor know what's best for you. I tried to plan my labor and nothing went the way i wanted to so, just go with the flow and do what you need to. The epideral did'nt hurt by the way. Congats on the pregnancy and good luck hope you and the baby are healthy and happy.

Answer 9

episiotomy is an incision made during childbirth to the perineum, the muscle between the vagina and rectum, to widen the vaginal opening for delivery. ( sounds like lots of pain.. )
epidural's on the other hand can be helpful with the pain of child birth, but dose have some dangerous side effects.. but then childbith itself is no picnic..

Answer 10

hi i had my baby boy at 18 and when i was in labor i had no pain relief , and i didn't tear i would just go for it and if u tear you will jus have stitches which you would have to have any way if they do an episiotomy . i wouldn't have an epidural as you have to stay in bed for ages after the birth and there are loads of problems like back pains n gaining weight after you have it . there are loads of other pain reliefs you can have like gas n air , pethidine but that can make baby drowsy .