Episiotomy scar implications for next birth?

[Lovage]

I had an episiotomy with DS which has left quite a rigid stiff scar (have had it treated with ultrasound so no longer as stiff as it was).

I've had contradictory information from different midwives about what is likely to happen when I give birth this time (due Oct). One said that the scar tissue would be weaker, so if I did tear, it would be along the line of the old scar (i.e. okay). Another said that it would be more rigid so I ran the risk of tearing somewhere else, and possibly down towards my bum, which would be worse. She therefore thought that I might be better having another episiotomy this time so as to avoid this. I don't know which to believe!

Does anyone know of any research about this? Or anyone had experience of either?

Hi Lovage,

I had a large stiff scar that went right onto my bum and also had light box treatment on it. I had my second two years later and was told it would be too rigid to tear. In the end i had a small incision made going the other way - only a couple of cms.

I would mention it to your midwife when you are in labour - and certainly before if you see the same one (i didn't). My midwife saw the scar and exclaimed that i'd had a bumectomy (i wish!)

HTH

my sister had a 3rd degree tear after an episiotomy

Are you me?
Except that I didn't get ultrasound treatment as every GP I saw fobbed me off and when I finally got to a gynae it was too late. But I disgress. I'm going back to my gynae to raise it with her. I don't just want the opinion of someone who sees the birth, I also want the opinion of someone who sorts out the mess afterwards, if you see what I mean. Would that be an option for you?

Lovage, cant give an opinion I'm afraid but fascinated to know how you got ultrasound treatment for your scar? I've been told I've got a lot of scar tissue (from a really nasty tear) but never been offered ultrasound. Did you have to get referred? Thanks in advance! Hope you dont mind me asking

Butting in, I had ultrasound treatment on my episiotomy scar just a few weeks after I had DS as I had a really achey, dragging feeling whenever I stood up. The GP referred me to a physio and luckily we had health insurance through DH's work so I was able to see someone straight away. It was better after just a couple of sessions.

I had a first degree tear on the other side, making me symmetrically scarred - how neat . Healed more quickly and less painfully than episiotomy.

Janey73 - after 6 months of it still being too sore to have sex, my GP referred me to a physio. I got to see her fairly quickly (may have been some fast-track post-birth scheme - was certainly weeks rather than months). She was just fantastic, lovely and caring and sympathetic and a specialist in pregnancy related physio. And her magic ultrasound really helped. She also gave me stretching exercises to do on it (a bit like the inaccurately named perineal 'massage'), which probably helped too, but it seemed like it was the ultrasound that helped.

Apparently, there's some research been done that shows that ultrasound in these circumstances works just as well whether the machine is actually plugged in or not (i.e. it may all just be a placebo). But I don't care - it worked!

MrsTittlemouse - no, I don't think I'm you! Sorry you didn't get treatment. Is it definitely too late? Mine wasn't til 6 months after and I didn't get the impression there was a time limit (but if you're preg again now, they won't do it now, of course). Absolutely with you on 'someone who sorts the mess out afterwards' being useful. I might talk to my GP again - she's pretty good (used to be an Obs and Gynae Registrar). Although she's much more up the intervention-ist end of childbirth than I like, so I'm not sure I'd trust her judgement entirely.

My FIL is a consultant in Obs and Gynae and although I'm sure he'd be absolutely unembarrassed to discuss it with me and delighted to be be useful, I don't think I can quite bring myself to do that!