Butchered episiotomy

[Mumofonexo]

Hi all, I’m over a year postpartum I had a forceps delivery, episiotomy and third degree tear. I can’t find any real life pictures of what an episiotomy looks like when healed only diagrams. I don’t think mine was done correctly hence why I tore so badly. Can someone please take a look and tell me if you think it’s been botched? No doctor will admit fault.

Have you been for a debrief at the hospital op? I had a botched ELCS so you have my sympathy, it's hard being the one who had it go wrong.

Yeah but it doesn’t cause fecal incontinence 🥺 also less risk of prolapses.

I am so sorry this has happened to you.
I have been a midwife for many years and it angers me so much that the psychological effects of physical trauma are minimised. Yes you have a healthy baby but that doesn’t mean you should accept how you have been left.
Episiotomies are not performed in random areas of the perineum and there are actually scissors which when used mean that it is always in the right place
Your baby’s head should have been guided out to avoid tearing. Please ask about instrument used and where they cut you. Ask about the teaching given when performing them. Whilst they are used to aid where delivery needs to be quicker or sometime when using forceps, they are always in the same place.
Please don’t feel that you are in the wrong to ask questions. You have been traumatised and the long lasting effects should be recognised

Thank you. And thats exactly it! You are made to feel like you don’t matter anymore because you’ve had a baby.

I will definitely ask that! I was just asked to push and had a spinal in so I’m not sure if they pulled too hard or not. They really needed to put a curtain up as I could just see blood everywhere then a giant swab. When my baby was out I could see the needle stitching me up and I thought I was going to die it was horrific. They said they didn’t put a screen up so they could talk to me but no one in that room said a word to me 😢

Makes me ashamed to be a midwife tbh
I don’t understand the lack of screen etc - it’s part of ensuring a sterile field to do the suturing.
Of course being able to see the needles and swabs is not acceptable and just added to the trauma
I’m sorry x

It can cause all sorts of issues, it's major surgery.

That's just awful, I remember being frightened of the reflection of blood in the lights above me during my section. 😢

I get that but you don’t end up housebound wearing a nappy x

I've been present at a birth during which the mother was screaming 'don't cut me' and the doctor went ahead and did a double episiotomy anyway. It was the most awful thing I've seen.
However, the baby was in poor condition when she was delivered, very swiftly after double cut. I don't think a wait to get the mother into surgery would have been very good at all.
The mother hasn't healed very well either, and I can't imagine the trauma she felt. She had a lengthy debrief with nurses and some therapy. She has gone on to have another child by c section.
Is it OK for a Dr to go ahead and cut when specifically told not to? Would the baby have died if they hadn't done what they did? Very difficult questions.
Birth is really unbelievably brutal sometimes, and you are a hero to have gone through what you did to bring your child into the world.

@dairydebris

That’s absolutely horrific! As well as the mum it must traumatise the staff seeing that happen 😔 that poor mum!

it is very difficult and very circumstantial.
if the doctor had properly explained the procedure to me and told me they would have to cut I wouldn’t feel so angry. I had asked for the risks to be told it would be risk free and some minor grazing would occur.
I’m just upset that I was lied to, even if the outcome was the same it’s not telling the truth that has gotten to me.

Thank you 🩷

I had an episiotomy which then tore during a forceps delivery, ds's shoulders got stuck. Mine didn't heal well at the point between the smooth edges of the cut and the more ragged edges of the tear and I needed so.e steroid cream but so it took longer to heal. Are you by any chance still breastfeeding op? Mine was incredibly painful whilst was breastfeeding but really settled down and felt much more normal once I had stopped.

@Mumofonexo Re the angle, I was told (by the consultant) that being cut on the diagonal is the UK way of doing an episiotomy and straight down is the US way.

Bless you that sounds painful 😔 are you ok now?

Im not breastfeeding I couldn’t get them to latch unfortunately x

My poor mum had one straight down to her bum with my brother who was a whopping 10lbs after having me at 6lbs 😦 she must of had gestational diabetes or something but I’m not sure if they tested for that 30 years ago. She was never told to what degree hers went but she’s never had bowel issues so we can only presume it was a second degree.

from looking online I’ve seen they also do something called a j cut which might explain the angle of mine. It will be interesting to see what it says in my notes when I have my debriefing x

Yes and no. No pain, all the tissue feels normal but I do have a rectocele and can very clearly feel where my pelvic floor tightens if I squeeze my muscles and then the last inch doesn't. I'm avoiding a repair because I've heard they don't always work and it's not too bad yet. I don't really feel my episiotomy was mismanaged more than my early labour where I was just ignored rather than any guidance or awareness of why progress was slow....back to back baby. They were busy and just wanted me out the was as I wasn't dilating so gave me diamorphone after 24 hrs. I think had someone given me just a little support on active labour and positioning as well as a bit of gas an air for a reprive I might have been able to get my baby into a better position before he got stuck in the birth canal. By the time the episiotomy happened it was another 24 hrs later and a bit late for anything else.

Gosh I’m so sorry for what you’ve been through! I do feel like some midwives don’t listen to you. It does sound like maybe you should have been monitored better.

Have you been offered physio or anything?
x

Try rubbing it a bit of bio oil. It smooths scar tissue out a bit.

https://www.nhs.uk/conditions/caesarean-section/#:~:text=Risks%20of%20a%20caesarean,-A%20caesarean%20is&text=infection%20of%20the%20wound%20or,connect%20the%20kidneys%20and%20bladder

Yes you can, I know someone who walked with a permanent limp afterwards. I'm not minimising what you've been through but don't see a section as any easier/better.

I guess we will agree to disagree. Still wish I’d had a c section x

I'm so sorry it has traumatised you as much as it has, I do totally get it though as I felt the same. I read further down that you feel like you may be one and done - this is how I was too. I was so scared of making it worse and all the what if's that came with it (what if i went into labour and they refused to give me the c-section I'd asked for etc and I had to go through all that again or potentially make an old birth injury even worse etc, the anxiety surrounding it was awful) - I would really recommend the therapy if you would actually like to try for another baby (or even if you don't - just for your mental wellbeing!), specifically EMDR therapy - it helped me so much and allowed me to process some of the things that went wrong (there were a few things unfortunately) and how to handle them going forward..and over time I became more confident in myself that I could go through birth again and advocate for myself if i needed to.

With your episiotomy, I found around a year and half in it started to hurt less and become less sensitive - these days my eldest is now 7 years old and most of the time I don't even remember it's there. Inbox is always open if you want to chat :)

You can't really think like that though as I had done a lot of research and knew I absolutely didn't want forceps because of the risk of tears. I had it written all over my birth preferences NO FORCEPS, DO ANYTHING TO AVOID THEM. I was adamant. When they came in and said my babies heart rate was dropping and we needed to deliver immediately I begged for a C-section but she explained to me that forceps would be the safest option for the baby. She was so far down the canal and close to birth the actual act of trying to reach down and pull her out via c section would take too long. I was told I would be given 3 pushes with forceps and then they'd immediately move to a section and I had everything ready for that but that would be an absolute last resort. I understand now that that would have taken too long and if we'd had a section I'd be unlikely to have delivered a healthy baby (lack of oxygen causing brain damage) let alone a live birth.

Please don’t tell me how to think. I’m entitled to feel and think a certain way x

Of course, but I mean you can't blame yourself for not demanding a C-section etc. because that wasn't an option for you. I DID demand one and it wasn't possible because it wasn't safe and my baby wouldn't have made it.

Nearly 30 years on from my first (private, done by consultant) I still have a lot of numb scar tissue.

Mine healed apart (big gap in lips part) so don't think yours looks too bad!