To all ladies who have delivered a baby vaginally?

Question

i went to a childbirth preparation class with my husband a few weeks ago and the instructor said that when i get to the stage during labor when the baby is "crowning" that there might come a point where the doctor will ask me if i want an episiotomy or if i want to try to push her out naturally and risk tearing, so my question is...is it common to tear or need an episiotomy to get the baby out...and if it is then which one would/did you choose...i know this can be a touchy subject but i am really concerned about it and the best way for me to allay my fears is to hear from women who have gone through it already

Answer 1

Starting around 34 weeks, you could try massaging your perineum (the area around your vagina). Daily perineal massage may increase the area's stretching ability, leading to less need for an episiotomy and fewer natural tears.

Try this technique yourself, with clean hands and trimmed nails, or have your partner do it for you. If you're going solo, have a large mirror handy so you can see what you're doing and to help familiarize yourself with your perineal area.

* Sit in a semi-reclined position in a warm, comfortable area, spreading your legs apart.

Lubricate your fingers, thumbs, and perineal area with vitamin E oil (from punctured vitamin E capsules), pure vegetable oil, or personal lubricant. Don't use baby oil, mineral oil, or petroleum jelly.
• Place your thumbs about 1 to 1 1/2 inches (to or just past your first knuckle) inside your vagina and spread your legs. Press down toward the rectum and toward the sides at the same time. Gently and firmly continue stretching until you feel a slight burn or tingling.

• Hold this stretch for about two minutes — until the tingling starts to subside.

• Now slowly and gently massage the lower part of the vagina back and forth, hooking your thumbs onto the sides of your vagina and gently pulling the tissue forward, as your baby's head will do during delivery. Keep this up for three to four minutes.

• Finally, massage the tissue between the thumb and forefinger back and forth for about a minute.

• Be gentle because a vigorous touch could cause bruising or swelling. During the massage, avoid pressure on the urethra (urinary opening) as this can lead to irritation or infection.

Of course, perineal massage isn't for everyone and it may not help in every case. The most important thing you can do is to choose a midwife or doctor who's experienced and comfortable delivering babies without doing episiotomies. In general, midwives tend to perform this surgery less often than physicians. Regardless of the type of practitioner you choose, discuss your wishes and expectations with that person before the birth.

Answer 2

Lucky you! With my first baby (10 years ago), although I was prepared like you, the doctor never did ask me. She just went ahead and cut. While I was offended that she didn't ask, it really wasn't a big deal. I've had two more kids since then, and I have torn along the old scar line both times. I have heard that it is heals faster when an episiotomy is done, but there are arguments for allowing it to tear, too.

To answer your other question: yes, I think it is extremely common for a woman to either tear or need an episiotomy, so you are wise to think about it in advance.

Answer 3

Yes, most of the time you do need an episiotomy. Your doctor will usually make the best decision for you during the labor though. With my first, I had an episiotomy, with my second, I had to tear because of the way the baby was positioned. My third baby though was smaller (a girl) and I didn't require either. If you are really concerned I would ask your doctor, but I would say that your doctor will make the best decision for you.

Answer 4

I have a three month old and a two year old. It is extremely common to have a tear or need an episiotomy. Unless you have a midwife or health care provider that spends extensive time messaging to stretch the area, then it is fairly likely. A more serious tear, labeled by degrees 1-4, 4 being serious, is one that goes all the way through you perineum. There has been a shift to just allow a natural tear. One reason is that a more serious tear may result from episiotomy. "Although episiotomies are supposed to prevent tears, some women tear beyond the surgical cut and end up with even more serious lacerations than they would have if they'd torn naturally." Check out http://www.babycenter.com/refcap/pregnancy/childbirth/1451354.html#0 and http://www.childbirthconnection.org/article.asp?ck=10203 for more. I had a 3rd degree tear with my first and a 2nd degree tear with my three push second delivery. Just an FYI--My tear opened after being stiched up. The doc didn't even have me come in, he just said to let it heal and it did. So obviously recovery may not be fun, but it is going to happen whether you have an episiotomy, a tear, or even if the stitch job isn't so great:) Congrats!

Answer 5

I was never asked this question. I think that if the doctor is able to tell that you will tear based on the size the baby's head looks then he might ask you. I never had an episiotomy with any of my 3 children and it was only with my first that I even tore. It wasn't even a bad enough tear to have stitches. Talk to your doctor about this ahead of time if you are concerned, and see what they normally do during deliveries.

Answer 6

When I delivered my daughter 24 yrs ago I had her in Germany in a german hospital. The doctor automatically gave me an episiotmoy and it was the most horrible recovery ever. 38 stitches in and out.
Last year, my daughter gave birth without one and suffered only one small abrasion with no need for stitches. The reason... it really is not common to tear nowadays as the nurses are trained to help stretch the opening by massaging and lubricating so that the baby can fit without the risk of tearing (they explained all of this to us). It was much more natural and my daughters recovery was so quick and much less painful than my own was. She had a normal sized baby - 7 lbs 2 oz. With a large baby, you may need to have one..but, I have heard that if they do the cut, you can still tear from it if the baby's head is huge or you deliver a larger baby.

Answer 7

In case of normal birth, viz; conceive, bear and deliver the child, where there is good suggestion and periodical check ups, majority of the deliveries are with no tearing, or even if there are, one or two stitches are involved. It will also heal naturally with the after delivery medication and advises. You will only experience what is called labour pain and it is a sort of personal experience. However, I can say it may be there for a while only at the time immediately before the seconds of the child being pushed through it heads down . Even for this attending doctors will be prescribing the ways and means to shink and push once the labour pain starts. Hence, there need to be no fear regarding the normal delivery. The size of the grown up child and other features can be monitored to some extent nowadays and the attending doctors are able to suggest the carrying mother on going for a normal delivery or not. If everything happens to your liking the normal deliveryl, go for it and enjoy. Best wishes.

Answer 8

I had an episiotomy, but didn't even know until my husband told me. My doctor didn't ask me, he just did what was necessary because my baby was giant. He said it is better to be cut than to tear. You won't feel it and the cut can heal back together in a cleaner way rather than a tear.

Answer 9

With my first, my doctor just did the episiotomy without even asking me-he said I needed it and I trusted him. With my second, my doctor never offered and I ended up not needing it. I tell you, not having it was the best feeling ever. I remember after my son was born, I just kept smiling and telling my husband "I didn't have to get cut!"..I was so excited and of course, a little drugged up. The episiotomy hurt and I didn't want to go through that again. Had I NEEDED it, I would have agreed, but that time, my doc saw no signs of tearing so he never asked. Good Luck~

Answer 10

I tore a wee bit when I pushed the baby out. Sometimes an episiotomy is medically necessary because the baby needs some more room to come out. Not all women tear or need an episisotomy so my inclination is to let it go natural, push through the burn, and if it is determined that you are having significant trouble getting the baby to come out, then maybe you should consider an episiotome.
Good luck and don't dwell too much on this issue. So much happens during labor and delivery and the episiotome is just a glitch in the matrix when pushing a baby out!