to be ridiculously scared of episiotomy?

[RevoltingPeasant]

...And I do mean ridiculously, because I am not even pg yet.

It is honestly one of the things I dread most about the idea of having a child. Do they ask consent, given what stage things are likely at by the time they decide to do one? Can you refuse? (I have read that in some countries, obv not the UK, they routinely do them without maternal consent ). Do they anaesthetise or just figure you're in enough pain anyhow, so meh?

OKay this is making me feel slightly better.

So, ridiculously far in the future birth plan would say sth like

'Avoid epi if possible - but if necessary ASK CONSENT and get an experienced midwife or consultant to do it not the 23yo trainee'.

I think I can live with that.

I think the most important thing afterwards is the stitching. I too was stitched by a consultant both times.

I had one. Believe me, by the time they get round to giving you an episiotomy, you won't notice you are having one. They could have driven a double decker bus up my private parts and I wouldn't have noticed.

I was asked if I wanted one, as it seemed that ds wasn't coming out. I agreed, I didn't feel it; I have had NO problems with it. Totally agree with it, it was fine, no worries, healed v quickly.

YABU.

erm how dare you revolting peasant. I'm 21 and find your comment extremely insulting.

During my birth, the student midwife (who happend to be 20, and at the same uni as me) was the most helpful person there and really helped me through. All three of the other midwives on duty during my birth (it was a Longggg one) were complete bitches. Just because someone is young doesn't mean they aren't naturally good at what they do.
FYI I was stitched by a consultant (in theatre, because of the risk of needing a cesarean) This is supposed to mean that they have the time to stitch you properly and on the operating table it is easier to ahemaccess etc. And he made a complete mess of me. Now 14 weeks later I'm having to go back and have myself sorted out as I'm still in pain!

my midwife was in her 50's & fucked my entire labour up- she was totally clueless- my husband had to tell her things she really should have known- i would have preferred the lovely trainee who took me down to the labour suite, & actually knew what was what.

I had one with my first. Didn't feel it, I think some sort of local anesthetic was used. Was sore healing, but sitz baths and a heat lamp (exdh rigged one up himself with a shadeless lamp and a frame to hold the sheet away from the bulb) helped sooth and heal. I heard a hair dryer can help too.

Second child I had before the doctor arrived, and I tore. Didn't even feel it, and healed easier than the cut version for some reason.
pregnancy.about.com/od/postpartumrecover/qt/episiotomycare.htm

I'm terrified of needles and I'm actually really pissed off that no one told
Me about this. I'm terrified enough all ready and nigh on had a
Panic attack last night I'm do anxious and feel sick and I'm constantly crying about having this baby. Don't get me wrong she is a much longed for
First baby but I have been having help for
My fear and anxiety from before I was pregnant and the fact this want even mentioned makes me so mad and stressed out

My DH works with doctors and a couple took him to one side before the birth and this is what they said:

"Beware the doctor who's about to go off shift who does an episiotomy because he wants to go home. If it's mentioned, ask questions and make sure they've got a good explanation".

I did have one. The midwife in attendance was not about to go off shift (!) But when she mentioned it, to my surprise, DH suddenly got all assertive and started being a bit Jeremy Paxman (he hadn't mentioned any of the above to me). My midwife said "I've been a midwife for 30 years and this baby isn't coming out any other way". I had a local. I didn't feel it. DD came out with her hand on her head.

You'll have an opportunity to look round your labour ward. You'll also speak to a lot of midwives during your pregnancy. That's the time to check where you're planning on giving birth definitely gives locals before episiotomies. Try not to worry.

Kayano - have you spoken to your midwife about how frightened of the labour you are? You're not the first person to have felt like this.

kayano I'm so sorry that you're finding out about this in this way :( I don't like needles either, tho' am not terrified; it's one reason I find this so scary. Look, forewarned is forearmed. Take courage from the vast majority of women here saying how they didn't feel it and it was fine - I am!!

JAM don't be silly - I am in my early 30s and work with young people. I am not being ageist. Experience counts - it just does - I am better at my job at the age of 32 than I was at the age of 27. I expect my colleagues in their 50s who have been doing our job for 30 years to know more than me. And if your job involves making scars which will last a lifetime in someone's vagina, you'd best know what you are doing. Read the PP who had a random junior doctor stitch up her epi because 'she fancied having a go' - that is not okay. Obv consultants will fuck up sometimes, but there is much less chance of it than of a student midwife screwing up - that's why they are consultants.

I am that anyone could find that comment ageist.

Kayano - this thread is not representative of the universal situation. There are lots of people on here with epis, I myself bumping up the stats considerably, but that does not mean it's a given part of childbirth. The midwife I had with dd3 hadn't done one for months when she did mine - and that was as a result of previous injuries iyswim. Had she been delivering my first baby I think I would have had a good chance of managing without. Talk to your midwife about your feelings and put it all down in your birth plan. It doesn't have to be a list - can be a bit of prose about how you feel and what you are scared of and what you are aiming for.

Robot thanks, that is good to know. I would ideally have a homebirth for my first but that's another battle with DP story.

Anyhow am not even pg yet so this is all a bit theoretical.....

Yes had hypnotherapy and been to psychologist. It's just really got worse this week but I'm run down and exhausted :(

Oh and re stitching - I would be quite hapy with a student because they will be very carefully supervised. Better a student than somebody who thinks they know it all but isn't paying attention.

northernL yes, that is true - kayano, there is another thread from Jan 2011 in Childbirth about epis and there is a midwife on there saying she hadn't done one for about a year, so it is not a given. Having done some googling you can apparently significantly lessen the risk of an epi by doing perineal massage and there is also some device called an EpiNo which might help, tho' can't really see what it does. You will be okay :)

Northern (again!! :)) I was in hospital the other week for an op and a trainee anaesthetist, under consultant supervision, made a hash of my hand when inserting a drip. I mean, it was fine, only swelling and bruising, no one died, but I would not want someone with that lack of expertise doing sth similar to my vaj, ta very much

OP, I was terrified about having an episiotomy and was v clear in my birth plan that one was only to be done unless it was absolutely unavoidable. Cue Pre-eclampsia, meconium in waters & baby in distress and I needed an emergency forceps delivery. I was so worried about the baby that I didn't care about what they did and, in fact, when I asked the consultant when she was going to do it, she told me she already had! Didn't feel a thing. The stitching wasn't a barrel of laughs but better than a scale & polish at the dentist, if you're looking for a pain comparison.

My vagina didn't really hurt after any of that; my arse, on the other hand... All that pushing gave me an anal fissure which hasn't healed 6 mos on. But that's a whole other story.

PS It is done with scissors, but special medical ones. Don't picture nail scissors like I did!

It is ageist to say you wouldn't let someone of a certain age perform a medical procedure that you would let someone of a different age do. How isn't that ageist? Why the age 23 anyway? They may be 35 and just retrained as a midwife and only ever performed a few, whereas someone at 22 may have qualified fresh after a nursing degree and being doing it a lot longer.

I do not agree the longer you have been doing something the better you are at it. Caring about what you do and how you go about it makes a lot bigger difference!

If you need one in the first place, is presumably the birth isn't going as smoothly as it should ie. forceps/big baby/heart rate dropping and in need of a quick birth. This means that there would be a consultant or senior midwife delivering anyway!

They would never let a random junior doctor lose on you. If it were to be done by a student, it would be under the close supervision of another doctor. I fail to believe that the pp actually heard the doctor say "she fancied having a go" and if she did, she's an idiot for letting her do it.

At every point a student was involved, I was asked for my consent. When I went in for a sweep as I was over due, the very nice midwifery student asked if she could do it, although there was a risk that she couldn't and the midwife would have to. Same with having my waters broken, I was asked to give my consent first, they would never just let someone who had no training cut and stitch you.

I promise you the best midwives I had throughout pregnancy and labour were the younger ones. They are a lot more enthusiastic, and seemed a lot more compassionate. I suppose it numbs you seeing people in labour everyday, year after year. They also had a lot fresher ideas, like showing me different breastfeeding positions, whereas the original midwife just showed me the traditional one.

Like I said, a consultant messed my stitching up, even though it was done with my legs in stirrups in theatre, which is supposed to be the best place as they have the lighting/time/access to make a good job of it. So the skill of the doctor has nothing to do with age.

TruthSweet - I tore with DS, had about 10 stitches, they stung for about a second when I peed for a day, maybe at the most, with DD I had labial grazing...

Oh dear god!!!!!

Okay JAM I get what you are saying - no disrespect, but we're just going to have to disagree on this one.

I fully believe that some more experienced people - consultants, midwives, the lot - are crap at their jobs or have crap days, least. However, I think the chances of having a crap experienced person are lower because mechanical skilled work like stitching does require practice. I don't mean a younger midwife wouldn't be nice and lovely; the trainee anaesthetist who left me with a bruise that covered my entire hand was very sweet. But I don't think the consultant supervising her would have done that.

I don't know about the validity of the PP's story, but it's above if you want to read it - she says there was a random woman in the room who later turned out to be a junior dr etc.

On consent - I wasn't asked for my consent with the trainee - just told, this is who's doing it. By the time you are about to go into theatre, it's a bit late to object. Like I said, only a bruise and some swelling, not the end of the world - but wouldn't want someone liable to make a similar-level mistake (iyswim!) on my bits.

I had one epi under local anaesthetic, which I didn't feel at all. I still tore even though I'd had the epi, but I didn't feel it. With my second child, I didn't have an epi but tore and didn't feel it. The stitches were fine, done by a midwife by both times, and healed up fine.

I understand your not trying to be rude but you're being extremely patronising as well as ageist.

1. Saying you want someone over the age of 23 is different to saying you want someone experienced. Like I said, a 35 year old may have been a cardiac nurse for 10 years, and it could be her first episiotomy. Where as a 25 year old midwife may have been performing episiotomies for five years. So you are being ageist in the sense that you assume an older person has more experience.

2. Experience does count for something, however, As we've already cleared up, students are always supervised. They have also been recently trained therefore it is fresher in their minds, and they will probably be a lot more cautious.

The woman who put my line in my hand failed four times. FOUR times. It is still scared, when DP arrived (was admitted for induction 4 days previously) he said I looked like I'd been doing heroin! I said that I did not want her doing my epidural (for obvious reasons), to which I was told she was the most senior anethitist available. It was 4am and she was so rude and just seemed lazy about the whole thing. I was given a different doctor for my epidural, but later on when the labour started going badly, DS was twisted and lying on a nerve in my spine, I was in so much agony I couldn't even remember my own name, I literally wanted to curl up into a ball and die. She was bought in to do my Spinal Block in preperation for the forceps. She could of paralyzed me through he sheer incompetance and cockyness and if DP would of realised she was the woman who made me so bruised, he would of refused on my behalf, and she was a senior anethetist.

Anyone can be bad at their job, whether they have been doing it a long time or not.

KANJO- I had an epi under local though I really didn't want one. They did ask though. Its not pleasant, I won't lie but, they gave me a local and then checked I couldn't feel anything before starting. I'd been pushing for nearly two hours before they said, right you need some help. It wasn't a spur of the moment thing, they asked consent and I'd had plenty of encouragement from the MV's to get DD out first. Try to remember that you might not need one- not everyone does!

Afterwards though- remember to take time to look after your bits. Hot sitz baths- 3 times a day, tea tree oil in the water is anti bacterial- make sure you change towels regularly and if you have any stitches ask the community MV to check your stitches as I found no one asked and I couldn't / didn't want to look myself.

I healed really well but you hear so many horror stories, please remember they can have an emotional experience attached to them which is different for each woman :)

Student MV was very attentive compared to community MV at my start of home birth but hospital MV were better than community- yet I've also heard the reverse of the same Team. Your circumstances will be unique and the more relaxed you can stay, the better for you and baby.

I wouldn't over think things to start with-it never turns out as you expect.