ever heard of anyone actively requesting an episiotomy? (warning: poss tmi)

[Tutter]

as a result of ds1's birth i had shocking piles

he had (still has) a mahoosive head and they had to make 3 cuts to get him out

even with help, i managed to give myself bad bad piles which took ages to go, and have come back to haunt me several times since

the stitches as a result of the episiotomy gave me no grief whatsoever

ds2 (due in july) apparently has another massive head

am a tad concerned about the state my rear undercarriage will be in if i have to push like i pushed last time

seriously, am planning to walk in and tell them to get the damned scissors sharpened...

lulu? anyone?

I had dreadful piles after ds1 - after the birth they were worse than the pain I was in during labour

DrMartha...lol at pushing "neatly".

What position did you give birth in last time? It might be worth trying to give birth in an upright position, kneeling, leaning over the bed etc which will open your pelvis and make it easier to get the head out so you won't need to push as hard as if you were on your back and working against gravity. But with it being your second it may well be easier anyway.

Not sure about the elective epis really, it's the sort of thing it's worth talking to the midwives about in advance as you may find some are quite reluctant to do one unless there's already a problem iyswim.

daisy, i was happily on all fours over a birthing ball until the last few minutes when they hoicked me up onto the bed (they were planning ventouse)

DrMM, yes am hoping (praying) that the second takes a whole lot less pushing, but am just prepared for it not to be exactly a breeze

(could always take my own scissors and hand them to dh...?)

hmmm....asking for an epi in advance ...

i think that you can bear in mind that scans and estimations of head size and baby size can be a bit hit and miss.....

i would look at managing your diet and things like that to see if you can avoid piles , if that is possible

lost of water, fruit, fibre, if you need to take iron supplement, that can make you constipated, so mabye look at something like spatone for the last trimester, which will boost your iron levels, without constipating you

also, your undercarriage has been strecthced once, so might not take as much of a battering second time

you might find that all fours or a supported squat is a good position for delivering a big headed baby..

or in water to support the perineum

and as Drmcmoo has said, don;t try to hold back on the pushing

you might find that you are able to get away with a smaller tear or less of an episiotomy

the really important thing is not to stress in advance and during the birth that you will need an epi , or have a big tear, you need to accept baby is coming out , big head or not, and you need to relaaaaaaaax all the perineal area , rather than tense as he is born

sheila kitzinger and janet balaskas have done some interesting writing about pre birth relaxation and breathing to practice , to keep all your undercarriage nice and erm, untense!!

This is very interesting. My DS has an unfeasibly big head and I had an epi, that bit healed fine, but the tearing took months. Piles have only just gone, took 6 months...they were talking about operating. No plans for no 2 yet

a friend of mine who is a doctor did ask for an epi whilst in labour and was granted it! And he wasn't a huge baby at all. Don't know if asking in advance would work but you can try!

Both my sons (4 and 2)were on the big side, and I had epis both times. The first birth was great, despite failed ventouse and forceps.
With second son (9,5), I was convinced that would need an epi (I'm quite petite and husband quite large) but had a midwife who was hell-bent on no medical intervention.
I spent 3 hours in the second stage, with midwife telling me "one last push and he's out" and me screaming for a doctor. In the end, my husband went to maternity reception and had a doctor paged. Finally the baby started to get in trouble and then everyone treated it as an emergency.
Ended up with both epi and second degree tear (baby's head was 3cm larger than average size), but luckily no lasting damage to pelvic floor. I had piles for about a week but they cleared up too.
I am now pregnant with number 3 and due in June. The baby is huge, completely off the scale, especially the head.
This time I'm going for an elective c/s due to worries about pelvic floor and health of baby. Not exactly thrilled at prospect of c/s but better than another emergency situation. Definitely last baby!
I would say, follow your instincts. Make sure all the staff know that you are not adverse to an epi so that you can have an epidural/spinal block in good time if needs be. A midwife relative told me that you are not supposed to push for more than two hours, so if you know that you are doing your very best, make sure you get all the medical help that you and your baby need.

Echo what MarthaMcMoo said about not holding back- I suffered terribly after dd so when it came to ds's birth I just went for it and actually tried to poo whilst pushing (although husband assues me I didn't) which was much more effective and ds was born in about 10 mins, as opposed to 2hrs first time round. He had a 75th centile head and was over 9lbs but I didn't tear at all this time. Can't recommend trying to poo highly enough!

Bizarrely the only thing that has improved my piles has been giving birth again!! Hope this happenss for you too and everything goes OK

But tutter it's different with second and subsequent babies. My second there were a few small tears (and epi with first one) and it was hugely hugely better after. Third no tears even nor the last two.