To think that episiotomies are more common than my midwife claims at hospital births?

[Lovinglife2019]

I don't know that many people who've had children recently at a hospital, maybe 6, but ALL of them "had to have" an episiotomy. 1 of them was due to requiring a forceps delivery, but the rest seem to be because the staff told them they would tear really badly otherwise and this was the best thing for them. None of them found the recovery that easy and most of them aren't convinced they actually needed one after talking to other friends who didn't have them and delivered at a midwifery led unit or at home. Don't know how true this is.
When discussing birth preferences, I raised this with the midwife and she said it was just coincidence and actually episiotomies aren't that common.
For medical reasons I will have to deliver at the hospital, and would like to avoid an episiotomy unless medically necessary but am concerned it might be pushed on me.
Am I being unreasonable to doubt the midwife or have lots of people out there had hospital births without episiotomies and it is just coincidence?

I had two straightforward births and two episiotomies but I live in a country where they are almost done as standard. I barely felt them, to be honest, i’d rather have a controlled cut than tearing. The most painful thing was having the stitches pulled out three days later. God knows why they don’t use dissolvable stitches! 😅

I had a forceps delivery and had one. The doctor was trying to avoid forceps but in the end it was necessary. So it wasn't pushed on me and they definitely tried their best to avoid it.

My recovery was absolutely fine.

I am sure the midwife would have been telling you the truth!

Ultimately, you have to trust the advice being given to you at the time.

I had one with my first son. I was struggling to push him out and his heart rate dropped so they recommended one.

In my second two labours I had a second degree tear. The episiotomy recovery was much easier to be honest.

Well, an episiotomy is neater than a tear. The midwife looks at the skin of the perineum and sees how it is stretching and if it looks like there might be a big tear they do an episiotomy.

I had a small one, it was stitched and there was no problem with it.

I told the midwife I didn’t want an episiotomy and she told me she would give me one if she decided to. So you don’t need to consent

I wasn't asked either.

The registrar - called down as they was a time limit to pushing despite me being almost there and at least half of time not feeling the urge to push but being told to- just did it saying nothing to anyone. MW told us after and didn't seem impressed TBH.

I tore down it in later births and TBH those healed better less sore but it wasn't as bad as I thought it would be TBH and no lasting impact on me.

I had a forceps birth so had an episiotomy. I was told rather than asked. No time for consent! The forceps hurt beyond belief, but not the episiotomy as they quickly gave a local anaesthetic-like at the dentist! And afterwards I was very bruised and sore from the forceps for quite a while, but the stitches didn’t give me any bother. I tore naturally with my second birth and the subsequent stitching up took a lot longer, was very painful and ended up being a lot more ‘untidy’.

You can look up the actual statistics of each maternity unit and it will tell you what percentage of women had an episiotomy. That will give you a clearer picture and just anecdotes from friends.

Also, of course you have to consent to an episiotomy! Walking onto labour ward doesn’t suddenly make your body property of the hospital Your body belongs to you, you decide if anybody touches it or does anything to it. There was a case recently in the USA where a woman’s birth was being filmed, she was told she needed an episiotomy but repeatedly said no and the dr did it anyway, she took him to court and settled for a large sum. The UK is also clear on consent laws. If you’re unsure of your rights and options/choices then do some research so you can go into it armed with knowledge.

I've had four babies and not had one.
The midwife delivering DC2 offered one as he had his hand up near his head, I refused to her surprise, he was born shortly afterwards and I didn't tear.

I had one, but the midwife said it probably would have been ok without. I didn’t think the recovery was difficult - I would definitely prefer a small cut than a tear any day.

2 babies, 2 lots of stiches, 1 forceps and 1 quick delivery. both uncomfortable to sit on.

I had one and my cunt made funny sucking noises when I walked for months afterwards - embarrassing or what?

I've had two hospital births and didn't have one either time. None of my friends have had to have them either. I was under the impression from my hospital classes that their preference is not to do them unless totally necessary as apparently a small tear will actually heal better than a cut. Of course if baby is in distress or stuck, it's likely to be part of the intervention.

I've given birth twice. Once with ventouse and once without. No episiotomies. I don't think they do them if they don't need to. Both my births were in consultant led units, one due to induction and one as I was bleeding and it didn't stop

I’m a midwife, been qualified 2 years now plus 3 years as a student midwife, and in that time I have performed 1 episiotomy. They are not routinely done unless it’s an instrumental delivery in which case the doctor performs it.

I'm very grateful for mine. It healed quickly and with no problems. There's no way I wouldn't have torn badly without it. Not an instrumental delivery, so I am unusual in that. I remember giving consent - I can't imagine they'd have done it otherwise given that I'd already had a long conversation about having a drip even.

I do know a couple of women who've had them recently (in the last couple of years). It's the same with a lot of things though e.g. waters breaking as the first sign of labour - was told it's really uncommon yet it happened for me and 3 other mums I know. Also had a friend who all her nct friends and her ended up with c sections - not a single vaginal birth in their group of 6. I find that really odd!

I had to google it
I don’t know anyone who’s had one.

Had one with my 2nd (ventouse). Didn't with my first, also ventouse. Epesiotomy healed better than tear - scar tissue from tear was why I needed the epesiotomy 2nd time around.

I had one with 1st baby, 8lb 14 oz, lots of stitches, healed nicely, no issues. 2nd baby, slight tear, 9lb 5oz, couldn't sit down for almost a week

Quite common in France.

I had one with DC1, didn't feel a thing and recovery was pretty ok. I was more annoyed by midwife pushing down hard on my stomach and making me push without contractions...but DH said apparently baby was in distress.

Stitching up was totally botched by student midwife (nurse winced when she came to take stitches out).

DC2, went with a consultant who said he'd cut in such a way as to repair bad stitches from before and again, felt nothing but he did something magic to correct previous one and I can't even tell where it was now. Also recovery was great.

My worst fear is a C section or episiotomy i get terrible anxiety just thinking about such a scenario even just typing this out but i think once the time comes and your in agony pushing you won't care what they did to get baby out safely it's just one of those things you can't predict but i hardly think they have some sort of quota to meet for who can give the most episiotomies

Presumably the reason why they're more likely in a labour unit is because most people have had complications in the midwife led unit and have been moved to have episiotomies, forceps etc? If you're there from the outset there's no medical reason why you will need them any more than if you were elsewhere. I didn't have a choice but to give birth in the labour ward and had hands down the easiest birth out of everyone we know with no interventions, minimal tearing, just gas and air from 7cm and very quick. It is ultimately the luck of the draw and you just go with whatever you're dealt with at the time. However I'm sorry your friends experiences have put you off labour units. If you've got to give birth on one then focus on things you can control like pain relief options, if you want them, rather than focusing on something you can't.

I would look at the data if it's available. There's no point other mums telling you their experiences when you want to know how likely it is.

I had one (plus a tear) and I know a few people who had them. Tears are of course common place and studies show they heal better than episiotomies.
Episiotomies should not be common place anymore, the advice is against them unless instruments are needed.

1. They are more likely in the labour ward because Most trusts don’t allow midwife led units to do anything complicated (unless it’s linked to a teaching hospital). You also need to remember that women who go to a midwife led unit are often less likely to be induced or offered epidurals / spinals - both of which are often linked to needing to be cut.

1. They are only ‘offered’ when you need an assisted delivery or if there are specific risk factors that would make you more prone to a 3rd or 4th degree tear. These types of tears are more damaging as they are harder to stitch properly than a cut made from a scalpel.