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Talk to me about an episiotomy...

(42 Posts)
PotatoPolly Thu 23-Jan-14 12:59:43

DH came home from work and said that he'd been discussing this with his mate (why?!) and that the friend said that his wife had refused an episiotomy and ended up with an EMCS mid way through the birth.

The reasoning was that the skin would never, ever heal properly and would be prone to opening for the rest of her life.

Don't want to scare myself with Dr Google, so any opinions on this please? I want to make an informed decision!


PenguinsDontEatKale Thu 23-Jan-14 14:32:07

Zinher - It is a clinical call. Routine episiotomy has been discredited (think of trying to tear a piece of fabric. Not think of cutting a snip in that bit of fabric, how much easier is it to tear it more now?). It is normally necessary for instrumentals (they need to make extra space for the instruments!) but generally otherwise they would recommend if you seem to be having difficulty with the last little bit and more space would help it happen, as opposed to to avoid a minor tear.

PenguinsDontEatKale Thu 23-Jan-14 14:32:37

Sorry, that should say 'now think' not 'not think'

dottygamekeeper Thu 23-Jan-14 14:40:26

I had an episiotomy first time round as ended up needing ventouse - they had just given me a spinal block didn't feel anything. If you hadn't had an epidural or a spinal block I am guessing they would give you a local if they decided to do an episiotomy?

Second time round I had tear, not because of the episiotomy but because (fairly large - 9lb 6) DD came out with her arm up in a strange position - I am pretty sure they gave me a local afterwards to stitch me up. I don't remember noticing the tear as it happened, there is so much else going on!

Both times reasonably sized babies, 8lb 10 than 9lb 6, episiotomy and tear all healed fine - really I wouldn't worry about it.

zinher Thu 23-Jan-14 14:49:42

PenguinsDontEatKale the fabric analogy has me covering my eyes and ears at the same time. Scary thought but makes a lot of sense.

emmac3616 Thu 23-Jan-14 14:50:49

I had a suction and forceps delivery and they asked me if I wanted to tear or be cut - I asked what the obstetrician thought and she said she'd prefer to be cut because they can control where it goes (i.e. not hole to hole!!!) - they did and it was fine - went sideways and down and was stitched up just fine. Only slight thing was I was having a water birth until the last 20mins when he got stuck and I was taken to the labour ward. As a result I had only gas & air and as it was all a bit rushed the local anaesthetic didn't have time to take effect so it was a bit uncomfortable when they cut. BUT to be fair at that point you don't care (I just wanted DS to come out safely) and it was not THAT bad (!). I would recommend - as long as you keep it clean and dry afterwards (i.e. infection free) heals very well.

PotatoPolly Thu 23-Jan-14 19:06:37

Thank you everyone! You've confirmed exactly what I thought smile

I'd rather be cut in a controlled way than tear!

Thanks again smile

I had one with ds1, after being in labour 37.75 hours, and pushing for 1.5 hours. Having it sutured was pretty sore - but I could have had gas and air - I didn't think to ask for it.

It was sore for a few days afterwards, and that first poo was scary, but it healed with no problems whatsoever, and I had no problems with it in my subsequent labours - I got a small graze - not even a tear - that didn't need a single stitch.

If I hadn't had the episiotomy, I am pretty sure I would have ended up with either a ventouse or forceps - I had been moved to the high risk labour room, so I think the senior midwife who had me moved was thinking one of those would be necessary - but having the episiotomy meant I delivered him myself.

chickydoo Thu 23-Jan-14 19:24:43

Had 3
DC 1 forceps....hideous
Dc2. Stuck.. Had to have one to get shoulders out
Dc3. Tore, not too badly small cut too.
Dc4. All ok

It is a war zone down there!! I can't see it, so don't care. DH doesn't mind one bit.

Trooperslane Thu 23-Jan-14 19:38:58

I had one. Didn't even realise it until I was being sewed up after dd arrived

Was more worried about the mahoouasive pile tbh.

Was all totally cleared up and healed ages before my 6 week check.

ChaffinchOfDoom Thu 23-Jan-14 20:33:18

the does it hurt question -- you honestly honestly do not notice it. I have a vague memory the local felt nice and cold... but that part is so exciting and wonderful and amazing, it's just lovely to push grin

ImBrian Thu 23-Jan-14 20:38:19

I have had a tear and and episiotomy. Tge tear was more painful healing but I did manage to pop the stitches on my episiotomy which was sore as hell. They just left it be and it healed fairly fast but it scared the crap out of me when I has a look down there and I had a 10p size hole split in my stitches.

MostWicked Thu 23-Jan-14 21:40:49

I had an episiotomy for my first. It healed OK in about 6-8 weeks, but it was sore and uncomfortable for a while during that time.
Second time around I didn't want another one. It was a ventouse delivery and the doctor wanted to make a small cut. I said that I would rather tear. When he was stitching me up, he said the tear was much smaller than he would have cut. It healed much quicker and better than first time.

It was my midwife who told me that tears are often easier to stitch and heal better, but there are times when an episiotomy is necessary.

EmB1715 Fri 24-Jan-14 08:15:54

Hmm I've also been told that tears heal better. Unless it's an instrumental delivery I wouldn't let them cut me. And the does it hurt question... I was so surprised when the midwife told me that I had torn, so no, you don't notice it. Not sure about an epi though. The local (which MW jabbed in about 10 places) was the most unpleasant bit!

SaltySeaBird Fri 24-Jan-14 08:19:37

I had one, it hurt at the time as I was just on gas and air and it needed to be done quickly but after DD was born I didn't even notice it. I was up and about the next day, didn't have so much as a tingle down there.

flymo79 Fri 24-Jan-14 15:42:37

am interested in the difference between having an epi and just tearing? can anyone enlighten if you should make the decision early or something?

PenguinsDontEatKale Fri 24-Jan-14 15:47:06

Fly- Not necessarily a decision to make early, no. Because you could find that you only have a tiny tear (1st degree) or a graze. Both of which are much more minor than an episiotomy.

Personally I would prefer to tear unless there were clinical concerns (see my fabric analogy below). But if you would prefer an episitomy if tearing looked possible I guess you could put it in your birth plan.

TwoThreeFourSix Fri 24-Jan-14 16:10:05

I had one, but wasn't even asked to agree (not in the UK). Didn't notice it in the slightest as had an epidural and was busy pushing! DH found it a worse experience that I did!

I was given it just a few seconds before DS came out - he was in distress and they needed to act quickly.

Stitches hurt like crazy when being done but that's because they were very badly done by a student midwife (the nurse who took them out was amazed that the student wasn't told to re-do them).

Stitches didn't hurt again after that though, until they were taken out.

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