I just want to point out that episiotomies are NOT routine birth practice.

[HaveYouTakenLeaveOfYourCervix]

on pretty much every birthplan i see it is written

I do not want an episiotomy unless absolutely necessary.

Why do women think that they would be given an episiotomy if it wasn't absolutely necessary and an emergency situation?

Do women think midwives are scissor weilding harpies who routinely cut perineums because they want to?

Episiotomy is NOT a routine procedure. You will NOT be given one unless you really really need one.

that's all.

I had one, can't say it wasn't necessary as I had a ventouse, but my birth plan for dc2 said "midwife or at least someone who can sew to repair any damage and if anyone comes near me with stirrups I will not be responsible for my actions" this was on account of 6 months of being unable to sit comfortably or walk more than 100 yards after the registrar made a complete arse of the stitching and left me so messed up down there that I can't poo properly (7 years later!) and I also can't have oral sex as the thought of dh seeing it makes me want to cry. The stirrups thing was after they tied my feet in them even though I had severe spd and was screaming in pain as it felt like my pelvis was being broken which actually wasn't far from the truth.

K birds, i see your point. blame the lack of sleep. but hacked off that yet another woman would think that i would do it.maybe i'm wrong to take it personally.

birds no totally, I just wondered if it might be an intensifier iyswim.

I've had one episiotomy with local anaesthetic and totally painless, one very painful tear and one less painful tear.

I'd opt for the episiotomy with local every time.

Hallo
We're going to move this to childbirth
Thanks
M Towers

I've never been forcibly moved before.

NB, for the record OP, we have therefore added the word "I just want".
THanks
M Towers

an actually - I look even ore bloody patronising and looking for a fight without the AIBU bit.

My original was an AIBU. Now I just look nasty. Which I'm not.

Well a 40% rate is highly suggestive of a routine policy in some hospitals. Perhaps not where you work, but it does seem to be going on. Like I've said already, its frustrating not to be able to put you to the stats that I've seen on the subject, because it would support my argument a great deal. I'm thankful that Shagmundfreud also seems to have seem similar figures so I know I'm not pulling numbers out of my backside.

Tell me why its done more often in some places than others? That also suggests a level of policy rather than need.

And it certainly doesn't help just how widely hospital policies vary on so many different aspects of maternity care in labour. How the bloody hell are women supposed to know what is 'routine', whats simply 'policy' and what is just frankly the whinge of a particular doctor or midwife?

Either way, whether its 'routine' or not, there are massive unanswered questions about why there is just so much variation in exactly the same way that there are massive differences in c-section rates.

A lot of women are very keen to avoid a c-section and a lot of those same sentiments are equally applicable to episiotomy. Its put on birth plans for some of the same reasons. I think it also speaks volumes about the lack of trust and communication between health care providers and women on several levels.

I find it quite troublesome that you need to ask why women put this on their birthplan tbh.

that was my aim birds.

whim not whinge*

In words of one syllable Smiths (as you seem to be asking for an argument - yes I am now being deliberately rude)

I want to know why. Then I can look in to doing something about it.

And I suspect the 40% you are quoting includes instrumental births so not a clear breakdown of figures.

right. off to work. lets hope i don't keel over at 4 tomorrow morning.

I think that when I went over my birth plan (aka MW coffee mug coaster) I wanted to go through all the sorts of things that could happen and work out what I wanted in relation to them

e.g.

If I had to have a c-section it would have to be under GA and DH would do skin to skin until I was conscious
If I had to have an instrumental delivery I would prefer ventouse to forceps unless the Dr wasn't experienced in ventouse deliveries or was unable to use ventouse for medical reasons (i.e. in a toss up between the two - ventouse all the way)
I would prefer delayed cord clamping except where medical necessity prevented it
Vit K injection was to be given
If I had to be transferred into hospital post-birth DH was to drive the baby in their car seat not the baby go in the ambulance with me (obv if baby needed to go in then baby would go in ambulance)

and so on and so forth

I didn't want DH to be stuck going 'What's that? I have no idea if TS would be okay with that - she's never talked about that with me!!' Of course birth never goes according to plan but if you know what sorts of things might occur and how you would like to deal with it then you are one step ahead.

This has been really interesting. I'm now outing myself as a midwife. When I trained, 1980s, mws did not suture in my unit, you had to call a doctor. This led to a great deal of care being taken to preserve the perineum and a slapping of hands if scissor happy. Not consciously progressive care but good result. It meant that as a stude I failed to do the "required" no of epis for qualification (I only did one). My tutor decided to overlook this. If have done 2 since. I have delivered at least 800 babies.

However, I came to a different unit 6 yrs ago, 5 miles from where I trained and I was horrified that 25-30% of primips had had epis with non-instrumental delivery. This has now reduced with staff awareness.

Really interesting thread, especially the fact that in quite a few cases it seems to have been the dr who was more keen to cut as I had the opposite experience. The mw became concerned that Ds and I were getting tired due to a momentary dip in DS's heartrate. She suggested an epi and a vontouse delivery, and went to get a Dr. The Dr said she didn't think it needed doing straight away (DS's heartrate had gone back to normal) and asked if I wanted to carry on pushing by myself for a bit. DS was born about 5 mins later and I ended up not needing a single stitch.

To be clear, the mw was fantastic throughout. She clearly explained what she was suggesting and why, and stressed that it was my choice. She also got a second opinion and fortunately it was from a Dr who was not too scissor happy. My only regret is that I didn't see that Dr again, so didn't get to thank her for saving me from some of the epi-related horrors I've read about on here.

I wish I had been offered an Episotomy! I tore terribly :-(

Midwife of 16 years

734 personally conducted deliveries

5 episiotomies

well, op you seem to have just had a shte one at work and come on here to have a moan, as i know you to a reasonable sort...and am pretty sure you are not* doing episiotomies without good reason.

However...in the places where one might encounter such a thing..

what is the best thing to write on your birth plan to protect yourself from this?

cos, having been on MN a while, i have seen a good few posts from women who refused an epi and delivered without a tear (actually the best story was the woman who crossed her legs and shouted 'Fuck Off!' and thus avoided one...)

which does rather suggest they are being offered in non-emergency situations, and where a bit of patience would produce the baby soon enough.

what would you write?